Vaccination against Influenza among Health Care Workers in Al Mashaer during Hajj 2019 (1440 H); Uptake and Barriers

Abstract

Background: Hajj (i.e., pilgrimage) is one of the largest mass gatherings in the globe. It brings people from around the world into small confined areas, which facilitates the transmission of droplet infections, like influenza. Saudi Arabia requires all healthcare workers (HCWs) receive the influenza vaccine since they can transmit influenza among infected patients to un-infected patients, including high-risk groups. We sought to assess the commitment of the HCWs toward vaccination as well as the reasons for vaccine refusal. Methodology: A cross-sectional study was performed during Hajj season 2019 among HCWs in Al Mashaer, Makkah, Saudi Arabia. Anonymous, self-administered questionnaires were distributed to collect the information on demographic characteristics, vaccine uptake, and their attitudes and concerns towards receiving the vaccine. Results: A total of 760 completed questionnaires were received, with a response rate of 95%. Males represented (58%), and the average age (Mean±SD) was 36.7±7.65 years. More than half of participants (56%) were working in the primary Health Centers (PHCs), while (44%) were working in the hospitals. (93%) of the participants have received the vaccine before in their life. For the 2019 Hajj season, (76%) of them received the vaccine. Following the authority’s recommendation (74%) was the main reason for vaccination, 24% were not vaccinated before attending this Hajj, and 25% did not intend to take the vaccine in the future. Concerns about the vaccine side effects (46%) and misconceptions regarding its efficacy (44%) were the main barriers for vaccination refusal. Logistic regression analysis showed that the other health cadres, pharmacists, and working in hospitals were independently associated with vaccine avoidance in the 2019 Hajj. While for the future intention to take the vaccine, working in the hospitals, HCWs from the northern region, other health cadres, nurses, and pharmacists were independently associated with vaccine rejection. Conclusion: Despite the good uptake of the vaccine, there are still misconceptions about the efficacy of the vaccine and concerns about its side effects. Awareness programs are required to address those concerns, especially for younger staff, pharmacists, and other cadres. Higher vaccine uptake among healthcare workers will impact the vaccination of the general population. Key Words: Pilgrimage, Seasonal influenza vaccine, healthcare workers, Saudi Arabia.