Increasing Rates of Influenza Vaccination Among Healthcare Workers

Influenza is a contagious respiratory illness that can cause serious complications and death, especially among vulnerable populations such as the elderly, the immunocompromised, and those with chronic medical conditions. Healthcare workers (HCWs) are at high risk of exposure to influenza viruses and can transmit the infection to their patients, colleagues, and family members. Therefore, influenza vaccination is recommended for all HCWs to protect themselves and others from influenza and its consequences.

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However, influenza vaccination coverage among HCWs remains suboptimal in many settings and countries. According to a survey conducted by the Centers for Disease Control and Prevention (CDC), only 75.9% of HCWs in the United States reported receiving influenza vaccination during the 2022-2023 season . This is below the Healthy People 2030 target of 90% coverage for this group . Moreover, influenza vaccination coverage varied by occupation, work setting, and employer policies. For instance, assistants and aides had the lowest coverage (58.5%), followed by other clinical personnel (69.8%) and administrative staff (72.9%). Physicians had the highest coverage (94.5%), followed by nurse practitioners and physician assistants (92.4%) and nurses (89.3%). HCWs who worked in hospitals had higher coverage (85.7%) than those who worked in long-term care facilities (68.4%), ambulatory care settings (74.9%), or home health care settings (63.8%). HCWs whose employer required or recommended influenza vaccination had higher coverage (94.4% and 82.8%, respectively) than those whose employer did not have any policy or did not make any recommendation (44.9%) .

Several barriers and facilitators have been identified that influence influenza vaccination uptake among HCWs. Barriers include lack of awareness, knowledge, or trust in the vaccine; fear of side effects or needle pain; perceived low risk or severity of influenza; inconvenience or cost of accessing the vaccine; and personal, religious, or philosophical objections . Facilitators include education and communication campaigns; reminders and prompts; role modeling and peer support; incentives and rewards; easy and free access to the vaccine; and employer policies and mandates . Evidence suggests that multifaceted interventions that address multiple barriers and facilitators are more effective than single-component interventions in increasing influenza vaccination coverage among HCWs .

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In conclusion, influenza vaccination is an important preventive measure for HCWs to reduce the burden of influenza on themselves and their patients. However, many HCWs remain unvaccinated or under-vaccinated, which poses a public health challenge. To achieve higher and more equitable influenza vaccination coverage among HCWs, comprehensive strategies that combine education, motivation, and facilitation are needed, as well as strong leadership and support from employers, professional organizations, and health authorities.

Bibliography
: CDC. Influenza Vaccination Coverage Among Health Care Personnel — United States, 2022–23 Influenza Season. Available at: https://www.cdc.gov/flu/fluvaxview/hcp-coverage_22-23-estimates.htm
: Office of Disease Prevention and Health Promotion. Immunization and Infectious Diseases: IID-12 Increase the percentage of health care personnel who are vaccinated annually against seasonal influenza. Available at: https://health.gov/healthypeople/objectives-and-data/browse-objectives/immunization-and-infectious-diseases/increase-percentage-health-care-personnel-who-are-vaccinated-annually-against-seasonal-influenza-iid-12
: Talbot TR. Improving Rates of Influenza Vaccination Among Healthcare Workers: Educate; Motivate; Mandate? Infect Control Hosp Epidemiol 2008;29:107-110.
: Hollmeyer HG, Hayden F, Poland G, Buchholz U. Influenza vaccination of health care workers in hospitals—A review of studies on attitudes and predictors. Vaccine 2009;27:3935-3944.
: Thomas RE, Jefferson T, Lasserson TJ. Influenza vaccination for healthcare workers who care for people aged 60 or older living in long-term care institutions. Cochrane Database Syst Rev 2016;(6):CD005187.
: Ahmed F, Lindley MC, Allred N, et al. Effect of Influenza Vaccination of Healthcare Personnel on Morbidity and Mortality Among Patients: Systematic Review and Grading of Evidence. Clin Infect Dis 2014;58:50-57.

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