Determinants of low uptake of vaccination against influenza, measles, and hepatitis B among healthcare professionals in Greece: a multicenter cross-sectional study

Abstract

ABSTRACT Vaccination is recommended for healthcare professionals (HCPs) to protect them against vaccine-preventable diseases (VPDs); however, uptake rates are low. This study aimed to evaluate HCPs’ influenza, hepatitis B, and measles vaccine uptake in all healthcare levels in Crete, Greece. We conducted a questionnaire–based, cross-sectional multicenter study in 2018, including HCPs employed at 18 primary care centers and 3 hospitals. Overall, 2,246 HCPs responded (57.2% of the target population). The influenza vaccine uptake rate was 36.1% (810/2,246), with the annual vaccination rate at 14.8% (332/2,246) over the previous 5 years. Concurrently, the hepatitis B 3-dose vaccine uptake rate was 60.3% (1,316/2,181). Among the participating HCPs, 70.7% (1,457/2,061) had measles immunity due to previous illness (959/2,061, 46.5%), a 2-dose vaccination scheme (461/2,061, 22.4%), or serological confirmation (37/2,061, 1.8%). Vaccine uptake rates differed between groups depending on age, profession, and workplace setting. Logistic regression analysis revealed that risk factors for no influenza vaccine uptake during the previous season were younger age (≤45 years; odds ratio [OR] 1.35, 95% confidence interval [CI]: 1.08–1.66), profession other than physician (OR 2.94, 95%CI: 2.09–4.12), and working in hospitals (OR 1.39, 95%CI 1.02–1.89). Older age (>45 years) was an independent risk factor for not receiving a measles (OR 26.74, 95%CI: 17.41–41.06) or hepatitis B vaccine (OR 1.36, 95%CI 1.09–1.7). Working in primary care was an independent risk factor for not getting a hepatitis B vaccine (OR 1.52, 95%CI: 1.15–2.1). Our findings indicate that individualized and targeted interventions should be implemented to increase vaccine uptake among HCPs.