2019-20 influenza coverage among healthcare workers: how a Northern-Italian Region tackles hesitancy

Abstract

Abstract Introduction WHO stresses the need to implement multi-component interventions to raise coverage among healthcare workers (HCWs). We investigated different HCWs influenza immunization programs within Friuli Venezia Giulia (FVG) Region hospitals (Italy) during 2019-20 flu season with the aim of identifying the most effective strategies to tackle hesitancy. Methods In December 2019 we collected from FVG hospitals: number of employed HCWs, vaccination strategies against flu and refusers management during 2019-20 flu season. We obtained data about HCWs flu vaccination coverage from the regional database; Chi-square test was used to find correlation between strategies and coverage. Results We collected data from 7/7 hospitals for a total of employed HCWs of 12,557 (average 1,794; range 467-3,922); 2 hospitals being academic centers and 2 research institutions. All hospitals promoted flu vaccination using emails, notice on hospital website and posters display; 3/7 organized training courses. Vaccination was always provided within the hospital in a dedicated easy and free access room; most hospitals (5/7) also offered ward on-site sessions, some allowing ward self-administration (3/7) or organizing on demand extra-sessions (2/7). No countermeasures were taken in case of refusal. Regional HCWs flu vaccination coverage resulted to be 24.9% (range 17-33.3). Multi-component intervention including passive and active offer, communication and education activities was confirmed to be significantly associated with higher HCWs flu coverage (OR 1.7; CI 1.6-1.9; p < 0.01), as well as being the hospital an academic center or a research institution (OR 1.3; CI 1.2-1.5; p < 0.01). Conclusions Different strategies to foster HCWs vaccination were adopted in FVG Region during 2019-20 flu season. The multi-component approach producing the best results should be further analyzed in order to identify the most effective recipe to be shared both nationally and internationally. Key messages Investigating the relation between HCWs flu immunization strategies and their effect is crucial to identify best practices. A multi-component approach including passive and active offer, communication and education activities seems the most effective way to tackle influenza vaccine hesitancy among HCWs.