Factors associated with influenza vaccination among healthcare workers in acute care hospitals in Canada

Background: Influenza vaccine coverage rates among healthcare workers (HCWs) in acute care facilities in Canada remain below national targets. Objective: To determine factors associated with influenza vaccine uptake among HCWs. Methods: This secondary analysis of a prospective cohort study included HCWs aged 18-69 years, working >= 20 h/wk in a Canadian acute care hospital. Questionnaires were administered to participants in the fall of the season of participation (2011/12-2013/14) which captured demographic/household characteristics, medical histories, occupational, behavioural and risk factors for influenza. Generalized estimating equation logistic regression was used to determine factors associated with vaccine uptake in the season of participation. Results: The adjusted odds ratio for influenza vaccination in the current season was highest for those vaccinated in 3 of 3 previous seasons (OR 156; 95% CI 98, 248) followed by those vaccinated in 2 of 3 and 1 of 3 previous seasons when compared with those not vaccinated. Compared with nurses, physicians (OR 4.2; 95% CI 1.4, 13.2) and support services staff (OR 1.8; 95% CI 1.3, 2.4) had higher odds ratios for vaccine uptake. Conversely, HCWs identifying as Black had lower odds of uptake compared with those with European ancestry (OR 0.44, 95% CI 0.26-0.75) when adjusted for other factors in the model. Conclusion: Healthcare workers differ in their annual uptake of influenza vaccine based on their past vaccination history, occupation and ethnicity. These findings indicate a need to determine whether there are other vaccine-hesitant groups within healthcare settings and learn which approaches are successful in increasing their uptake of influenza vaccines.