Low influenza vaccine uptake by healthcare workers caring for the elderly in South African old age homes and primary healthcare facilities

Abstract

Background The elderly bear the highest burden of South Africa’s estimated annual > 10 million influenza cases and > 11,000 influenza-related deaths. Unvaccinated healthcare workers (HCWs) are at high occupational risk of contracting influenza, and may transmit influenza to elderly patients in their care. Thus, the South African National Department of Health recommends that HCWs receive annual influenza vaccination. This study aimed to determine influenza vaccination coverage among HCWs; identify reasons for their vaccination status; and investigate if HCWs recommend vaccination to their elderly patients. Methods A descriptive study was conducted in 18 community health centres and 44 private sector and non-governmental organisation managed old age homes across South Africa, using a self-administered structured questionnaire, which was distributed to 360 HCWs present on the day of data collection. Data were captured using Microsoft Excel® and imported to Epi Info™ 7 (Centers for Disease Control and Prevention, USA) for descriptive statistical analysis. Ethics approval (SMUREC/P/36/2018: PG) and permission to conduct the study at the facilities were obtained. All participants provided informed consent. Results The response rate was 76.7% (276/360). Most participants were female (90.9% [251/276]), nursing professionals (81.2% [224/276]) with a mean age of 41.1 ± 11.7 years. Although 62.7% of participants indicated having ever received at least one dose of the influenza vaccine, influenza vaccine uptake for 2017 and 2018 was 24.36% (41/276) and 33.3% (92/276) respectively. The main reasons given for never being vaccinated against influenza were related to the unavailability of the vaccine (70.9%) and vaccine hesitancy (27.2%). Most participants (67.8% [187/276]) recommended vaccines to elderly patients in their care. Conclusion The main reasons behind low influenza vaccine uptake by HCWs in South Africa who care for the elderly were related to unavailability of the vaccine and vaccine hesitancy. Strategies to educate HCWs on the importance of influenza vaccination, while concurrently increasing sustained and easy access to the vaccine by HCWs are needed to preserve public health.

Influenza Vaccine Hesitancy among Healthcare Workers in a Northeastern Province in Thailand: Findings of a Cross-Sectional Survey

“…Although these comparisons are limited due to differences in study sites and the HCW definition, which was expanded to include all types of HCW working in the hospital in this study as opposed to only doctors or medical service providers in the past studies [22,23], they indicate that HCW in Nakhon Phanom may be more hesitant towards influenza vaccines than normally expected. Our result is also slightly higher compared to studies in countries such as Egypt, Hong Kong, and South Africa, where influenza vaccine hesitancy among HCWs was reported to be below 50% [33][34][35][36].…”

Acceptability, cost-effectiveness, and capacity of a facility-based seasonal influenza vaccination among high-risk groups: a study protocol in selected tertiary care hospitals of Bangladesh

“…Among healthcare professionals, the vaccination coverage varied from 20 to 56% in the LMICs under study [ 10 ]. The potential cause for the low vaccination coverage may be attributed to the suboptimal rates of influenza vaccine uptake [ 11 – 14 ]. Research conducted on populations at high risk for influenza revealed varying rates of influenza vaccine uptake [ 11 – 14 ].…”

“…The potential cause for the low vaccination coverage may be attributed to the suboptimal rates of influenza vaccine uptake [ 11 – 14 ]. Research conducted on populations at high risk for influenza revealed varying rates of influenza vaccine uptake [ 11 – 14 ]. Specifically, the uptake of the influenza vaccine was observed to be 33.3% among healthcare workers, 5.4% among elderly individuals, 27% among pregnant women, and 33.7% among adults with co-morbid conditions [ 11 – 14 ].…”

Awareness and Attitudes towards Influenza and Influenza Vaccination among Healthcare Professionals in Pakistan

“…On the other hand, vaccination is an effective tool in preventing influenza and serious cases and hospitalizations related to this disease 4 . Health workers are one of the priority groups for which the influenza vaccine is recommended annually 5 . However, studies conducted in different places in the world often show low coverage of influenza vaccine among health workers, which can have repercussions on illness, absenteeism, and transmission of influenza to patients, compromising the adequate functioning of health services 6,7 .…”