Vaccination against influenza among Lebanese health care workers in the era of coronavirus disease 2019

Abstract

Background Health-care workers (HCWs) are at a higher occupational risk of contracting and transmitting influenza. Annual vaccination is an essential tool to prevent seasonal influenza infection. However, HCWs vaccine hesitancy remains a leading global health threat. This study aims to evaluate the flu vaccination coverage rates among Lebanese HCWs and to assess their knowledge, attitudes, practices, perceived barriers, and benefits toward the flu vaccine during the COVID-19 pandemic. In addition, we sought to identify the factors associated with flu vaccine uptake. Methods A cross-sectional study using an online survey was conducted in Lebanon among HCWs between 14 and 28 October 2020. Multivariable logistic regression was carried out to identify the factors associated with influenza vaccine uptake. Results A total of 560 HCWs participated in the survey of whom 72.9% were females, and 53.9% were aged between 30-49 years. Regarding Flu vaccination uptake, the rate has risen from 32.1% in 2019-2020 to 80.2% in 2020-2021 flu season. The majority of HCWs had a good knowledge level and a positive attitude toward flu vaccination. Regarding their practices, less than 50% of HCW were currently promoting the importance of getting the flu vaccine. The majority (83.3%) ranked the availability of a sufficient quantity of vaccines as the most significant barrier to flu vaccination. The main perceived flu vaccination benefits were enhancing patient safety, minimizing the viral reservoir in the population, decreasing hospital admission, and avoiding influenza and COVID-19 co-infection. The odds of influenza vaccine uptake was lower in unmarried compared to married HCWs (OR = 0.527, CI (0.284-0.978). However, HCWs having received the influenza vaccine in the previous season (OR = 6.812, CI (3.045-15.239)), those with good knowledge level (OR = 3.305, CI (1.155-9.457)), low perceived barriers (OR = 4.130, CI (1.827-9.334)) and high perceived level of the benefits (OR = 6.264, CI (2.919-13.442)) of the flu vaccination were found more prone to get the flu vaccine. Conclusion Flu vaccination uptake has increased among HCWs during the 2020-2021 flu season compared with the previous one. Continuing education as well as ensuring free, equitable, and convenient access to vaccination are still required to increase the annual flu vaccination uptake among HCWs.

COVID-19 and Influenza Vaccination Campaign in a Research and University Hospital in Milan, Italy

“…Concerning the fundamental question of which factors could have contributed to this result, it can be noticed that, while a long tradition of hesitancy among HCWs towards flu vaccination has been ascertained even in recent years in Italy, as well as in several European countries [ 11 , 12 , 13 , 14 ], with Italian flu VCRs rarely exceeding the threshold of 20%, a meaningful increase was registered in Fondazione in the 2020–2021 and in the last campaign, i.e., in the two years of the COVID-19 pandemic. Similar results have been reported by other Italian [ 33 , 34 , 35 ] and international studies [ 36 , 37 , 38 ]. Therefore, it is possible to hypothesize that the SARS-CoV-2 pandemic could have played a significant role in increasing awareness on the importance of vaccination in general and specifically of flu vaccination, thus contributing to increase the flu VCRs, even among HCWs [ 39 , 40 , 41 , 42 , 43 ].…”

“…In the 2021–2022 influenza vaccination campaign for HCWs in Fondazione, a VCR > 50% (52.0%) was reached for the first time, confirming the positive trend started in the 2020–2021 campaign [ 25 ]. A great contribution by the COVID-19 pandemic in renewing HCWs’ awareness towards the need for protection against respiratory infections, primarily influenza, is highly probable and widely highlighted in the literature [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ].…”

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

“…Previous findings from Saudi Arabia [32] were in accordance with another study carried out in Lebanon during the COVID-19 pandemic in 2020 on 560 Lebanese HCWs, who had the belief that good knowledge of vaccination, having previously received the influenza vaccine, perception of flu vaccine benefits in decreasing hospitalization, and prevention of influenza-COVID-19 co-infection had a positive influence on attitudes towards influenza vaccination [59]. Kong et al conducted a meta-analysis and systematic review of 27 studies from 1 January 2019 to 31 December 2021 with the aim of evaluating the "effect of COVID-19 pandemic on influenza vaccination intention" [20].…”

The Role of Psychological Factors and Vaccine Conspiracy Beliefs in Influenza Vaccine Hesitancy and Uptake among Jordanian Healthcare Workers during the COVID-19 Pandemic

“…Regarding influenza vaccine uptake and hesitation, HCWs are a key target group that is considered among the most studied groups worldwide [43][44][45][46][47]. The necessity of annual accommodation of new vaccine formulations confers a peculiarity of influenza vaccination and raises questions about declining vaccine effectiveness, leading to vaccine hesitancy [48][49][50].…”