Low influenza vaccine uptake by healthcare workers caring for the elderly in South African old age homes and primary healthcare facilities

Background The elderly bear the highest burden of South Africa’s estimated annual > 10 million influenza cases and > 11,000 influenza-related deaths.

Unvaccinated healthcare workers (HCWs) are at high occupational risk of contracting influenza, and may transmit influenza to elderly patients in their care.

Thus, the South African National Department of Health recommends that HCWs receive annual influenza vaccination.

This study aimed to determine influenza vaccination coverage among HCWs; identify reasons for their vaccination status; and investigate if HCWs recommend vaccination to their elderly patients.

Methods A descriptive study was conducted in 18 community health centres and 44 private sector and non-governmental organisation managed old age homes across South Africa, using a self-administered structured questionnaire, which was distributed to 360 HCWs present on the day of data collection.

Data were captured using Microsoft Excel® and imported to Epi Info™ 7 (Centers for Disease Control and Prevention, USA) for descriptive statistical analysis.

Ethics approval (SMUREC/P/36/2018: PG) and permission to conduct the study at the facilities were obtained.

All participants provided informed consent.

Results The response rate was 76.7% (276/360).

Most participants were female (90.9% [251/276]), nursing professionals (81.2% [224/276]) with a mean age of 41.1 ± 11.7 years.

Although 62.7% of participants indicated having ever received at least one dose of the influenza vaccine, influenza vaccine uptake for 2017 and 2018 was 24.36% (41/276) and 33.3% (92/276) respectively.

The main reasons given for never being vaccinated against influenza were related to the unavailability of the vaccine (70.9%) and vaccine hesitancy (27.2%).

Most participants (67.8% [187/276]) recommended vaccines to elderly patients in their care.

Conclusion The main reasons behind low influenza vaccine uptake by HCWs in South Africa who care for the elderly were related to unavailability of the vaccine and vaccine hesitancy.

Strategies to educate HCWs on the importance of influenza vaccination, while concurrently increasing sustained and easy access to the vaccine by HCWs are needed to preserve public health.