New guidelines from the Advisory Committee on Immunization Practices (ACIP) and the Healthcare Infection Control Practices Advisory Committee (HICP AC) recommend that health-care personnel should receive a single dose of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) as soon as feasible, if they have not previously received T dap. This represents a change in previous bordetella Pertussis (Pertussis) immunization practices, which previously recommended completion of only a series of Pertussis vaccination during childhood. The ACIP's new policy is largely in response to an increasing in reported incidence of Pertussis within the United States over the past couple of decades and data suggesting that immunity to Pertussis wanes over time. This Master's Paper reviews the health care community's historical response to recommended vaccines and evaluates health care workers' perception of the new pertussis vaccination recommendation in one large University-based Hospital System. The literature review reveals that misperceptions about vaccines (such as vaccines cause infections or are not effective), individual barriers (such as high cost and inconvenience) and systematic obstacles (such as lack of vaccination policy and incomplete tracking of immunization) make it difficult to achieve high immunization rates across a wide variety of recommended vaccines. However, none of the studies included in the systematic review discussed the new T dap vaccine. Our study of health care worker peceptions of the T dap recommendation is the first published report on the topic. Results from our study indicate that health care workers feel the pertussis vaccine is very important to the health of the public and that health care workers strongly agree that vaccination will prevent them from getting pertussis or giving pertussis to patients. Health care workers agree that Tdap vaccination is a personal responsibility and they also feel that T dap vaccination should be required for persons who work at a hospital. Both free vaccines and workman's compensation, to cover complications of vaccination, are very important to HCWs. This willingness of health care workers to accept the new vaccine requirement is very different from the resistance healthcare workers have applied to other immunization recommendations as reported in the published literature. UNC Health Care System's Tdap vaccination requirement is an appropriate health care policy and other he...