Term of Award

Spring 2019

Degree Name

Doctor of Public Health (Dr.P.H.)

Document Type and Release Option

Dissertation (restricted to Georgia Southern)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Jiann-Ping Hsu College of Public Health

Committee Chair

Gulzar Shah

Committee Member 1

Jeff Jones

Committee Member 2

Stacy W. Smallwood


Objective: The purpose of this study is: (1) to systematically review the current state of employee vaccination policies in existence across the 18 public health districts in Georgia; (2) to examine the perceptions of the significance (or necessity) of vaccination laws and knowledge of employee vaccination policies and; and (3) to identify the barriers to implementation of vaccination policies in public health districts without them. Methods: For this cross-sectional quantitative study, a survey was administered to the census of public health employees who are employed in a full and part-time capacity at the 18 public health districts in Georgia. This research involved descriptive, bivariate and multivariable logistic regression analysis using SAS 9.4 ©. Results: A total of 1,527 employees completed the survey. Eighty-six percent of employees correctly identified the presence or absence of an employee vaccination policy. Employees who indicated that they have direct patient contact have significantly higher odds (AOR:1.62, CI: 1.25-2.09; p=0.0002) of correctly identifying if their public health district had an employee immunization policy. Employees perception of risk of vaccine-preventable diseases was not significant for any of the independent variables for those districts that have a policy. However, for those districts that do not have a policy, or they were not sure if there was a policy 8.3% indicated a perceived high risk of contracting a vaccine-preventable disease, 15% indicated moderate risk, 23.7% indicate 50/5 risk, 32% indicated slight risk and 17.4% indicated no risk. Blacks were significantly less likely to believe vaccinations were effective and significantly more likely to believe vaccinations had side effects. A significant association between vaccine effectiveness for all five vaccinations and the following independent variables: population size, public health district, and patient contact was identified. Conclusion: Employees working in public health districts in Georgia perceive vaccines to be of high importance and efficacy. Future initiatives should be focused on continued education regarding side effects of vaccination and the importance of vaccination policies. Through identification of public health employees’ perceptions of vaccination importance and effectiveness and their knowledge of their current state and content of employee vaccination policies, barriers to implementing vaccination policies can be reduced.

OCLC Number


Research Data and Supplementary Material