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Factors Associated with Healthcare Worker Acceptance of Vaccination: A Systematic Review and Meta-analysis

Published online by Cambridge University Press:  10 May 2016

Marija Vasilevska ,
Jennifer Ku  and
David N. Fisman
Marija Vasilevska
Affiliation:
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Jennifer Ku
Affiliation:
School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada
David N. Fisman*
Affiliation:
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
*
Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 547, Toronto, Ontario M5T 3M7, Canada (david.fisman@utoronto.ca).
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Abstract

Background and objective.

Healthcare workers experience occupational risk of infection and may transmit infections to patients. Vaccination provides an efficient means of protecting workers and patients, but uptake may be low. We sought to identify factors influencing vaccine acceptance by healthcare workers in order to obtain insights leading to more effective vaccination programs in this population.

Design.

Systematic review and meta-analysis.

Methods.

We searched Medline, Embase, and CINAHL databases to identify studies published up to May 2012. Factors influencing vaccination acceptance were devised a priori. Random-effects meta-analysis was performed to generate summary estimates of effect. Heterogeneity and publication bias were explored using statistical tools.

Results.

Thirty-seven studies evaluating a variety of vaccines (against influenza, pertussis, smallpox, anthrax, and hepatitis B) were included. Homogeneous effects on vaccine acceptance were identified with desire for self-protection (odds ratio [OR], 3.42 [95% confidence interval (CI), 2.42–4.82]) and desire to protect family and friends (OR, 3.28 [95% CI, 1.10–9.75]). Concern that vaccine transmits the illness it was meant to prevent decreased acceptance (OR, 0.42 [95% CI, 0.30–0.58]). Differences in physician and nurse acceptance of immunization were seen between Asian and non-Asian studies.

Conclusions.

Consideration of self-protection (rather than absolute disease risk or protection of patients) appears the strongest and most consistent driver of healthcare workers’ decisions to accept vaccination, though other factors may also be impactful, and reasons for between-study divergence in effects is an important area for future research. This finding has important implications for the design of programs to enhance healthcare worker vaccine uptake.

Infect Control Hosp Epidemiol 2014;35(6):699–708

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue 6 , 01 June 2014 , pp. 699 - 708
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved.

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