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

Figures & data

Table 1. Participants’ characteristics and vaccination status

Sex
Males	443/1,825	(24.3%)
Age (years)
(median, range)	47 (21–67)
Age groups
≤45 years	914/2,156	(42.4%)
>45 years	1,242/2,156	(57.6%)
Profession
Physician	313/1,674	(18.7%)
Nurse	880/1,674	(52.6%)
Paramedical	236/1,674	(14.1%)
Other	245/1,674	(14.6%)
Workplace
Primary Care Centers	418/2,246	(18.6%)
Hospital A	458/2,246	(20.4%)
Hospital B	823/2,246	(36.6%)
Hospital C	547/2,246	(24.4%)
Vaccine/Immune Status
Influenza
2017-18 season	810/2,246	(36.1%)
Annually (last 5 years)	332/2,246	(14.8%)
Occasionally (last 5 years)	732/2,246	(32.6%)
No vaccination (last 5 years)	1,182/2,246	(52.6%)
Hepatitis B
3 doses vaccine uptake	1,316/2,181	(60.3%)
1 or 2 doses vaccine uptake	232/2,181	(10.6%)
No vaccine	626/2,181	(28.7%)
ΗΒsAg(+)	7/2,181	(0.3%)
Susceptible to hepatitis B	858/2,181	(39.3%)
Measles
History of illness	959/2,061	(46.5%)
Positive serology only	37/2,061	(1.8%).
2 doses vaccine uptake*	461/1,065	(43.3%)
1 dose vaccine uptake*	62/1,065	(5.8%)
No vaccine*	542/1,065	(50.9%)
Susceptible to measles	604/2,061	(29.3%)

*Among HCPs without a history of illness or serologically proven immunity.

Figure 1. Vaccine uptake and overall protection against (a) influenza, (b) hepatitis B, and (c) measles among all healthcare professionals included in the present study

Table 2. Vaccine uptake and overall protection for influenza, hepatitis B and measles in different categories of HCPs. Univariate analysis based on demographic and other characteristics of HCPs

	Influenza				Hepatitis B		Measles
	1-yearvaccine uptake	p value	5-yearvaccine uptake	p value	3 dosesvaccine uptake	p value	2 dosesvaccine uptake*	p value
Sex
Males	42.8%		16.7%		44.9%		33.1%
Females	32.2%	p < .001	9.2%	p < .001	61.3%	p < .001	40.5%	p .04
Age
≤45 years	30.8%		12.4%		66.0%		71.4%
>45 years	40.6%	p < .001	16.5%	p .011	59.0%	p .013	13.3%	p < .001
Profession
Physician	55.6%		23.5%		46.1%		40.6%
Nurse	29.1%		8.2%		74.5%		45.8%
Paramedical	32.1%		10.6%		45.7%		22.4%
Other	31.3%	^ap < .001	6.2%	^ap < .001	49.4%	^ap < .001	25.5%	^ap < .001
Workplace
Primary Care	48.0%		21.3%		47.5%		70.0%
All hospitals	33.1%	p < .001	13.2%	p < .001	63.1%	p < .001	39.4%	p < .001
Hospital
Hospital A	44.5%		28.6%		69.1%		83.3%
Hospital B	20.2%		6.1%		80.9%		39.2%
Hospital C	47.1%	p < .001	11.3%	p < .001	32.0%	p < .001	27.4%	p < .001

*The percentage of nonimmune HCPs that received the vaccine (without any history of illness or positive serology). Chi square test was performed. For different professional categories two different analyses were conducted; either a) comparison among two groups: physicians compared to other professions or b) comparison among “physicians and nurses” and “paramedical and others” HCPs.

Table 3. Risk factors for vaccine non – uptake among HCPs’ categories

Vaccine non-uptake for*	Odds ratio (95% CI)	P
Influenza (2017–18 season)
Age ≤ 45 years	1.35 (1.08–1.66)	0.0071
Non–physician only	2.94 (2.09–4.12)	0.0001
Work in hospitals	1.39 (1.02–1.89)	0.035
Work in hospital B	3.56 (2.71–4.71)	0.0001
Influenza (last 5 years)
Non-physician only	2.67 (1.94–3.67)	0.0001
Work in hospitals	1.84 (1.36–2.48)	0.0001
Work in hospital B	6.41 (4.92–8.51)	0.0001
Measles †‡
Age >45 years	26.74 (17.41–41.06)	0.0001
Work in hospitals	59.16 (25.81–135.6)	0.0001
Hepatitis B‡
Age >45 years	1.36 (1.09-–1.70)	0.0071
Non–physician or nurse	1.75 (1.38–2.21)	0.0001
Work in primary care	1.52 (1.15-2.-1)	0.0027

*The dependent variables (no vaccination against influenza for either season 2017–2018 or the last five years, no hepatitis B vaccine uptake or no measles vaccine uptake) were adjusted for sex, age (≤ 45 years old and >45 years old), profession (physicians, nurses, paramedics, other) and workplace (either primary care centers or hospitals).

‡ No vaccine uptake of measles and hepatitis b was evaluated versus any dose of vaccine uptake.

† Analysis of no measles vaccine uptake among the HCPs that reported to be nonimmune to measles.