Trends, Uptake, and Predictors of Influenza Vaccination Among Healthcare Practitioners During the COVID-19 Pandemic Flu Season (2020) and the Following Season (2021) in Saudi Arabia

Abstract

Background Healthcare practitioners (HCPs) are at high risk of influenza. Seasonal influenza vaccines can reduce influenza-associated morbidity in healthcare settings, but despite mandatory influenza vaccination in the Kingdom of Saudi Arabia, the vaccination uptake rate among HCPs is below expectations. This study investigated vaccination trends from 2017 to 2020 to identify factors affecting vaccination among HCPs during the COVID-19 pandemic flu and subsequent seasons. Methods Cross-sectional study among HCPs was conducted in January 2021. A structured questionnaire was shared via social media. Vaccine uptake predictors were identified using descriptive statistics and logistic regression models (p-value 0.05). Results A total of 424 HCPs (118 physicians and 306 nurses) completed the questionnaire. Vaccine uptake increased from 2017 to 2019 (45% to 52% to 62%) but fell (to 59%) during the 2020 COVID-19 pandemic flu season. Multivariable analysis indicated participants >40 years old (AOR 3.09, 95% CI 1.64–5.83), female (AOR 1.74, 95% CI 1.13–2.67), non-Saudi (AOR 2.62, 95% CI 1.72–4.01), nurses (AOR 2.70, 95% CI 1.75–4.17), and who possessed accurate knowledge of the flu vaccine efficacy duration (AOR 3.04, 95% CI 1.87–4.94) were more likely to have received the vaccine. However, 79% of HCPs declared their intention to be vaccinated in the 2021 flu season, with participants >40 years old, female (AOR 2.25, 95% CI 1.38–3.68), non-Saudi (AOR 3.79, 95% CI 2.34–6.16), or nurses (AOR 2.94, 95% CI 1.82–4.76) more likely to do so. Conclusion Influenza vaccination uptake declined among HCPs during the 2020 flu season compared with the previous season but is expected to increase in the upcoming 2021 season. Nevertheless, the findings are encouraging and indicate increased willingness of HCPs to become vaccinated in the upcoming 2021 season, but coverage could be further increased by policymakers via a comprehensive plan focusing particularly on younger HCPs, Saudis, males, and physicians.

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

“…Our findings of an overall influenza vaccination rate of 49.9% were similar those of Alkathlan and colleagues during the COVID-19 pandemic [ 32 ]. In addition, following multivariate logistic regression, our analysis shows a very strong likelihood of older HCWs 35–44 years and above accepting the influenza vaccine in the next flu season, with the likelihood growing stronger in an age group-dependent manner.…”

“…This provides a better understanding of factors affecting influenza vaccination among HCWs in the next and subsequent flu seasons during the COVID-19 pandemic. Another study during the COVID-19 pandemic in Saudi Arabia assessing vaccination trends from 2017 to 2020 with 424 HCWs as participants had the majority being nurses (72.2%), with physicians making up 27.8% [ 32 ]. Of note is the similar sample size to our study, as we included 401 HCWs in our analysis, and the majority of participants in our study were nurses (49.2%) against 12.5% physicians, which was the lowest of all HCW roles in our study.…”

“…Jones and colleagues in 2020 suggested that measures to control the COVID-19 pandemic might be quashing the cold and flu season [ 58 ], which could influence HCWs’ choice towards influenza vaccination. Following multivariate logistic regression, HCWs above 40 years of age, female, nurses, and participants who were knowledgeable about flu vaccination had a higher likelihood of having received the influenza vaccine and were more willing to accept vaccination in the next flu season in 2021 [ 32 ].…”

“…Prior to the COVID-19 pandemic there was a huge gap in knowledge about the attitudes of HCWs towards influenza vaccines as well as other vaccines in sub-Sahara Africa (SSA) and South Africa. Several studies have been reported in other parts of the world, including studies conducted in Canada, the UK, Saudi Arabia, Nigeria, and Ghana, finding a common theme whereby midwives, nurses, or physicians who reported accepting immunization for either Flu, HPV, or other conditions were those who trusted in their safety and efficacy and were thus more likely to recommend the vaccine to their peers and patients [ 31 , 32 , 33 , 34 , 35 ].…”

Flu Vaccination Coverage and Predictors of Non-Vaccination in Military Health Corps Personnel 2016–2017 and 2019–2021

“…In the coming years, it will be important to focus vaccination promotion efforts on new targets such as physicians, pharmacists, psychologists, veterinarians and dentists, who continue to show the lowest adherence. In other studies the results were different; in one conducted in Italy, the most vaccinated specialty discipline was medicine [ 30 ].…”