IMPROVING INFLUENZA VACCINATION UPTAKE AMONG HEALTHCARE PROFESSIONALS: A GLOBAL UMBRELLA REVIEW IDENTIFYING BEHAVIORAL AND SYSTEM-LEVEL LEVERS FOR POLICY ACTION
Author(s)
Isidoros Kougioumtzoglou, MBA1, Apostolos Stratopoulos, MSc, PhD2, Kallia Mortaki, MSc2, Panagiotis Rigopoulos, MSc2, Michail Barous, MSc2, Louiza Chatzigeorgiou, Bsc2.
1PhD Candidate, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece, 2VIANEX SA, Athens, Nea Erithraia, Greece.
1PhD Candidate, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece, 2VIANEX SA, Athens, Nea Erithraia, Greece.
OBJECTIVES: Seasonal influenza imposes a recurrent and preventable burden on healthcare systems, with substantial clinical and economic impact. Healthcare professionals (HCPs) play a critical role in both transmission control and vaccination advocacy; however, vaccination uptake remains persistently suboptimal. This study aims to identify the key determinants of influenza vaccination uptake among HCPs and inform policy strategies to improve coverage at scale.
METHODS: An umbrella review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Cochrane Library, and Google Scholar were systematically searched for review articles published between 2000 and 2025 examining HCPs’ beliefs, attitudes, and behaviors toward influenza vaccination. Eligible studies included systematic and narrative reviews focusing on HCPs. Methodological quality was assessed using AMSTAR-2. Determinants were synthesized across three domains: behavioral, professional, and system-level drivers.
RESULTS: Twenty-five reviews were included, encompassing diverse healthcare settings and regions. Vaccination uptake among HCPs remains below recommended targets, with variation across contexts. Behavioral drivers included perceived protection of self and family and confidence in vaccine effectiveness as facilitators, while safety concerns and low perceived disease risk were principal barriers. Professional factors showed higher uptake among physicians and frontline clinical staff compared with non-clinical personnel, with younger professionals more likely to vaccinate and recommend vaccination. System-level interventions, including free and on-site vaccination, organizational programs, and mandatory vaccination policies, were strongly associated with higher uptake, often achieving near-target coverage. HCP vaccination behavior was consistently associated with higher likelihood of recommending vaccination, amplifying population-level impact.
CONCLUSIONS: Influenza vaccination uptake among HCPs is driven by the interaction between behavioral factors and health system design rather than knowledge alone. Educational interventions alone are unlikely to achieve meaningful improvements. Strategies should integrate behavioral interventions with structural measures, including facilitated access and institutional policies. Strengthening HCP vaccination represents a scalable, system-level intervention with potential to improve population-level vaccination coverage and reduce influenza burden.
METHODS: An umbrella review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Cochrane Library, and Google Scholar were systematically searched for review articles published between 2000 and 2025 examining HCPs’ beliefs, attitudes, and behaviors toward influenza vaccination. Eligible studies included systematic and narrative reviews focusing on HCPs. Methodological quality was assessed using AMSTAR-2. Determinants were synthesized across three domains: behavioral, professional, and system-level drivers.
RESULTS: Twenty-five reviews were included, encompassing diverse healthcare settings and regions. Vaccination uptake among HCPs remains below recommended targets, with variation across contexts. Behavioral drivers included perceived protection of self and family and confidence in vaccine effectiveness as facilitators, while safety concerns and low perceived disease risk were principal barriers. Professional factors showed higher uptake among physicians and frontline clinical staff compared with non-clinical personnel, with younger professionals more likely to vaccinate and recommend vaccination. System-level interventions, including free and on-site vaccination, organizational programs, and mandatory vaccination policies, were strongly associated with higher uptake, often achieving near-target coverage. HCP vaccination behavior was consistently associated with higher likelihood of recommending vaccination, amplifying population-level impact.
CONCLUSIONS: Influenza vaccination uptake among HCPs is driven by the interaction between behavioral factors and health system design rather than knowledge alone. Educational interventions alone are unlikely to achieve meaningful improvements. Strategies should integrate behavioral interventions with structural measures, including facilitated access and institutional policies. Strengthening HCP vaccination represents a scalable, system-level intervention with potential to improve population-level vaccination coverage and reduce influenza burden.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
P6
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Methodological & Statistical Research
Topic Subcategory
Public Health
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Vaccines