Predictors of influenza vaccination among healthcare workers in Serbia

Abstract Introduction The vaccination against influenza among health care workers (HCWs) stays suboptimal in many countries worldwide, including Serbia, where based on 2024 cross-sectional survey, 23.5% reported being vaccinated in last vaccination season. Numerous factors are associated with vaccination and we aim to explore contribution of sociodemographic and job-related factors as well as vaccination against other viral infections. Methods We used data obtained from the 2024 cross-sectional survey among sample of 1919 healthcare workers (HCWs) in Serbia. A binary logistic regression (BLR) was conducted to assess association of selected predictors and influenza vaccination in previous season, namely: vaccination against COVID-19 and Hepatitis B, having chronic disease or living with someone who has it, previous influenza experience, sex, age, region, level of healthcare, number of patients, profession. Results BLM model was statistically significant (p = 0.000) and explained 24.1% of the variance in influenza vaccination status. HCWs who reported being vaccinated against COVID-19 and Hepatitis B had higher odds of being vaccinated against influenza (aOR=4.28, 95%CI=2.71-6.76 and aOR=3.67, 95%CI=1.84-6.17, respectively). Region was a significant predictor with HCWs from two regions having four times higher odds compared to Belgrade region (aOR=4.01 95%CI=2.63-6.80 and aOR=4.01 95%CI=2.44-6.75). Living with someone with a chronic disease, having a mild or severe form of influenza in the past, profession (medical/dental doctors vs nurses), and self-reported average number of patients were not significant predictors. Conclusions The strongest predictors were place of living (region) and previous COVID-19 and Hepatitis B vaccination, indicating that general confidence in vaccines has a major role in influenza vaccination. Results indicate a stronger focus on specific regions in the communication and awareness-raising campaigns. Key messages • Regional differences should be considered when planning influenza vaccination campaigns. • Previous COVID-19 and Hepatitis B vaccination is strong predictor of influenza vaccination.