Influence of the COVID-19 Pandemic on Influenza and SARS-CoV-2 Vaccination Willingness Among Dutch Nursing Home Health Care Workers.

Abstract

Objectives: To explore the influenza and COVID-19 vaccination status among Dutch nursing home (NH) health care workers (HCWs), factors associated with vaccination including the influence of the pandemic, and the facilitators and barriers to vaccination willingness.

Design: An explanatory sequential mixed methods study.

Setting and participants: HCWs providing direct care to residents in Dutch NHs.

Methods: An online questionnaire (September 2022) assessed vaccination status, barriers to vaccination, and the influence of the pandemic on influenza vaccination willingness. Facilitators and barriers to vaccination willingness were identified in 10 semistructured interviews and 1 focus group (February and September 2023).

Results: A total of 298 HCWs completed the questionnaire (87.5% women, 43.5% > 50 years of age). Nearly all HCWs (94.0%) received the primary COVID-19 vaccination(s). Influenza vaccination coverage was 41.7% prepandemic, 56.4% in 2021-2022, and 54.7% of the HCWs intended to receive an influenza vaccination in 2022-2023. Perceived urgency was identified as an important reason for the increased influenza vaccination coverage during the pandemic and for the difference between COVID-19 and influenza vaccination willingness. We identified knowledge gaps and (dis-)beliefs regarding vaccine efficacy, the role of preventive measures, and the role of the own immune system. Facilitators to vaccination willingness included addressing practical issues (eg, flexible scheduling, on-site vaccine provision).

Conclusions and implications: The influence of the pandemic on influenza vaccination willingness among Dutch NH HCWs appears to be temporary, underscoring the importance of addressing practical barriers to vaccine access. Concerns about the added value of vaccinations relative to trust in one's immune system or health and other preventive measures should be addressed in strategies aimed at optimizing vaccination uptake. To achieve this, a foundation of trust must first be created by neutral and factual communication and education.