In the United States, home health aides include a group of paraprofessionals that provide direct health care services such as changing bandages and dressing wounds, as well as delivering medications to the elderly, convalescents, or individuals with disabilities either at the patient's home or in a residential care facility . These workers also provide personal care such as bathing, dressing, and grooming as required by the patient . Despite their direct and close proximity to vulnerable and sick populations, many of these workers receive very little education about infectious disease control and vaccination [2–3]. Given the U.S. is experiencing an increasingly aging population and a shift in patient care to non-hospital settings , there will likely be an increase in demand for this health worker population and a need to understand their vaccination practices.
Current U.S. national studies on seasonal flu vaccination prevalence rates indicate that among U.S. healthcare workers, vaccination remains low at 44.8% with individuals employed as health diagnosing and treating practitioners having the highest rates (52.3%), and other healthcare support occupations (e.g. Birth Attendants, Morgue Attendants, Phlebotomists, Patient Transporters) having the lowest (32.0%). In the same study, seasonal flu vaccination rates were highest for white collar workers other than healthcare workers (24.7%), and lowest for farm workers (11.7%) . These sustained low immunization rates in the U.S. healthcare workforce are perplexing, given that (1) Medicaid in most States provides subsidy for influenza vaccine, (2) evidence for influenza vaccine being efficacious, and (3) systematic reviews of effective methods to increase immunization rates have been well documented [4,6]. Evidence from tailored interventions to increase seasonal influenza vaccination suggests that each individual and agency has their own values and internal structures that influence vaccination rates .
As the number of home health aide professionals increases in the United States, understanding seasonal flu vaccination rates within this workforce is paramount. In the present study we sought to describe seasonal flu vaccination rates in a nationally representative sample of U.S. home health aides and examine correlates for receipt of flu vaccination to inform the development of a tailored vaccination intervention among home health aides.