Background: Only limited data are available on emergency medical technicians' (EMT) influenza vaccination compliance.

Methods: A questionnaire was administered to St. Louis EMTs during March to June 2011 to assess compliance with the 2010/2011 and 2009/2010 seasonal and pandemic H1N1 influenza vaccinations, factors that predicted uptake of 2010/2011 seasonal influenza vaccine, and intent to be vaccinated.

Results: In all, 265 EMTs participated. EMTs' attitudes and beliefs toward influenza vaccines differed significantly when comparing vaccinated to nonvaccinated EMTs. EMTs whose employer had a mandatory vaccination policy were significantly more likely to receive the seasonal influenza vaccine (100% vs 75.6%, respectively) or the H1N1 vaccine (100% vs 66.8%, respectively) compared with those without such a policy (χ(2) = 8.8, P < .001 and χ(2) = 6.7, P < .01, respectively). In logistic regression controlling for demographics, determinants of 2010/2011 seasonal influenza vaccination included belief that EMTs should be vaccinated every year, perceived importance of vaccination, perception that influenza vaccine has few adverse effects, and past vaccine-seeking behavior. In logistic regression controlling for demographics, determinants of intent to be vaccinated included having the vaccine available on-site and free of charge and belief that EMTs should be vaccinated every year.

Conclusion: EMT-targeted interventions should be used to increase vaccine compliance, including implementing a mandatory vaccination policy and addressing EMTs' beliefs and attitudes about vaccine in an education campaign.

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