Skepticism toward Emerging Infectious Diseases and Influenza Vaccination Intentions in Nurses

Nurses generally show low compliance with vaccination recommendations. We assessed whether low vaccine acceptance is due to skeptical attitudes toward emerging infectious diseases (EIDs). Skepticism toward EIDs manifests as doubts about the real threat of emerging diseases and as distrust in the motives and the competence of institutions that fight these diseases. We performed a cross-sectional questionnaire study in 293 Swiss nurses using a newly developed scale to assess skepticism toward EIDs. Skepticism affected nurses' intentions to vaccinate themselves against seasonal influenza and against possible future pandemic influenza. The influence of skepticism persisted after controlling for other factors that are known to determine nurses' vaccination behavior, namely vaccination habits, feeling at risk of catching influenza, and perceiving vaccination as a professional duty. Skeptical attitudes toward EIDs seem to have a unique and hitherto ignored impact on vaccination intentions. Nurses' vaccine acceptance could be increased if vaccination campaigns specifically target skeptical attitudes toward EIDs. These campaigns should address nurses' doubts about the real threat of EIDs and should rebuild their trust in institutions which fight these diseases.