Organisational strategies linked to high influenza vaccination uptake among health workers in Madrid

Background

Influenza vaccination uptake among healthcare workers (HCWs) remains suboptimal despite its importance for patient safety and workforce protection. Evidence on effective organisational strategies in Spain is limited. This study aimed to identify successful practices in centres with medium–high uptake in Madrid and assess their transferability.

Methods

A qualitative descriptive study was conducted using semi-structured interviews. Six centres (three hospitals, three primary care) from the Regional Health Service with medium–high uptake (2023–2025) were purposively selected (42.2%–63.8% hospitals; 51.0%–63.8% primary care). Twenty key informants were interviewed (11 hospital-based, 9 primary care). Interviews were audio-recorded, transcribed verbatim and analysed using an inductive–deductive thematic approach supported by Atlas.ti.

Results

Successful practices were consistently linked to combined organisational strategies rather than isolated actions. Accessibility was central, enabled by walk-in vaccination, mobile teams and flexible schedules. Institutional leadership and visible role modelling reinforced uptake, while local champions facilitated peer influence and informal diffusion. Continuous, peer-based communication contributed to normalising vaccination behaviour, and integration into routine workflows reduced structural barriers. In hospitals, additional factors included multichannel communication (intranet, SMS), real-time feedback (“vaccinometers”) and symbolic incentives. Training and early engagement of residents supported sustainability.

Conclusions

High influenza vaccination uptake among HCWs is driven by accessibility, organisational culture and leadership. Transferable actions include on-site and mobile vaccination, continuous communication, use of local champions and feedback of coverage data. These findings support system-level interventions to strengthen vaccination programmes.

Key messages

• High influenza vaccination uptake among healthcare workers is driven by accessibility, leadership, and organisational culture rather than single interventions.

• Simple, low-cost organisational strategies can be transferred across settings to improve vaccination coverage in healthcare systems.