Are School Nurses' Beliefs About the Influenza Vaccine Related to Non-Medical Exemption Rates of Preschool Children?
By: Lorraine Marie Chewey
Published: 5/18/2016
Uploaded: 06/06/2018
Uploaded by: Pocket Masters
Pockets: 2016 (May) Teachers College Columbia University Ed.D. Dissertations, Gottesman Libraries Archive, Historical Dissertations
Tags: Immunization, Influenza, Non-Medical Exemptions, preschool, School Nurses

Description/Abstract: This dissertation examined factors influencing school nurses' influenza vaccine behaviors, and associations between these and non-medical exemption rates for seasonal influenza among preschool children. Seasonal influenza is a serious infectious disease and a major cause of considerable morbidity and mortality in the United States each year. Complications of influenza present economic and societal burdens related to health care utilization, health-related lost productivity, and academic achievement. Epidemiological studies have identified preschool-age children as a high-risk group who are more likely to suffer from influenza-related complications. Both healthy children and children with chronic diseases are at an increased risk for influenza-related complications, and possess a unique propensity to transmit disease. Based on recommendations from the Centers for Disease Control and Prevention (CDC), New Jersey became the first state to require influenza vaccination for entry into preschool in 2008.
Annual influenza vaccination is widely recognized as the single most effective strategy in preventing the spread of the disease, and reducing potentially life-threatening complications that can result. Experts have identified health care personnel (HCP) as possible vectors in the transmission of influenza, and a priority group for receipt of the influenza vaccine. Yet despite these recommendations vaccine acceptance among HCP remains below targeted goals. Nurses, in particular appear to be the most resistant group of HCP to accept the influenza vaccine.
In this study, 76% of the school nurses reported receipt of the influenza vaccine. Non-medical exemption rates of preschool children for influenza were low (3%), and consistent with state-reported rates. No associations were noted between the school nurses' influenza-related knowledge, attitudes, beliefs, or behaviors and non-medical exemptions. The low rate of non-medical exemptions may not have offered sufficient statistical power to identify any such associations. However, findings from this study demonstrated that school nurses' perceived benefits of accepting the influenza vaccine were correlated with their vaccine acceptance. Further, school nurses' attitudes regarding the influenza vaccine and personal vaccine acceptance were associated with their willingness to recommend the vaccine to others. As nurses represent the largest sub-group of HCP, and are often responsible for overseeing immunization compliance for schoolchildren, these associations warrant closer examination.