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Effect of Community-Based Influenza Vaccination on Influenza Vaccination Uptake among Healthcare Workers in Nigeria

Abstract

Influenza remains an important occupational and public health concern among healthcare workers because of their frequent exposure to patients with respiratory infections and their potential role in transmitting influenza within healthcare facilities and the wider community. Influenza infection among healthcare workers may contribute to staff absenteeism, reduced workforce availability, disruption of healthcare services, and transmission to vulnerable patients. Annual influenza vaccination is an important preventive measure for reducing the risk of influenza infection and transmission. However, influenza vaccination uptake among healthcare workers in Nigeria may be limited by inadequate vaccine availability, cost, low awareness of vaccination benefits, concerns about vaccine safety and effectiveness, inconvenient vaccination schedules, limited access to vaccination points, and competing work responsibilities. Community-based influenza vaccination services may improve access by bringing vaccination closer to healthcare workers through outreach sessions, workplace vaccination activities, mobile vaccination teams, community vaccination points, and other convenient delivery approaches. Against this background, this study investigates the effect of community-based influenza vaccination on influenza vaccination uptake among healthcare workers in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Andersen's Behavioral Model of Health Services Use. The Health Belief Model explains how healthcare workers' perceptions of susceptibility to influenza, perceived severity, perceived benefits of vaccination, perceived barriers, self-efficacy, and cues to action may influence vaccination decisions. The Social Ecological Model emphasizes the interaction between individual, interpersonal, organizational, community, and broader health-system factors in determining vaccination behaviour. Andersen's Behavioral Model explains healthcare utilization through predisposing, enabling, and need factors, with community-based vaccination services serving as an enabling factor that may improve access and convenience. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based influenza vaccination may influence vaccination uptake among healthcare workers in Nigeria. The study will adopt a quantitative quasi-experimental or analytical comparative research design. The study population will comprise healthcare workers employed in selected public and private hospitals, primary healthcare centres, clinics, and other healthcare facilities in Nigeria. A multistage sampling technique will be used to select states, local government areas, healthcare facilities, departments, and eligible healthcare workers. Community-based influenza vaccination will be assessed using indicators such as availability of outreach vaccination services, frequency of vaccination sessions, accessibility of vaccination points, workplace or community vaccination activities, mobile vaccination services, vaccination campaign intensity, vaccine availability, convenience of vaccination schedules, vaccination education, counselling, reminders, trained vaccination personnel, and follow-up activities. Influenza vaccination uptake will be assessed using indicators such as receipt of influenza vaccination within the recommended vaccination period, vaccination status, completion of annual vaccination, intention to receive future vaccination, documented vaccination history, time from vaccination offer to uptake, and reasons for accepting or declining vaccination. Data will be collected using structured questionnaires, vaccination registers, healthcare worker records, occupational health records, vaccination cards or certificates where available, and programme monitoring documents. Descriptive statistics will be used to summarize healthcare workers' demographic and occupational characteristics, exposure to community-based vaccination, vaccine availability, and vaccination uptake patterns. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of community-based influenza vaccination on vaccination uptake. Where a quasi-experimental design is adopted, vaccination uptake before and after implementation of community-based vaccination activities may be compared, or uptake among healthcare workers with access to outreach vaccination may be compared with those receiving conventional vaccination services. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that community-based influenza vaccination has a significant positive effect on influenza vaccination uptake among healthcare workers in Nigeria. Healthcare workers who have convenient access to community or workplace-based vaccination services are expected to demonstrate higher vaccination uptake than those who must seek vaccination through less accessible conventional services. Bringing vaccination closer to healthcare workers may reduce time constraints, transportation barriers, inconvenience, and missed opportunities for vaccination. Education, counselling, reminders, and direct vaccination opportunities may further improve awareness and encourage healthcare workers to receive annual influenza vaccination. However, inadequate vaccine supply, cost, limited awareness, concerns about vaccine safety or effectiveness, high workloads, inconvenient vaccination schedules, weak occupational health programmes, and inconsistent outreach activities may reduce uptake. The study therefore expects accessible, convenient, adequately supplied, and well-organized community-based influenza vaccination services to contribute significantly to improved influenza vaccination uptake among healthcare workers in Nigeria. The study is expected to contribute to the literature on influenza vaccination, community-based vaccination, healthcare worker immunization, occupational health, vaccine uptake, infectious disease prevention, healthcare-associated infection prevention, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention, National Primary Health Care Development Agency, state ministries of health, hospitals, primary healthcare facilities, occupational health departments, immunization programme managers, healthcare worker organizations, development partners, and policymakers regarding strategies for improving influenza vaccination coverage among healthcare personnel. The study will also provide evidence-based recommendations for expanding workplace and community-based influenza vaccination programmes, ensuring adequate vaccine availability, strengthening healthcare worker education, implementing reminder and recall systems, integrating influenza vaccination into occupational health services, improving vaccination accessibility, addressing vaccine concerns, and establishing routine monitoring of influenza vaccination uptake among healthcare workers across Nigeria.

Keywords: Community-based influenza vaccination, influenza vaccination uptake, healthcare workers, influenza, occupational health, vaccine uptake, immunization services, infectious disease prevention, workplace vaccination, Nigeria, public health.