Influenza Vaccination Uptake and Hesitancy among Healthcare Workers in Early 2021 at the Start of the COVID-19 Vaccine Rollout in Cape Town, South Africa

Abstract

Vaccination attitudes among healthcare workers (HCWs) predict their level of vaccination uptake and intention to recommend vaccinations to their patients. To our knowledge, no study has been conducted in South Africa to assess hesitancy toward influenza vaccines among HCWs. We adapted a questionnaire developed and validated by Betsch and colleagues and used it to conduct online and face-to-face interviews among HCWs at the start of the COVID-19 vaccine rollout. Multivariate logistic regression was used to assess predictors of influenza vaccine hesitancy. Of 401 participants, 64.5% were women, 49.2% were nurses, and 12.5% were physicians. A total of 54.9% were willing to accept, 20.4% were undecided, and 24.7% intended to refuse influenza vaccination. Participants who were above 25 years of age and physicians were more likely to accept the vaccine. Key predictors of vaccine acceptance were confidence in the effectiveness, consideration of benefits and risks, and willingness to be vaccinated to protect others. Influenza vaccine hesitancy was highest in those who did not trust that influenza vaccines are safe. For future flu seasons, tailored education programs on the safety and effectiveness of flu vaccines targeting younger HCWs, could be vital to improving vaccine uptake.

Understanding COVID-19 Vaccine Hesitancy among Healthcare Workers in South Africa

“…Sociodemographic indicators of hesitancy mirror those found in other South African studies [ 19 , 38 , 39 , 40 ], which found that males and the younger cohort were less likely to vaccinate. In our study, doctors and other HCWs displayed higher levels of hesitancy compared to nurses.…”

Seasonal Influenza Vaccine Intention among Nurses Who Have Been Fully Vaccinated against COVID-19: Evidence from Greece

“…Additionally, we found that older nurses were more likely to accept the influenza vaccine than younger nurses. Several studies suggest that older healthcare workers are significantly associated with higher influenza vaccine uptake and willingness compared to younger age groups, even during the COVID-19 pandemic [ 22 , 54 , 55 , 56 , 57 , 58 ]. This could be explained by old age being an independent predictor of severe complications from influenza virus infections such as pneumonia [ 59 , 60 ].…”

The Bambisana Study Protocol: A mixed methods pre- and post- test study assessing community and social media influence to increase influenza vaccination uptake among youth in Soweto, South Africa

“…Adults (18 years and older), living in these clusters or accessing clinic services in the five study clinics (Senaoane Clinic, Mofolo Community Health Centre, Meadowlands Zone 2 Clinic, Siphumlile Clinic, and Thembelihle Clinic) are deemed eligible for the study. The HDSS communities were included as below (Table 1): (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), sex (male and female) and community (two per cluster). These approaches aim to gather contextual data essential for understanding the factors influencing young people's decisions regarding influenza vaccination, including both motivators and barriers.…”

“…C) Qualitative evaluation Additional FGDs, including 10-12 participants per FGD, will be conducted: 8 mid-way through the intervention (during vaccination season) and 8 post-intervention. These FGDs will be mixed gender and will be stratified by age group (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), and community (two per cluster). Key informant interviews (KII) (n=20) with key influencers including, religious leaders, traditional healers and youth leaders, as well as other influencers that may identified through community engagement and communications activities.…”