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Prev Med. 2013 Sep;57(3):206-11. doi: 10.1016/j.ypmed.2013.05.021. Epub 2013 Jun 1.

Trends in influenza vaccine coverage among primary healthcare workers in Spain, 2008-2011.

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Instituto de Salud Pública de Navarra, Pamplona, Spain.



To evaluate trends in seasonal influenza vaccination coverage in primary healthcare workers (PHCWs) in Spain between 2008 and 2011.


We made an anonymous web survey of PHCWs in 2012. Information on attitudes towards and knowledge of influenza vaccine, and immunization in previous seasons was collected. Self-reported vaccination coverage and factors related to vaccination continuity were analysed.


Of 5433 workers contacted, 2625 (48.3%) responded to the survey: 47.0% were general practitioners, 10.3% paediatricians and 42.7% nurses. Their reported vaccination rates from seasons 2008-2009 to 2011-2012 decreased over time: 58.4%, 57.4%, 53.2% and 49.3% (linear trend, p < 0.001). Among workers vaccinated in any previous season, 70.2% were vaccinated again in 2011-2012, compared with 5.2% among those not previously vaccinated (p < 0.001). Continuity of vaccination increased with age and with the worker or cohabitant having a major chronic condition. Vaccination was higher in workers who recognized vaccination as effective and those worried about being infected or infecting patients.


Influenza vaccination coverage in PHCWs has declined, especially after the pandemic. Intensive interventions are needed to change this trend. Knowledge of vaccination should be reinforced by stressing the effectiveness of the vaccine and the risks of influenza for workers and patients.


Healthcare workers; Influenza vaccination; Pandemic influenza; Primary health care; Vaccine coverage

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