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

Lisa M Kolodziej; Kelly C Paap; Laura W van Buul; Sacha D Kuil; Cees M P M Hertogh; Menno D de Jong

doi:10.1016/j.jamda.2024.105420

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

J Am Med Dir Assoc. 2024 Dec 27;26(2):105420. doi: 10.1016/j.jamda.2024.105420. Online ahead of print.

Authors

Lisa M Kolodziej¹, Kelly C Paap², Laura W van Buul², Sacha D Kuil³, Cees M P M Hertogh², Menno D de Jong⁴

Affiliations

¹ Amsterdam UMC Location University of Amsterdam, Medical Microbiology and Infection Prevention, Amsterdam, the Netherlands; Amsterdam institute for Immunology and Infectious Diseases, Infectious Diseases, Amsterdam, the Netherlands; Amsterdam Public Health, Aging & Later Life, Amsterdam, the Netherlands. Electronic address: l.m.kolodziej@amsterdamumc.nl.
² Amsterdam Public Health, Aging & Later Life, Amsterdam, the Netherlands; Amsterdam UMC Location Vrije Universiteit Amsterdam, Medicine for Older People, Amsterdam, the Netherlands.
³ Amsterdam UMC Location University of Amsterdam, Medical Microbiology and Infection Prevention, Amsterdam, the Netherlands; Amsterdam institute for Immunology and Infectious Diseases, Infectious Diseases, Amsterdam, the Netherlands; Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands.
⁴ Amsterdam UMC Location University of Amsterdam, Medical Microbiology and Infection Prevention, Amsterdam, the Netherlands; Amsterdam institute for Immunology and Infectious Diseases, Infectious Diseases, Amsterdam, the Netherlands.

PMID: 39706577
DOI: 10.1016/j.jamda.2024.105420

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% aged > 50 years). 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.

Keywords: COVID-19; Vaccination coverage; health personnel; human; influenza; nursing homes; vaccination hesitancy.