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 journalArticlepeer-review

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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