Flu Shots Unveiled: A Global Systematic Review of Healthcare Providers' Uptake of, Perceptions, and Attitudes toward Influenza Vaccination

Background and purpose: Influenza, with its potential for widespread transmission and significant health repercussions for individuals and populations, demands the immediate implementation of effective preventive measures. Vaccination stands as a long-standing evidence-based strategic approach to bolster immunity, especially for healthcare providers at heightened risk due to repeated exposure. Nevertheless, studies indicate a variance in adherence to recommended vaccination protocols and a notable prevalence of hesitancy and negative attitudes toward influenza vaccination among this critical group globally. Recognizing the multifaceted nature of attitudes is essential for the development of targeted interventions and strategies tailored to address the specific concerns and motivations of healthcare providers. To this end, this study synthesized the evidence gathered from an exhaustive systematic review of studies on healthcare providers' uptake of and perceptions and attitudes toward influenza vaccination.

Methods: A systematic literature search was conducted across the databases PubMed, CINAHL, PsycINFO, Scopus, Web of Science, and EMBASE. The review adhered to PRISMA guidelines, using Covidence for screening. The process involved 4970 references, with 2684 screened after duplicate removals and 1891 excluded, leaving 793 full texts evaluated, resulting in a final 368 selected references for analysis. Due to the considerable heterogeneity observed among the studies, a narrative synthesis method was employed.

Results: Five themes emerged from the systematic review's analysis, offering a multifaceted perspective on healthcare providers' attitudes toward influenza vaccination: (1) fostering positive views: factors promoting attitudes toward influenza vaccines; (2) navigating hesitancy: barriers and challenges to attitudes on influenza vaccines; (3) empowering change: interventions and their impact on healthcare providers' attitudes; (4) pandemic overlap: intersecting attitudes toward influenza and COVID-19 vaccines; and (5) twin challenges: the impact of mandatory policy on attitudes and influenza vaccination.

Conclusions: Healthcare providers' attitudes toward influenza vaccination are complex and influenced by intrinsic and extrinsic motivations, barriers, demographics, organizational factors, interventions, pandemic contexts, and policy considerations. Effective strategies for promoting influenza vaccination should be multifaceted, adaptable, and tailored to address these interconnected aspects, ultimately contributing to improved vaccination rates and public health outcomes.