Predictors of Influenza Vaccination Uptake and the Role of Health Literacy among Health and Social Care Volunteers in the Province of Prato (Italy)

: Annual influenza vaccination is recommended for volunteers involved in primary health and social services. Little is known about the volunteers' adhesion to influenza vaccination recommendations. The aim of this study was to assess influenza vaccination determinants among a group of volunteers who provided essential activities during the first SARS-CoV-2 pandemic wave in the province of Prato, Tuscany (Italy) and to evaluate the role of health literacy in influencing vaccination determinants. Method: In this cross-sectional study, the predictors of influenza vaccination uptake were assessed through the administration of a questionnaire. Variables significantly associated with influenza vaccination uptake were included in five multivariate logistic regression models through a backward stepwise procedure. Results: Among the 502 enrolled volunteers, 24.3% reported being vaccinated in the 2019-2020 season. Vaccination uptake was 48.8% in participants aged 65 years or older and 15.7% in those aged 64 years or younger. Considering the whole sample in the final model of multivariate logistic regression analysis, the predictors of influenza vaccination uptake were age (OR = 1.05; 95% CI = 1.03-1.07), presence of heart diseases (OR = 2.98; 95% CI = 1.24-7.19), pulmonary diseases (OR = 6.18; 95% CI = 2.01-19.04) and having undergone surgery under general anesthesia in the prior year (OR = 3.14; 95% CI = 1.23-8.06). In the multivariate model considering only participants with a sufficient level of health literacy (HL), none of these predictors resulted in significant associations with vaccination uptake, except for age (OR= 1.04; 95% CI = 1.02-1.07). Conclusions: Our findings revealed a very low influenza vaccination uptake among volunteers, suggesting the need to increase awareness in this at-risk group by means of a better communication approach.