Abstract

Objective: Vaccinating healthcare workers (HCWs) is a fundamental strategy to protect them from occupational exposure risks and the potential for transmission of infectious diseases to susceptible patients. This study aimed to evaluate HCWs’ vaccination status after periodic occupational health screenings in a tertiary healthcare facility, identify risk groups for pneumococcal disease, influenza, and hepatitis A, and determine potential missed vaccination opportunities.

Methods: This retrospective cross-sectional study reviewed records of HCWs who underwent periodic occupational health screening at a tertiary healthcare facility between January 1, 2016, and January 1, 2026. Only the most recent record was analyzed for HCWs with multiple screening records, resulting in a total of 775 HCWs being evaluated. Demographic characteristics, comorbidities, serological status, and vaccination records were assessed. Risk groups for pneumococcal disease, influenza, and hepatitis A were identified based on current guidelines. A potential missed vaccination opportunity was defined as a situation in which an HCW had an indication for vaccination and presented to the occupational health unit, but the screening records contained no documentation that the vaccine had been recommended, administered, or declined.

Results: The mean age of participants was 37.1±9.9 years, with 70.8% being female. Anti-HBs positivity was observed in 693 (89.4%) HCWs. Of the 158 HCWs susceptible to hepatitis A, 60 (38%) had received vaccination. Immunity to hepatitis A and hepatitis B varied significantly across occupational groups. Anti-HBs seronegativity was 4.3% among nurses, compared to 23% among secretaries and 20.8% among cleaning personnel. The proportions of anti-HAV-negative and unvaccinated HCWs were 17% among physicians and 15.6% among nurses. Seronegativity rates were 11.1% for measles, 4% for rubella, 5.5% for mumps, and 2.8% for varicella. Among 126 HCWs with an indication for pneumococcal vaccination, only 10 (7.9%) had been vaccinated, indicating a potential unmet vaccination need of 92.1%. Among HCWs in risk groups due to chronic disease or age, 18.2% had received influenza vaccination. The influenza vaccination rate among all HCWs during the 2025 season was 1.6%, indicating a potential unmet vaccination need of 98.4%.

Conclusion: A substantial immunization gap was identified among HCWs, particularly for pneumococcal and influenza vaccines. The difference between hepatitis B immunity and other adult vaccinations highlights the importance of institutional monitoring and guidance. Using occupational health screenings as an opportunity to systematically assess immunization and strengthen adult vaccination strategies at the institutional level may help protect HCWs and prevent healthcare-associated transmission.