Monitoring influenza vaccination coverage and acceptance among health-care workers in German hospitals – results from three seasons

ABSTRACT

Health-care workers are an important vaccination target group, they are more frequently exposed to infectious diseases and can contribute to nosocomial infections. We established a country-wide online monitoring system to estimate influenza vaccine uptake and its determinants among German hospital staff (OKaPII). The online questionnaire included items on vaccination behavior and reasons for and against influenza vaccination. After a pilot phase in 2016, a country-wide roll-out was performed in 2017. Questions on measles (2018) and hepatitis B (2019) vaccination status were added in subsequent years. In 2017, 2018 and 2019 in total 52, 125 and 171 hospitals with 5 808, 17 891 and 27 163 employees participated, respectively. Influenza vaccination coverage in season 2016/17 and 2017/18 was similar (39.5% and 39.3%) while it increased by 12% in 2018/19 (52.3%). Uptake was higher for physicians than for nurses. Self-protection was the most common reason for influenza vaccination. While physicians mainly identified constraints as reasons for being unvaccinated, nurses mainly referred to a lack of vaccine confidence. Of the hospital staff, 87.0% were vaccinated against measles, 6.3% claimed to be protected due to natural infection; 97.7% were vaccinated against hepatitis B. OKaPII shows that influenza vaccination coverage among German hospital staff is low. Occupational group-specific differences should be considered: physicians might benefit from easier access; information campaigns might increase nurses’ vaccine confidence. OKaPII serves as a platform to monitor the uptake of influenza and other vaccines; it also contributes to a better understanding of vaccination behavior and planning of targeted interventions.

KEYWORDS:

• Vaccine hesitancy
• influenza
• vaccination
• health-care worker
• hospital
• Germany

Acknowledgments

We would like to thank all colleagues at Robert Koch Institute who were involved in the planning and implementation of the OKaPII study. Our special thanks go to Cornelius Remschmidt and Alexandra Sarah Lang who have been involved in the conception and conduct of the pilot phase.

Declaration of Interest Statement: Sabine Wicker is a member of the German Standing Committee on Vaccination (STIKO) at Robert Koch Institute in Germany. None of the other authors had any potential conflict of interest.

Abbreviations

HCW	=	Health-care workers
STIKO	=	German Standing Committee on Vaccination
OKaPII	=	Online monitoring system on influenza vaccination coverage in German hospitals

Supplementary material

Supplemental data for this article can be accessed online at publisher’s website.