Influenza vaccination uptake among public primary healthcare workers in Seberang Perai Tengah district, Penang

Influenza poses a significant public health burden globally, contributing to substantial morbidity and mortality, particularly among vulnerable populations. Healthcare workers (HCWs) are at increased risk of contracting and transmitting influenza, making vaccination a key preventive strategy. Despite the well-established benefits and strong recommendations advocating influenza vaccination for all HCWs, only a few studies have examined vaccination uptake among HCWs in Malaysia. This study aimed to determine the prevalence of influenza vaccination among public primary HCWs in Seberang Perai Tengah district, Penang, reasons for vaccination or non- vaccination and to identify its associated factors.

A cross-sectional study was conducted from January to March 2025 inviting all HCWs from nine health clinics and six dental clinics in the district. Data for socio-demography, work-related characteristics, history of influenza vaccination, reason to vaccinate or nonvaccination for influenza, knowledge and attitude towards influenza and its vaccination were collected using a validated self-administered questionnaire in a Google form. Knowledge and attitudes towards influenza and its vaccination were assessed using an 18-item questionnaire on a five-point Likert scale. A higher score for each component, knowledge (0-15) and attitude (0-3), indicates better knowledge and more positive attitudes, respectively. Descriptive statistics were used for demographic data and prevalence. Multiple logistic regression was performed to identify factors associated with vaccination uptake.

A total of 359 HCWs participated. The participants had a mean age of 37.9 years (SD=7.09), with females comprising 77.7% of the sample. Nurses represented the largest proportion (33.7%), followed by assistant or aide (24.2%), and doctors (11.7%). The prevalence of influenza vaccination uptake was 97%, with only 12 participants reported never being vaccinated. The primary reasons for vaccination were self-protection (94.2%), followed by protecting family and friends (70.9%) and the availability of free vaccination at work (50.7%). Among the unvaccinated participants, 58.3% expressed concerns about side effects and 25% stated reasons for fear of getting sick from the vaccine and personal reluctance. Multiple logistic regression revealed that the attitude score was significantly associated with influenza vaccination uptake (Adjusted OR: 2.12, 95% CI: 1.30-3.44, p=0.002). Vaccinated participants had a higher median knowledge score (11.0, IQR 4.00), and attitude score (3.0, IQR 1.00) compared to non-vaccinated participants suggesting better knowledge and attitude towards influenza or its vaccinations. While most participants held positive views, misconceptions persisted; 30.4% believed the vaccine might cause influenza, and 39.3% believed influenza could be transmitted via blood.

The high vaccination rate reflects strong acceptance and awareness among HCWs. Misconceptions regarding vaccine safety persist, and necessitate targeted educational efforts. Although high uptake suggests favourable attitudes, further longitudinal studies are needed to explore motivational factors and causality more definitely. Targeted education can address misconceptions and side effects, supporting sustained high vaccination rates and reducing hesitancy.