Randomized trial of a program to increase staff infl uenza vaccination in primary care clinics

PURPOSE: Although vaccination of health care workers against inf uenza is widely recommended, vaccination uptake is low. Data on interventions to increase staff immunization in primary care are lacking. We examine the effect of a promotional and educational intervention program, not addressing vaccine availability, to raise the inf uenza vaccination rate among staff in primary care clinics. & METHODS: The study included all 344 staff members with direct patient contact (physicians, nurses, pharmacists, and administrative and ancillary staff) in 27 primary care community clinics in the Jerusalem area during the 2007-2008 inf uenza season. Thirteen clinics were randomly selected for an intervention that consisted of a lecture session given by a family physician, e-mail-distributed literature and reminders, and a key f gure from the local staff who personally approached each staff member. & RESULTS: Inf uenza immunization rate was 52.8% (86 of 163) in the intervention group compared with 26.5% (48 of 181) in the control group (P <.001). When compared with the rate of immunization for the previous season, the absolute increase in immunization rate was 25.8% in the intervention clinics and 6.6% in the control clinics. Multivariate analysis showed a highly signif cant (P <. 0 0 1) independent association between intervention and immunization, with an odds ratio of 3.51 (95% conf dence interval, 2.03-6.09).& CONCLUSION: We have developed an effective intervention program to increase previously low vaccination rates among primary health care workers. This simple intervention could be reproduced easily in other clinics and organizations with an expected substantial increase in inf uenza immunization rates.