Utility of Healthcare System-Based Interventions in Improving the Uptake of Influenza Vaccination in Healthcare Workers at Long-Term Care Facilities: A Systematic Review

Abstract

Healthcare workers (HCWs) in long-term care facilities (LTCFs) can represent a source of influenza infection for the elderly. While flu vaccination coverage (VC) is satisfactory in the elderly, HCWs are less likely to be vaccinated. There is no definitive evidence on which types of healthcare system-based interventions at LTCFs would be more useful in improving the vaccination uptake among HCWs. We performed a systematic review in different databases (Pubmed, Cochrane Database of Systematic Reviews, Health Evidence, Web of Science, Cinahl) to provide a synthesis of the available studies on this topic. Among the 1177 articles screened by their titles and abstracts, 27 were included in this review. Most of the studies reported multiple interventions addressed to improve access to vaccination, eliminate individual barriers, or introduce policy interventions. As expected, mandatory vaccinations seem to be the most useful intervention to increase the vaccination uptake in HCWs. However, our study suggests that better results in the vaccination uptake in HCWs were obtained by combining interventions in different areas. Educational campaigns alone could not have an impact on vaccination coverage. LTCFs represent an ideal setting to perform preventive multi-approach interventions for the epidemiological transition toward aging and chronicity.

Pharmacists’ attitudes toward influenza vaccination: does the COVID-19 pandemic make a difference?

“… 36 , 37 Vaccination mandates have proven to be the most impactful intervention for increasing SIV among HCWs. 38 In Switzerland, unlike some countries, there are no mandatory vaccines, and many HCWs are opposed to mandatory vaccination. 39 …”

“… 17 , 42 Similar to that in previous studies, facilitated access to vaccination most likely played a role, as 88.7% of pharmacists were vaccinated in a pharmacy. 38 , 41 , 43 …”

Impact of Influenza Vaccination on All-Cause Mortality and Hospitalization for Pneumonia in Adults and the Elderly with Diabetes: A Meta-Analysis of Observational Studies

“…It is important to mention that the included studies assess the effectiveness of influenza vaccination in countries where vaccination coverages are diverse. In European countries vaccination is generally recommended in the elderly, adults with chronic conditions or healthcare workers to reduce transmission [ 35 ], but influenza vaccination coverage rates are generally still not adequate [ 36 ]. In England, where influenza vaccine is offered to all people with chronic conditions, Vamos et al found that vaccination coverage ranged from 63.1% in 2008/09 to 69.0% in 2006/07 [ 22 ].…”

COVID-19 Vaccination Hesitancy among Healthcare Workers—A Review

“…Ultimately, workplace vaccine mandates have proven the most successful intervention at increasing influenza vaccination, and this success was enhanced when combined with other interventions, such as education [35]. On the other hand, influenza outbreaks are relatively common, historically occurring in 30-60% of long-term care facilities each year [36] and studies have been inconclusive so far about whether vaccinating HCWs against influenza actually prevented infection [37].…”