Influenza Vaccine Acceptance, Hesitancy, and Their Psychological Determinants Among Healthcare Workers in a Malaysian Public Hospital

Abstract

Introduction:
Healthcare workers (HCWs) are potential vectors for nosocomial influenza transmission, which can adversely affect vulnerable populations. Influenza vaccination among HCWs is therefore vital for effective infection control. This study aimed to assess influenza vaccine acceptance and hesitancy among HCWs and to identify sociodemographic and psychological determinants influencing vaccine acceptance using the 5C model.

Methods:
A cross-sectional survey was conducted at Balik Pulau Hospital (BPH) from July 1 to October 31, 2023. Eligible HCWs who understood English or Malay and were able to provide a written informed consent were included. Sociodemographic characteristics, psychological determinants, and vaccine acceptance were summarised descriptively. Multiple logistic regression was performed to examine the associations between sociodemographic variables and the psychological determinants in the 5C model—confidence, complacency, constraints, calculation, and collective responsibility—in relation to influenza vaccine acceptance.

Results:
Among the 203 HCWs surveyed, 87.2% expressed acceptance of receiving the influenza vaccine. Confidence in the influenza vaccine was the only significant predictor of acceptance (adjusted OR=1.67; 95% CI: 1.23-2.27; P=0.001), while sociodemographic variables—including age, gender, religion, profession, and education level—were not significantly associated with vaccine acceptance.

Conclusion:
High influenza vaccine acceptance among HCWs at BPH was primarily driven by strong confidence in the vaccine. Most respondents perceived the vaccine as safe, effective, and compatible with their religious beliefs. Enhancing education and trust towards vaccines may further improve uptake and strengthen public health initiatives.