Influenza vaccination rates among healthcare workers: a systematic review and meta-analysis investigating influencing factors

Impact of COVID-19 pandemic on influenza vaccination rates among healthcare workers and the general population in Saudi Arabia: A meta-analysis

We aim to identify how the seasonal IVRs have been impacted by the COVID-19 pandemic in Saudi Arabia. We conducted a meta-analysis of cross-sectional studies to statistically examine IVRs before and after the COVID-19 pandemic among the general population and HCWs in Saudi Arabia. The meta-regression analysis showed a significant correlation among the general population was observed between the IVR and the timing of the study, with a mean effect size estimate of 14.3 (95% CI = 5.7-22.9; p < .001). Among HCWs, no significant relationship was observed between the IVR and the timing of the study, with a mean effect size estimate of 6.7 (95% CI = -19.3-32.7; p = .5). COVID-19 might have contributed to a rise in IVR among HCWs, whereas the general population has seen a decline in IVR.

Dynamics of Absences Due to Respiratory Infections, Including COVID-19, Among Medical Staff in a Regional Pediatric Hospital

Background: Respiratory infections pose a significant public health challenge, particularly among healthcare workers (HCWs). The COVID-19 pandemic exacerbated absenteeism due to respiratory illnesses, affecting healthcare workforce stability. Identifying factors influencing absenteeism is crucial for workforce resilience and effective care. Methods: This retrospective longitudinal study analyzed HCW absenteeism due to respiratory diseases from 2017 to 2023 at the "Sf. Maria" Children's Emergency Hospital in Iași, Romania. Data from 3827 HCWs were examined, including demographic and occupational variables (age, gender, job role) and disease types. Statistical analyses (chi-square tests, ANOVA, and regression models) were conducted using SPSS to assess absenteeism trends and associated risk factors. Results: Sick leave peaked in 2020 (8322 days) and remained high in 2021 (8134 days), gradually decreasing in 2022-2023 but not returning to pre-pandemic levels (~5000 days/year). Nurses accounted for most leave days, while male staff and HCWs aged 41-50 were most affected. Seasonal variations showed higher absenteeism in transitional months and lower rates in summer. COVID-19 was the leading cause of absenteeism during the pandemic, with quarantine measures further increasing sick leave duration. Conclusions: Pediatric hospitals must strengthen infection control measures to protect HCWs and sustain care continuity. Preventive actions such as immunization, staff training, and health monitoring are critical in reducing absenteeism, maintaining a resilient workforce, and ensuring quality care during health crises.

The vaccination acceptance, confidence, and conviction on influenza in the Middle East, Eurasia, and Africa among healthcare providers (VACCIMENA-HCP) project 2023: Determinants of vaccination behavior

Objectives

Annual vaccination is the most effective way to prevent and control the health and economic burden of seasonal influenza. Healthcare providers (HCPs) play a crucial role in vaccine acceptance and patient advocacy. This study aimed to explore the barriers and drivers of HCPs' vaccine acceptance and advocacy for the vaccination of their patients in countries in the Middle East, Eurasia, and Africa.

Methods

Healthcare providers from 10 countries (Azerbaijan, Egypt, Libya, Morocco, Nigeria, Pakistan, Russia, Saudi Arabia, Tunisia, and Türkiye) were surveyed using opportunity sampling between 20th December 2022, and 1st March 2023. The previously developed motors of influenza vaccination acceptance (MoVac-Flu) and engagement with vaccination advocacy (MovAd) scales were used.

Results

In the final sample of 721 responses, Russia was the leading country, enrolling 37% of all respondents. Sentiment cluster profiles were labeled as "engaged" or "hesitant" and "confident" or "diffident." Overall, 28% demonstrated hesitancy and 30.5% demonstrated diffident sentiments toward self-vaccination behavior. HCPs exhibited very low rates of routine vaccination and infrequent advocacy of seasonal influenza vaccinations. In contrast, those who felt engaged with influenza vaccination were more likely to be vaccinated themselves and found it easier to incorporate influenza vaccination in their practice. Those who felt engaged in influenza vaccination also felt more confident in advocating for it than those who felt hesitant. The evidence suggests that the strength of the relationship between engagement and confidence varies across countries.

Conclusions

This study provides insights into the behavioral patterns of HCPs regarding their own influenza vaccination and advocacy for patient vaccination. Cluster membership was a strong predictor of vaccination behaviors and attitudes, although regional differences were observed. For hesitant and diffident HCPs, tailored strategies to increase awareness and empower them regarding vaccines and vaccine-preventable diseases are crucial.

Online survey on barriers and drivers to flu vaccination among staff at a German university hospital during the Covid-19 pandemic 2022 (flu-vaccination motive study)

Introduction

The success of flu vaccination depends primarily on the willingness of health care workers (HCWs) to be vaccinated. To identify barriers and drivers to vaccination, an online survey among employees and students of a university hospital was performed to develop a local strategy to increase the vaccination willingness in line with the WHO recommendation.

Method

A cross-sectional, anonymous, self-administered online survey was performed among HCWs, other staff, trainees and students of the Greifswald University Hospital between 17.02.2022 and 17.03.2022.

