Occup Environ Med 69:230-235 doi:10.1136/oemed-2011-100134
  • Review

Predictors of seasonal influenza vaccination among healthcare workers in hospitals: a descriptive meta-analysis

Press Release
  1. Eelko Hak1,2
  1. 1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands
  2. 2Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
  1. Correspondence to Josien Riphagen-Dalhuisen, University of Groningen, Department of Pharmacy, Division of Pharmacoepidemiology and Pharmacoeconomics, PO Box XB45, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; j.riphagen{at}
  1. Contributors JRD and GG contributed equally to this work. JRD and GG designed the study, developed the search strategy, abstracted and analysed the data and drafted the report. JRD and GG take full responsibility for the data analysis. EH obtained funding, initiated the study and supervised the data analysis and writing of the report.

  • Accepted 2 November 2011
  • Published Online First 15 December 2011


Objective Vaccinating healthcare workers (HCWs) against influenza is one of the most important methods of decreasing influenza transmission among at-risk patients in healthcare facilities. However, despite recommendations, the rate of uptake of influenza vaccine among HCWs remains low. The objective of this meta-analysis was to determine the most important predictors of seasonal influenza vaccine acceptance among HCWs in hospitals.

Method A literature search of PubMed and Embase resulted in 4586 hits. Screening of the titles, abstracts and full text identified 13 studies eligible for inclusion in the meta-analysis. Based on the crude data, pooled risk ratios (Mantel-Haenszel risk ratios, mhRR) and their 95% CIs were calculated using Mantel-Haenszel analysis to estimate the associations of predictors with influenza vaccination status.

Results and conclusion Knowing that the vaccine is effective (mhRR 2.22; 95% CI 1.93 to 2.54), being willing to prevent influenza transmission (mhRR 2.31; 95% CI 1.97 to 2.70), believing that influenza is highly contagious (RR 2.25; 95% CI 1.66 to 3.05), believing that influenza prevention is important (mhRR 3.63; 95% CI 2.87 to 4.59) and having a family that is usually vaccinated (RR 2.32; 95% CI 1.64 to 3.28) were statistically significantly associated with a twofold higher vaccine uptake. We therefore recommend targeting these predictors when developing new influenza vaccination implementation strategies for hospital HCWs.


  • Funding The Netherlands Organization for Health Care (ZONMW) sponsored this study (grant number 125030012).

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.