Interventions to increase seasonal influenza vaccine coverage in healthcare workers: A systematic review and meta-regression analysis

Theodore Lytras, Frixos Kopsachilis, Elisavet Mouratidou, Dimitris Papamichail, Stefanos Bonovas

Research output: Contribution to journalArticle

Abstract

Influenza vaccination is recommended for healthcare workers (HCWs), but coverage is often low. We reviewed studies evaluating interventions to increase seasonal influenza vaccination coverage in HCWs, including a meta-regression analysis to quantify the effect of each component. Fourty-six eligible studies were identified. Domains conferring a high risk of bias were identified in most studies. Mandatory vaccination was the most effective intervention component (Risk Ratio of being unvaccinated [RRunvacc] = 0.18, 95% CI: 0.08–0.45), followed by “soft” mandates such as declination statements (RRunvacc = 0.64, 95% CI: 0.45–0.92), increased awareness (RRunvacc = 0.83, 95% CI: 0.71–0.97) and increased access (RRunvacc = 0.88, 95% CI: 0.78–1.00). For incentives the difference was not significant, while for education no effect was observed. Heterogeneity was substantial (τ2 = 0.083). These results indicate that effective alternatives to mandatory HCWs influenza vaccination do exist, and need to be further explored in future studies.

Original languageEnglish
Pages (from-to)671-681
Number of pages11
JournalHuman Vaccines and Immunotherapeutics
Volume12
Issue number3
DOIs
Publication statusPublished - Mar 3 2016

Keywords

  • epidemiology
  • healthcare
  • healthcare workers
  • influenza
  • influenza vaccine
  • meta-analysis
  • meta-regression
  • systematic review
  • vaccination
  • vaccine coverage

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pharmacology

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