Abstract
Influenza vaccination is recommended for nurses in China but is not mandatory or offered free of charge. The main objective of this study was to determine influenza vaccination coverage and the principal factors influencing influenza vaccination among nurses in China. During 22 March–1 April 2018, we conducted an opt-in internet panel survey among registered nurses in China. Respondents were recruited from an internet-based training platform for nurses. Among 22,888 nurses invited to participate, 4706 responded, and 4153 were valid respondents. Overall, 257 (6%) nurses reported receiving the seasonal influenza vaccine during the 2017/2018 season. Vaccination coverage was highest among nurses working in Beijing (10%, p < 0.001) and nurses working in primary care (12%, p = 0.023). The top three reasons for not being vaccinated were lack of time (28%), not knowing where and when to get vaccinated (14%), and lack of confidence in the vaccine’s effectiveness (12%). Overall, 41% of nurses reported experiencing at least one episode of influenza-like illness (ILI) during the 2017/2018 season; 87% of nurses kept working while sick, and 25% of nurses reported ever recommending influenza vaccination to patients. Compared with nurses who did not receive influenza vaccination in the 2017/2018 season, nurses who received influenza vaccination were more likely to recommend influenza vaccination to patients (67% vs. 22%, p < 0.001). Influenza vaccination coverage among nurses was low, and only a small proportion recommended influenza vaccine to patients. Our findings highlight the need for a multipronged strategy to increase influenza vaccination among nurses in China.
Highlights
Vaccination is the most effective method for the prevention of influenza [1], which is associated with 291,000 to 645,000 deaths each year globally [2]
We report a low coverage of influenza vaccination among registered nurses in China (6%) during the 2017/2018 season, which was considerably lower than coverage among nurses in other countries such as the United States (90.5%) [39], the United Kingdom
Our study found that influenza vaccination coverage among nurses varied by age, number of years working in the healthcare sector, and work setting
Summary
Vaccination is the most effective method for the prevention of influenza [1], which is associated with 291,000 to 645,000 deaths each year globally [2]. The effectiveness of influenza vaccine varies from season to season, with a pooled efficacy of 59% (95% CI 51%–67%) in adults aged 18–65 years [3], and is mainly influenced by age, underlying medical conditions, as well as the degree of antigenic match between vaccine strains and circulating influenza viruses [4,5,6,7]. The World Health Organization recommends annual influenza vaccination for high-risk groups including older adults, young children, pregnant women, people with underlying medical conditions, and healthcare personnel [9]. To build public trust and increase influenza vaccine uptake, policy makers and other decision makers need to better understand vaccination coverage and the factors influencing the acceptance of influenza vaccine among different risk groups [12]
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