Monitoring influenza vaccination coverage and acceptance among health-care workers in German hospitals - results from three seasons.

Health-care workers are an important vaccination target group, they are more frequently exposed to infectious diseases and can contribute to nosocomial infections. We established a country-wide online monitoring system to estimate influenza vaccine uptake and its determinants among German hospital staff (OKaPII). The online questionnaire included items on vaccination behavior and reasons for and against influenza vaccination. After a pilot phase in 2016, a country-wide roll-out was performed in 2017. Questions on measles (2018) and hepatitis B (2019) vaccination status were added in subsequent years. In 2017, 2018 and 2019 in total 52, 125 and 171 hospitals with 5 808, 17 891 and 27 163 employees participated, respectively. Influenza vaccination coverage in season 2016/17 and 2017/18 was similar (39.5% and 39.3%) while it increased by 12% in 2018/19 (52.3%). Uptake was higher for physicians than for nurses. Self-protection was the most common reason for influenza vaccination. While physicians mainly identified constraints as reasons for being unvaccinated, nurses mainly referred to a lack of vaccine confidence. Of the hospital staff, 87.0% were vaccinated against measles, 6.3% claimed to be protected due to natural infection; 97.7% were vaccinated against hepatitis B. OKaPII shows that influenza vaccination coverage among German hospital staff is low. Occupational group-specific differences should be considered: physicians might benefit from easier access; information campaigns might increase nurses' vaccine confidence. OKaPII serves as a platform to monitor the uptake of influenza and other vaccines; it also contributes to a better understanding of vaccination behavior and planning of targeted interventions.

Factors associated with parental acceptance of seasonal influenza vaccination for their children - A telephone survey in the adult population in Germany.

INTRODUCTION: Influenza vaccination of children with underlying chronic diseases is currently recommended in Germany, but targeting all children constitutes an alternative approach to control seasonal influenza. To inform the modelling of vaccination impact and possible communication activities, we aimed to assess among parents the acceptance of universal childhood vaccination against seasonal influenza and possible modifiers. METHODS: We conducted a telephone survey in households in Germany using random digit dialing. We interviewed parents with children aged <18 years by constructing three hypothetical scenarios in subsequent order: (1) hearing about the influenza vaccination recommendation through the media, (2) the vaccine being recommended by a physician, and (3) being informed about the availability of the vaccine as a nasal spray. We calculated the proportion of parents who would immunize their child and used univariable and multivariable logistic regression to identify factors associated with influenza vaccination intention. RESULTS: Response was between 22 and 46%. Of 518 participants, 74% were female, mean age was 41.3 years. Participants had on average 1.6 children with a mean age of 8.9 years. In scenario 1, 52% of parents would immunize their child, compared to 64% in scenario 2 (p<0.01) and to 45% in scenario 3 (p=0.20). Factors independently associated with vaccination acceptance in scenario 1 were previous influenza vaccination of the child or parent (adjusted odds ratio [aOR] 4.5 and 8.6, respectively), perceived severity of influenza (aOR=5.1) and living in eastern Germany (aOR=2.4). CONCLUSION: If seasonal influenza vaccination was recommended for all children, more than half of the parents would potentially agree to immunize their child. Involving physicians in future information campaigns is essential to achieve high uptake. As intranasal vaccine administration is non-invasive and easily done, it remains unclear why scenario 3 was associated with low acceptance among parents, and the underlying reasons should be further explored.