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November 4, 2025Influenza and Other Respiratory Viruses2 citationsOpen Access

Healthcare Workers From Two Sites in China in 2018–2019 Unlikely to Receive and Recommend Influenza Vaccination: A Qualitative Study Following a Quantitative Analysis to Improve Future Interventions

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JFJing FanRZRan ZhangQZQianyue Zhang

Key Points

  • Vaccination coverage remains low among healthcare workers despite knowledge of influenza infection.
  • Healthcare workers reported significant concerns about adverse events and cost-effectiveness of vaccination.
  • Qualitative analysis through focus groups highlighted critical barriers to recommending influenza vaccination.
  • Interventions that include employer requirements for vaccination may improve healthcare workers' recommendations.

Abstract

ABSTRACT Background The proportion of healthcare workers (HCWs) who receive and recommend seasonal influenza vaccination to their patients remains low in China. This study aims to understand why HCWs infrequently use and recommend the influenza vaccine and how to improve utilization. Methods A cross‐sectional questionnaire survey and a focus group interview were conducted among primary HCWs in Hubei Province in September 2018 and May 2019. We analyzed qualitative data using descriptive methods and a general inductive approach following a quantitative analysis. In addition, we used the Health Belief Model (HBM) framework to summarize predictors of HCW vaccination and recommendation. Results Primary HCWs acquired basic knowledge about influenza infection and vaccination and were less likely to receive and recommend influenza vaccination. However, from the focus group, HCWs reported influenza was a mild disease and would not recommend vaccination for patients who looked healthy. HCWs raised concerns about adverse events, cost‐effectiveness, and contraindications to influenza vaccination. HCWs reported, “I would be more likely to recommend vaccination if my employer required that I do so.” Conclusions Health education materials for HCWs could be improved by providing scientific evidence on the burden of influenza disease, the benefits of vaccination, and national and international policies on influenza vaccination. In addition, interventions that may improve influenza vaccination coverage include workplace requirements for influenza vaccination of HCWs and requirements for HCWs to recommend influenza vaccination to high‐risk groups in addition to providing no‐cost and on‐site vaccination.

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Cite This Study

Fan et al. (2025) studied this question.

synapsesocial.com/papers/690945348f2297dc13532f96https://doi.org/10.1111/irv.70157
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