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Expert Rev Vaccines . Differing influenza vaccine uptake and recommendation behavior among healthcare workers in primary health centers, secondary and

tetano

Editor, Senior Moderator
Expert Rev Vaccines

. 2026 Dec;25(1):2736329.
doi: 10.1080/14760584.2026.2736329. Epub 2026 Sep 23.

Differing influenza vaccine uptake and recommendation behavior among healthcare workers in primary health centers, secondary and tertiary hospitals, and schools in a metropolis of southern China​


Dan'er Lin 1 , Xiangting Zhang 2 3 , Junxian Hu 1 , Xiaohua Li 1 , Lin Yao 1 , Jianyun Lu 1 , Zhiyun Wang 1 , Yanfang Chen 1 , Yihan Lu 2 3

Affiliations

Free article

Abstract​


Background: Healthcare workers (HCWs) play a key role in recommending influenza vaccination. Few studies have examined HCWs' influenza vaccination and recommendation behavior in China.


Research design and methods: A cross-sectional survey was conducted among HCWs in primary health centers, secondary and tertiary hospitals, and schools in Guangzhou, China, in January 2026.


Results: Among 3,153 HCWs, 46.2% reported vaccination in at least one of latest four influenza seasons. Average seasonal uptake was 28.2%. Uptake varied by occupation, with higher uptake among public health practitioners (OR = 2.53, p < 0.001) and lower among school healthcare providers (OR = 0.64, p < 0.001), compared with physicians. Knowledge of influenza was negatively associated with vaccination (OR = 0.90, p < 0.001), whereas knowledge of influenza vaccines was positively associated with vaccination (OR = 1.09, p < 0.001) and recommendation behavior (OR = 1.11, p < 0.001). Personal vaccination was positively associated with recommendation behavior (OR = 3.12, p < 0.001). Exploratory generalized path analysis showed knowledge of influenza vaccines was positively associated with recommendation behavior (β = 0.131), mainly through recommendation attitude and personal vaccination, whereas opposite indirect pathways for knowledge of influenza resulted in no significant association.


Conclusions: Influenza vaccine uptake remained insufficient among HCWs. Different knowledge domains showed diverse association with vaccination and recommendation behavior. Vaccine-specific knowledge and risk-benefit perceptions were more consistently associated with HCWs' vaccination and recommendation practices.

Keywords: Healthcare workers; influenza vaccination; path analysis; recommendation behavior; vaccine uptake.
 
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