Factors influencing influenza vaccine acceptability among healthcare workers : a systematic review

Abstract

Background: Healthcare workers (HCWs), have a greater risk of contracting influenza during their regular patient care and could further spreading it to vulnerable patients, are strongly recommended for seasonal influenza vaccination (SIV) by the national and international health organizations. Although a variety of campaigns among HCWs were implemented and vaccination has been widely recommended, the coverage of SIV among HCWs remains low globally. Objective: Number of studies have investigated on various determinants affecting seasonal vaccination behavior among HCWs, yet they could not fully explain why the uptake rate of SIV among HCWs remains low. There is no systematic review to address this knowledge gap. By adopting the Health Belief Model (HBM) framework throughout this systematic review, it is expected to identify the factors influencing acceptability of SIV among HCWs. In addition, this review may act as a guideline to generate an evidence-based intervention to improve SIV uptake among HCWs in the future. Methods: A literature search was conducted by using bibliographic databases PubMed and MEDLINE published between 1st June, 2013 and 1st June, 2016 to identify relevant studies that investigate the factors influencing SIV uptake among HCWs. Results: 8 studies met the strict inclusion criteria and would be used as reference in this review. All research articles were cross-sectional studies and they were conducted in 5 countries. The main findings are: 1) perceived risk: non-vaccinated HCWs were more likely to underestimate the risk of infection. 2) Perceived severity: those who refused to take vaccination strongly believed influenza was a mild disease and would not pose threat to healthy people. 3) Perceived benefits: vaccination benefits of self-protection, patient protection and family protection were reported to be significantly associated to vaccine acceptance. 4) Perceived barriers: those who refused vaccine were frequently concerned about the effectiveness and safety of the vaccination and worried about the adverse effects. 5) Cues to action: non-vaccinated HCWs were received less encouragement in their workplace. In addition, younger age, female, junior HCWs, nurses or other HCWs (other than physicians) were less likely to be vaccinated. Conclusion: The HBM along with socio-demographic factors can act as potential predictors to vaccination behavior among HCWs. Future vaccination campaigns should emphasize the identified factors in order to improve vaccination rates among HCWs.