Attitudes, Motivation, and Predictors of Influenza Vaccination Uptake Among Primary Healthcare Professionals in Greece

Background: Influenza vaccination uptake among healthcare professionals remains subop-timal despite their key role in influencing public vaccination behavior. This study investi-gated motivational and behavioral determinants of influenza vaccination uptake and ad-vocacy among primary healthcare professionals in Greece. Methods: A cross-sectional study was conducted among 304 physicians and pharmacists using an anonymous online questionnaire. Vaccination uptake (2023–2024 season and annual) and motivational and advocacy constructs were assessed using the validated MoVac-flu and MovAd scales. Factor structure was evaluated using confirmatory and ex-ploratory factor analyses. Multivariable logistic regression models were applied to identify predictors of vaccination uptake. Results: The study sample consisted of 304 healthcare professionals of whom 61.2% were physicians and 38.8% were pharmacists. Most of the participants were female (52.6%) and aged 41-60 years (57.6%). Influenza vaccination uptake was 77.6% for the 2023–2024 sea-son and 75.3% for annual vaccination. A two- and a four-factor structure was found for the MoVac-flu (F1: Vax Self-Care, F2: Vax Awareness) and MoVAd (F1: Vax Communica-tion, F2: Vax Influence, F3: Vax Confidence, F4: Vax Choice) scales, respectively. Both scales demonstrated high internal consistency (Cronbach’s alpha coefficient > 0.87). Mo-tivation toward influenza vaccination and vaccination advocacy were high among the participants. Vaccinated participants had higher motivation and advocacy scores than non-vaccinated ones. In multivariable analyses, higher scores on Vax Self-Care (aOR = 3.22, 95% CI: 2.08-4.96, p < 0.001) and Vax Communication (aOR = 1.64, 95% CI: 1.14-2.34, p = 0.007) subscales, demonstrating enhanced motivation and advocacy, respectively, as well as male sex (aOR = 2.35, 95% CI: 1.14-4.83, p = 0.020) were associated with higher odds of annual vaccination. Higher scores on the Vax Self-Care subscale (aOR = 3.66, 95% CI: 2.33-5.77, p < 0.001) were also found to be associated with higher odds of 2023–2024 vaccination uptake, as well as living with vulnerable individuals (aOR = 2.95, 95% CI: 1.18-7.38, p = 0.020) Conclusions: Influenza vaccination uptake among primary healthcare professionals in Greece was relatively high; however, it was strongly driven by intrinsic motivational fac-tors, particularly the perceived personal and public health benefits of vaccination. Com-munication-related competencies also independently contributed to vaccination behavior, highlighting the link between professional practice and personal uptake. In contrast, con-textual factors, such as cohabitation with vulnerable individuals, appeared to exert a more situational and less consistent influence. These findings suggest that interventions focus-ing on strengthening intrinsic motivation and communication skills may lead to more sustained improvements in both vaccination uptake and advocacy among healthcare professionals.