Abstract
Several vaccine preventable diseases (VPDs) occur in South Africa including influenza, COVID-19, measles, mumps, rubella, tuberculosis, whooping cough, tetanus, diphtheria, pertussis, meningitis, hepatitis, chickenpox, shingles, and human papilloma virus. The approximate number of healthcare workers (HCWs) that have been affected due to occupational exposure to VPDs in South Africa is unknow, save for the Corona virus disease 2019 (COVID-19). This study seeks to investigate knowledge, attitudes, and practices (KAP) towards occupational vaccination from selected HCWs.
The study design is observational, using a cross-sectional survey study design to study HCWs in Tshwane (11,288 HCWs in 205 facilities). Participants (HCWs) completed an online questionnaire, comprising close-ended questions. Using the StatCalc population survey method (Epi Info™ version 7.2.4.0) the study population was estimated to be 371 HCWs, with an additional 297 (80%) to compensate for a low response rate, to give a total of 668 HCWs. Thus, a non-probability voluntary response sampling was adopted due to the low response rate observed in previous studies. Data were coded, and a code book developed. Data were analysed with the Statistical Package for Social Sciences (SPSS) version 28.
A total of 149 responses were obtained, representing a response rate of only 1.3% out of all HCWs in Tshwane. The study participants were mostly female (93.3%), 30-49 years old, and of black ethnicity (68.5%). Just over half had obtained a diploma (53.0%), and most were nurses by occupation (77.2%). Almost all were operational in an urban area (98.7%), and most were employed in Tshwane region 6 (78.5%), in the private sector (96.6%), or in a private hospital (81.2%). Cronbach's alpha was used as the measure of internal consistency; regarding the attitude questions a moderate level of internal consistency (0.630) was obtained. Excluding the question on going to work when sick, the level of internal consistency increased to high (0.801). Regarding the practices questions a moderate internal consistency (0.633) was obtained, while for the vaccine hesitance questions a very low level (0.297) of internal consistency was obtained. The HCWs’ overall knowledge was 60.5% regarding occupational vaccinations, about which they had an overall positive attitude. Just over half (52.9%) had positive practices regarding to occupational vaccinations. Based on the answers on vaccine hesitance, in the survey, HCWs had low vaccine hesitance, and more HCWs would get vaccinated if their employers or the Department of Health provided and paid for their vaccines.
Although there was a very low response rate, the overall study findings were positive, indicating good knowledge, positive attitudes, and positive practices of HCWs in Tshwane pertaining to occupational vaccination. Vaccine hesitance was low but a comprehensive occupational vaccination guide for primary HCWs is suggested to better inform and guide HCWs. The system created by the National Department of Health, the Electronic Vaccination Data System (EVDS), to track COVID-19 vaccinations could be expanded to collect and analyse more data on HCWs’ vaccinations, as well as mortality and morbidity relating to VPDs. These data can inform policy and training for HCWs on occupational vaccinations.