Impact of Communicative and Informative Strategies on Influenza Vaccination Adherence and Absenteeism from Work of Health Care Professionals Working at the University Hospital of Palermo, Italy: A Quasi-Experimental Field Trial on Twelve Influenza Seasons

Abstract

Every year, about 20% of health care workers (HCWs) acquire influenza, continuing to work and encouraging virus spreading. Influenza vaccination coverage rates and absenteeism from work among HCWs of the University Hospital (UH) of Palermo were analyzed before and after the implementation of several initiatives in order to increase HCWs’ awareness about influenza vaccination. Vaccines administration within hospital units, dedicated web pages on social media and on the UH of Palermo institutional web site, and mandatory compilation of a dissent form for those HCWs who refused vaccination were carried out during the last four influenza seasons. After the introduction of these strategies, influenza vaccination coverage went up from 5.2% (2014/2015 season) to 37.2% (2018/2019 season) (p < 0.001), and mean age of vaccinated HCWs significantly decreased from 48.1 years (95% CI: 45.7–50.5) to 35.9 years (95% CI: 35.0–36.8). A reduction of working days lost due to acute sickness among HCWs of the UH of Palermo was observed. Fear of adverse reactions and not considering themselves as a high-risk group for contracting influenza were the main reasons reported by HCWs that refused vaccination. Strategies undertaken at the UH of Palermo allowed a significant increase in vaccination adherence and a significant reduction of absenteeism from work.

Strategies to Increase Flu Vaccination Coverage among Healthcare Workers: A 4 Years Study in a Large Italian Teaching Hospital

“…However, the vaccination coverage registered in our teaching hospital represents an encouraging starting point and it is analogous, or even higher, than flu vaccination coverage rates registered in other national and regional settings [29,32,33,39,50,[53][54][55]. Our results confirmed that physicians are the professionals most willing to get vaccinated, as reported in the literature [20,33,50,54], even though the overall increase was the lowest during the considered period if compared to nurses and OHCWs. The job category that registered the highest increase in coverage rate (compared to the previous years) were the OHCWs (+76.3%) and the nurses (+75.8%), proving that the implemented strategies were effective in reaching groups originally less inclined to vaccination, maybe due to the wrong perception of being at low risk of illness or transmitting the infection.…”

“…Vaccination among HCWs involved in the everyday care of patients limits the spread of the virus, ensuring healthcare assistance continuity, thanks to both the individual and herd immunity [13,14,17,18]. Moreover, it reduces absenteeism [8,19,20].…”

Absences from work among healthcare workers: are they related to influenza shot adherence?

“…During the observation period, absenteeism work in vaccinated HCWs resulted to be far lower than among non-vaccinated colleagues, either considering the whole observation period or focusing on the 2017–18 influenza epidemic peak [ 36 ], thus confirming the existing relation between HCWs influenza vaccination coverage and absenteeism [ 19 , 21 – 23 , 37 – 39 ]. Even if some colleagues suggest the existence of a ceiling effect when vaccine coverage is over 40% [ 40 ], Italian and European results are still under this risk rate and therefore more efforts are needed to improve adherence.…”

“…On one hand, Wilde et al found that influenza vaccination did not reduce absenteeism among HCWs [19] and the study of Gianino et al seems to confirm this evidence in the Italian context as well [20]. On the other hand, non-specific [21] and ILI-related [22] absenteeism among HCWs were significantly reduced by influenza vaccination; this evidence was confirmed by the recent Costantino et al work which found a correlation between the increase in influenza vaccination coverage and the reduction of lost days of work [23].…”

Vaccination and Vaccine Effectiveness: A Commentary of Special Issue Editors

“…At the University Hospital (UH) of Palermo, Italy, a quasi-experimental field trial was conducted from 2007 to 2019 in order to evaluate vaccination increase during consecutive influenza seasons among health care workers (HCWs) of the UH of Palermo after communicative and informative tailored strategies were adopted, and the impact of this increase on the reduction of working days lost due to acute sickness during influenza season [ 11 ].…”