Increasing vaccination coverage among healthcare workers: Active call and mandatory laws. Data from a large general hospital in Southern Italy

• Published in: Vaccine Vol. 42; no. 24; p. 126098
• Main Authors: Stefanizzi, Pasquale, Di Lorenzo, Antonio, Capodiferro, Luca, Moscara, Lorenza, Noviello, Chiara, Vimercati, Luigi, De Maria, Luigi, Tafuri, Silvio
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 24.10.2024; Elsevier Limited
• Subjects: Adult; Allergy and Immunology; Chi-square test; Communication; Compliance; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 vaccines; COVID-19 Vaccines - administration & dosage; e-mail; Effectiveness; Electronic mail; Female; Health care; Health Personnel - statistics & numerical data; health services; Hospitals; Hospitals, General - statistics & numerical data; human resources; Humans; Immunization; Influenza; influenza vaccination; Influenza Vaccines - administration & dosage; Influenza, Human - prevention & control; Italy; Mail; Male; Mandatory Programs - legislation & jurisprudence; Medical personnel; Middle Aged; Operators; Pandemics; Pathogens; Physicians; Public health; Recall; Regression analysis; Regression models; Respiratory diseases; risk; Risk reduction; SARS-CoV-2; SARS-CoV-2 - immunology; Seasons; Severe acute respiratory syndrome coronavirus 2; Vaccination; Vaccination - legislation & jurisprudence; Vaccination - statistics & numerical data; Vaccination Coverage - statistics & numerical data; Vaccination policy; vaccines; Viral infections; Workplace intervention; Italy; SARS-CoV-2; Vaccination policy; Influenza; Workplace intervention; Communication
• ISSN: 0264-410X; 1873-2518; 1873-2518
• DOI: 10.1016/j.vaccine.2024.06.065

•Influenza and SARS-CoV-2 vaccination of healthcare workers are pivotal.•Mandatory vaccination alone may elicit hostility among workers.•An active recall intervention can increase vaccination uptake in healthcare workers. Influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are respiratory pathogens which significantly impact healthcare systems. Seasonal vaccination is recommended for all healthcare workers (HCWs) to reduce the risk for both operators and patients. Puglia, a region in Southern Italy, has been enforcing since 2018 a law mandating influenza vaccination in healthcare workers. However, vaccination coverages for this category have always been suboptimal. Our study tests the effectiveness of an active recall intervention on vaccination coverage for influenza and SARS-CoV-2 in the HCWs of a large Apulian hospital (Southern Italy). During the 2023–2024 influenza vaccination season, unvaccinated HCWs of Bari’s Policlinico General Hospital were contacted. The e-mail reminded them of a regional law mandating influenza vaccination to all HCWs and offered an appointment for vaccination. SARS-CoV-2 vaccination was also offered. In 2022–2023, 43.16 % of HCWs were vaccinated against influenza and 21.87 % against SARS-CoV-2. Coverage changed during the 2023–2024 season to 54.11 % and 13.58 %, respectively. A regression model showed that vaccination uptake’s increase was associated with the e-mail reception and with the operator being a physician vs. non-medical personnel. On the contrary, subjects who received the e-mail did not show an increased SARS-CoV-2 vaccination uptake, which was on the contrary influenced by the worker’s age, sex, job title, and area of risk. Our soft-mandate intervention was effective in increasing vaccination uptake by HCWs. Communication with a trained specialist was probably useful, and the possibility to access vaccination services with dedicated appointments increased convenience. Mandatory vaccination policies and active recall seem to synergically impact vaccination uptake.