Influenza vaccination coverage among health-care workers during the COVID-19 epidemic in 2020/2021 influenza season: Evidence from a web-based survey in northwestern China

Abstract

Vaccinating health-care workers against influenza during the COVID-19 pandemic can effectively prevent and control influenza and reduce COVID-19 strain on health systems. This study was conducted to explore influenza vaccination coverage and determinants among health-care workers during the COVID-19 pandemic in 2020/2021 influenza season in Ningxia. This cross-sectional survey included demographic characteristics of health-care workers, influenza vaccination status, reasons for not getting vaccinated, and whether influenza vaccination was recommended for others. We found that influenza vaccine rate of health-care workers was 39.6%. A binary logistic regression analysis showed that health-care workers’ vaccination coverage was higher when the individuals were aware of the effect of the influenza vaccine (OR = 0.624, 95% CI: 0.486–0.802). Health-care workers who from internal medicine (OR = 1.494, 95% CI: 1.146–1.948), pediatrics (OR = 2.091, 95% CI: 1.476–2.962), and surgery departments (OR = 1.373, 95% CI: 1.014–1.859) had a lower coverage than those who worked in vaccination and infectious disease departments. The main reasons that some stated for not getting vaccinated were that they felt it was unnecessary (52.22%). Health-care workers who were vaccinated against influenza were more likely to recommend influenza vaccination to their patients than health-care workers who had not been vaccinated. The incidence of influenza among health-care workers was higher than that of the general population in Ningxia. Under the policy of voluntary and self-pay influenza vaccination in Ningxia, the coverage rate of influenza vaccine among health-care workers was far below the vaccination requirements of influenza vaccine in influenza season even during the COVID-19 epidemic.

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“…This data aligns with an analysis conducted in intensive care units and nursing homes on HCWs' VC [30], which also observed a marked decrease in VC. Some studies had already indicated a certain decline in VC during the 2021/2022 season [5,24,27,[30][31][32][33][34][35], but the figures still remained similar to those obtained at the beginning of the pandemic, around 50-60%.…”

“…In the literature, we can observe that some of the main reasons for rejecting vaccination are as follows: the lack of a sense of influenza risk and the belief that the flu is not a severe illness [2,27,34,[38][39][40][41], concerns about side effects [27,32,[34][35][36][37][40][41][42][43], distrust of vaccine safety [22,32,34,35,37,39], doubts about vaccine efficacy [27,32,34,35,37,39,40], considering it unnecessary [32], self-perception as a healthy population [22,27,36], and workload as a barrier to either accessing vaccination points or a lack of time [27,32,39,44].…”

“…Similarly, the mandatory nature of vaccination has led to differing opinions. While authors have observed high and sustained vaccination rates through mandatory vaccination policies [24,32,35], the demonstrated efficacy is limited and sparks an open debate [48]. This raises doubts about the ethics of demanding and enforcing such policies, adding to the discomfort caused by the lack of autonomy and loss of empowerment experienced by HCWs, significantly impacting their decision-making ability and morale [24,35,42,46,48].…”

“…Thus, reducing barriers to vaccination and implementing active influenza vaccination campaigns among HCWs undoubtedly contribute to increased vaccination rates [4,25,32,47]. Active vaccination strategies [32,35,37,[42][43][44][45]51] that have proven to be effective include free vaccination, vaccine availability, active search of HCWs for on-site vaccination during working hours, resolution of doubts along with information dissemination, and flexibility of vaccination schedules at a fixed vaccination point. Nevertheless, despite implementing several strategies to improve vaccination rates postpandemic, we observe that the results have not been satisfactory.…”

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“…Similarly, HCWs reported concerns about COVID-19 vaccine safety as the main reason for vaccine refusal. Many international surveys have depicted aspects of similar results regarding SIV and COVID-19 vaccination [ 15 , 46 , 47 , 53 , 58 , 59 , 60 , 61 ]. Studies have also demonstrated that different occupational groups may require different approaches to overcome vaccine hesitancy [ 44 ].…”