Results

Of 4,709 online questionnaires, 1,515 were answered (response rate 32.2%). 45.3% stated that they were vaccinated annually, 33.4% irregularly and 7.7% had been vaccinated once. 13.6% had never been vaccinated. The proportion of non-vaccinated was highest among trainees and students (25.4%). 5.7% of those vaccinated said the willingness to be vaccinated has decreased because of the pandemic, and 12.1% felt encouraged. 5.8% of those vaccinated at least once did not want to be vaccinated in the future; 14.8% were undecided. The reasons for non-vaccination were dominated by perception of low assumed risk of infection (62.1%), followed by doubts about vaccine efficacy (22.8%) and fear of side effects (13.8%).

Conclusions

Because a timely reminder of vaccination was essential for 16.7% of staff, the occupational medical service will intensify the annual vaccination campaign within the hospital. Additionally, staff will be provided with a brief sheet on the importance of flu vaccination every year before the flu season with the option of personal advice from the occupational medical service. In a lecture, medical students are informed about the benefits of the flu vaccination.

A comparative analysis of knowledge, attitude, and practice (KAP) towards influenza and influenza vaccination among healthcare workers in Kyrgyzstan prior to and during the COVID-19 pandemic

INTRODUCTION

Influenza, a globally significant respiratory illness with pandemic potential, affects around 1 billion individuals annually, leading to increased risk for severe illness and mortality. Despite recommendations from the WHO Strategic Advisory Group of Experts on Immunization (SAGE) and MoH prioritization, influenza vaccination coverage rate among HCWs in Kyrgyzstan remains low, ranging between 16 % and 46 % over the past five years. Understanding the Knowledge, Attitudes, and Practices (KAP) dynamics of HCWs regarding influenza vaccinations, both before and during the COVID-19 pandemic is crucial for refining national strategies and institutional approaches to enhance vaccination coverage rates in this important risk group.

METHOD

This study employed cross sectional investigations aimed at assessing KAPs among HCWs regarding influenza disease and vaccination. Conducted prior to and during the initial phase of the COVID-19 pandemic, the project involved 2400 participants from diverse medical disciplines. EPI Info was utilized to run biostatistical analyses, with descriptive and logistic regression models, to elucidate the dynamics of KAP over time.

RESULTS

The findings indicate that HCWs with over 5 years of experience were more likely to get vaccinated or recommend it to patients (p = 0.000). Low confidence in vaccine effectiveness influenced on recommendations of influenza vaccination in pre-pandemic time, where insufficient (95 %CI 0.08-0.6; p = 0.003) or uncertain assurance in vaccine effectiveness (95 %CI 0.007-0.18; p = 0.000) was a barrier for vaccine promotion during the pandemic. The study underscores to consider mandatory influenza vaccination for HCWs which may impact on likelihood of flu vaccination (p = 0.001). Priority groups for influenza vaccination shifted during the COVID-19 period, emphasizing older adults, individuals with existing conditions, and HCWs, compared to the pre-pandemic focus on HCWs, children, and patients with pre-existing conditions.

CONCLUSION

Our investigation provides valuable insights into HCWs KAP concerning influenza vaccination in Kyrgyzstan, highlighting the need for targeted interventions addressing factors influencing vaccine acceptance. The study suggests policy implications, advocating for the revision of national strategies to strengthen capacity building for medical staff.

The impact of vaccine hesitancy on psychological impairment among healthcare workers in a Total Worker Health© approach

Introduction

Vaccination practice is a well-known individual protective measure for biological risk in healthcare. During the COVID-19 pandemic vaccine hesitancy has grown among healthcare workers (HCWs). The study aims to investigate how vaccine hesitancy influences the psychological burden experienced by healthcare workers.

Methods

This study aimed to explore attitudes of HCWs in acceptance or refusal of vaccinations related to the risk of psychological impairment (PI) and describe the associated occupational factors, during the seasonal flu/COVID-19 vaccination campaign of 2022-2023. 302 HCWs were enrolled in the study. A questionnaire was self-administered, including two scales on the risk of psychological impairment (Psychological Injury Risk Indicator, PIRI) and vaccine hesitancy (Adult Vaccine Hesitancy Scale, AVHS).

Results

PIRI scores revealed that 29.8% of participants were at risk of PI. Differences in sex, age, occupational seniority, professional category, and night shifts were found between HCWs at risk of PI and those not at risk. Females registered a four-fold higher risk than males (85.6% vs. 14.4%, χ2 = 4.450, p < 0.05). Nurses were the highest risk category, followed by physicians and technicians (54.4% vs. 30.0% vs. 12.2%, χ2 = 14.463, p < 0.001). 41.7% of participants received the flu vaccination, and 98.9% received the COVID-19 vaccine. HCWs were prone to being vaccinated to protect patients and family members. Conversely, vaccine refusal was attributed to the perception of flu vaccines as not beneficial and COVID-19 contagion at low risk. The latter was more frequently reported for HCWs at risk of PI (16.7% vs. 4.7%, χ2 = 11.882, p = 0.001). Finally, hesitant HCWs were at higher risk of psychological impairment than others.

Discussion

HCWs expressed vaccine acceptance considering their social role in the community as protectors. However, the underestimation of the risk of severity of COVID-19 was more relevant among HCWs at risk of PI than others. Psychological aspects need to be considered by healthcare providers when fighting vaccine hesitancy.