Introduction Influenza immunisation is offered and recommended to all staff in St. Vincent’s University Hospital. While uptake has improved, the overall proportion of staff not immunised remains of concern.

The department of occupational health, infectious diseases and clinical audit collaborated to audit the attitudes of staff to influenza immunisation in 2015/2016. The results informed quality improvements for the 2016/2017 campaign e.g. increased information sessions and additional mobile ‘out-of-hours’ clinics. A re-audit was subsequently carried out.

Methods Hard copy and email questionnaires were distributed to all staff, 301 questionnaires were completed.

Result Clinical staff accounted for 75% of respondents in 2016/2017 compared to 63% in 2015/2016. Sixty-four per cent of respondents were previously immunised, demonstrating immunised staff were more likely to complete the audit, particularly doctors, allied healthcare professionals and management/administration staff.

The top 3 reasons for immunisation were ‘it’s what’s recommended’, ‘protect myself from becoming unwell’ and ‘protect family members’. This is consistent with the previous audit, apart from one, where respondents cited ‘protect my patients’ over ‘protect my family members’.

Ninety-seven per cent of previously immunised respondents agreed they would be immunised during this influenza season and 82% felt staff should be immunised. They were more likely to agree it should be mandatory for staff. Information about influenza and mobile clinics were the top 2 reasons chosen to help increase immunisation uptake, for immunised and non-immunised respondents.

Thirty-five per cent of respondents were not previously immunised and the top 2 reasons were ‘I can manage the flu myself’ and ‘I am worried about side effects’. Of those, 52% felt staff should be immunised, suggesting dissonance in this group. Compared to the previous audit, they were more likely to be immunised during 2016/2017, more likely to agree that staff should be immunised and that immunisation should be mandatory for staff. They were also more likely to associate the lack of information and the absence of mobile clinics as reasons for poor uptake.

Conclusion This audit implies providing increased, focused information and additional mobile clinics directly increases the rate of immunisation uptake. However despite this, respondents refer to the need for more information and mobile clinics, demonstrating that influenza immunisation is a perfect case of a complex adaptive system. Focusing on the method of communicating information and a peer vaccinator programme might enhance the next campaig.