Actions and Beliefs Related to Hepatitis B and Influenza Immunization Among Registered Nurses in Texas


  • Melanie McEwen, Ph.D., R.N., is Associate Professor, School of Nursing, Nursing Systems and Technology, University of Texas Health Science Center at Houston, Houston, Texas. Elizabeth Farren, F.N.P., Ph.D., R.N., is Professor, The Louise Herrington School of Nursing, Baylor University, Dallas, Texas.

* Melanie McEwen, 6901 Bertner Street, Suite 730, Houston, TX 77030. E-mail:


Abstract  Studies indicate that roughly half of health care workers are not immunized against hepatitis B and influenza. Findings from a survey of 1,000 registered nurses (RNs) conducted to analyze their beliefs and actions related to immunization recommendations are reported. Only 8% of the responding RNs chose not to receive vaccination against hepatitis B. The primary reasons that nurses declined hepatitis B vaccination were because they were not working in nursing or did not believe they were at risk of exposure. Similarly, 86% of the RNs reported they had ever received a flu shot, and 69% reported of being immunized during 2 of the previous 4 years. Rationale for receiving immunization included belief in its effectiveness, belief that they were at risk of exposure, and that it was provided free of charge. Reasons for declining included concerns about side effects, lack of concern about getting the illness, and doubts about effectiveness. The nurses who responded to the survey appear to value immunizations and generally adhere to immunization recommendations. Further study needs to be conducted on related issues, including follow-up for assessment of long-term protection of hepatitis B immunization and adherence to guidelines for postexposure prophylaxis. Ongoing monitoring and further study of serious complications of hepatitis B immunizations are also needed.