Sociodemographic and Occupational Factors Associated With Coronavirus Disease 2019 Vaccine and Influenza Vaccine Uptake Among Healthcare Workers, in Albania, 2022-2023: A Multicenter Study

Anisa Xhaferi; Silvia Bino; Rovena Daja; Adela Vasili; Jonilda Sulo; Nana Mebonia; Earta Ndreu; Miljana Nika; Nadire Jani; Ermiona Dabaj; Nensi Sustarova; Anila Moçi; Dorina Toçi; Albana Fico; Eugena Tomini; Sara Robinson; Pernille Jorgensen; Mark A Katz

doi:10.1093/cid/ciaf202

Sociodemographic and Occupational Factors Associated With Coronavirus Disease 2019 Vaccine and Influenza Vaccine Uptake Among Healthcare Workers, in Albania, 2022-2023: A Multicenter Study

Clin Infect Dis. 2025 Jun 3:ciaf202. doi: 10.1093/cid/ciaf202. Online ahead of print.

Authors

Anisa Xhaferi^{1

2}, Silvia Bino^{1

3

4}, Rovena Daja¹, Adela Vasili¹, Jonilda Sulo^{1

2

4}, Nana Mebonia⁵, Earta Ndreu⁴, Miljana Nika⁶, Nadire Jani⁷, Ermiona Dabaj⁷, Nensi Sustarova⁷, Anila Moçi⁸, Dorina Toçi¹, Albana Fico^{3

6}, Eugena Tomini^{1

3}, Sara Robinson⁹, Pernille Jorgensen¹⁰, Mark A Katz¹⁰

Affiliations

¹ Institute of Public Health, Tirana, Albania.
² Mediterranean and Black Sea Programme in Intervention Epidemiology Training (MediPIET), European Centre for Disease Prevention and Control (ECDC) fellow, Stockholm, Sweden.
³ University of Medicine, Tirana; Tirana, Albania.
⁴ South East European Center for Infectious Diseases Surveillance and Control, Tirana, Albania.
⁵ European Center for Disease Prevention and Control, Stockholm, Sweden.
⁶ Mother Teresa University Hospital Tirana, Albania.
⁷ Regional Hospital of Durres, Albania.
⁸ Regional Hospital of Fier, Albania.
⁹ Maine Department of Health and Human Services, USA.
¹⁰ World Health Organization, Regional Office for Europe, Copenhagen, Denmark.

PMID: 40459287
DOI: 10.1093/cid/ciaf202

Abstract

Background: Healthcare workers (HCWs) are a priority group for coronavirus disease 2019 (COVID-19) and influenza vaccination. We evaluated sociodemographic and occupational factors, attitudes, and knowledge associated with the uptake of primary and booster doses of COVID-19 and seasonal influenza vaccines among HCWs.

Methods: Between February 2022 and February 2023, we administered a structured questionnaire to HCWs in 3 Albanian hospitals who were enrolled in a multiyear cohort study. The questionnaire assessed participants' knowledge, confidence, and attitudes toward COVID-19 and seasonal influenza vaccines, and included questions on COVID-19 and influenza vaccination history, perceptions of vaccine safety and effectiveness, and factors influencing vaccine decision-making.

Results: We included 1456 HCWs. Their median age was 44 (interquartile range: 33-53) and 77.3% were female. Overall, 20.7% were physicians, 47.0% nurses or midwives, and 21.5% support staff. In all, 93.6% received a COVID-19 primary vaccine series, 20% a COVID-19 booster, and 23.7% received an influenza vaccine in the 2022-2023 season. In the multivariable analysis, male HCWs were more likely to receive COVID-19 boosters (adjusted odds ratio [aOR] 2.08; 95% confidence interval [CI]: 1.55-2.80). However, they were less likely to receive influenza vaccines (aOR 0.69; 95% CI: .51-.95). Medical doctors were more likely to receive COVID-19 vaccine doses, while nurses had higher uptake of the influenza vaccine (aOR 1.87; 95% CI: 1.30-2.68). Confidence in the safety and effectivity of both vaccines was positively associated with vaccine uptake.

Conclusions: Among HCWs, primary series COVID-19 vaccine coverage was high, but COVID-19 booster doses and seasonal influenza vaccines were low. Findings related to age and sex differences among HCW groups with low vaccine uptake, as well as their knowledge and attitudes toward vaccines, should inform targeted strategies to improve COVID-19 and influenza vaccine uptake, particularly among younger HCWs, female HCWs, and nonphysicians.

Keywords: Albania; COVID-19; health care workers; influenza; vaccination.

Abstract

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