Effectiveness of on-site influenza vaccination strategy in Italian healthcare workers: a systematic review and statistical analysis

ABSTRACT

Introduction

One of the main determinants of non-adherence to influenza vaccination among healthcare workers (HCWs) is lack of time to attend vaccination services. Therefore, international Public Health Organizations have recommended on-site influenza vaccination in order to improve vaccination coverage among HCWs.

Areas covered

We conducted a systematic narrative review of the relevant literature to evaluate the effectiveness of this strategy among HCWs in Italy. Fifteen studies, selected among scientific articles available in MEDLINE/PubMed, ISI Web of Knowledge and Scopus and published from January 1^st, 2018, to May 31^st, 2022, were included. A significant relationship was evidenced between influenza vaccine uptake and adoption of an on-site outpatient clinic (OR = 2.06; 95%CI = 1.43–2.95). The review highlighted a significant increase in VC when on-site vaccination was implemented (even exceeding +150% compared to the previous season), among other measures. Nevertheless, none of the reported experiences proved to meet the minimum target of 75% VC among HCWs.

Expert opinion

Despite strategies to achieve greater willingness to immunize in this category, mandatory vaccination appears to be the only one that can guarantee protection for HCWs and the patients they care for.

KEYWORDS:

• Healthcare workers
• vaccine compliance
• influenza
• nosocomial infection
• mandatory vaccination

Author contributions

FPB and ST conceived the study. FPB and AM did the literature research. FPB did the systematic review. EC and PS participated in the design of the systematic review. ADL supervisioned the systematic review. FPB and ST codrafted the first version of the article.

Article highlights

• HCWs are at a greater risk of exposition to influenza viruses than the general population.

• HCWs are among the at-risk categories for whom influenza vaccination is strongly recommended

• Public Health Organizations have recommended on-site influenza vaccination in order to improve vaccination coverage

• Our study evaluate the effectiveness of the on-site strategy among HCWs in Italy.

• A significant relationship was evidenced between vaccine uptake and the vaccination in an on-site clinic.

• The scenario of management strategies for hesitant individuals is very difficult

• On-site vaccination is associated with better immunization attitude.

• None of the reported experiences proved to meet the minimum target of 75%

• Mandatory strategy seems to be necessary to deal with low uptake

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or mending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The study was founded by Apulia’s Regional Observatory for Epidemiology.