Background and Objective:
In Europe there is still a suboptimal Tdap (Tetanus, diphtheria, acellular pertussis) booster coverage, which might explain the increased incidence of Pertussis and, specifically in Italy, the relatively large proportion of Tetanus cases diagnosed. The aim of this study was to assess coverage status, knowledge, and attitudes on Tdap vaccination in health workers (HCWs) at the University Hospital “Federico II” in Naples, South of Italy, in 2022, to improve current vaccination strategies.

Methods:
A cross-sectional study was conducted using a validated anonymous questionnaire. Knowledge and attitude were measured as scores (1-30). Multivariable logistic and linear regression models were employed to identify correlates of Tdap booster and knowledge and attitude towards the vaccination, as appropriate. Models were controlled for age, sex, job, Department, and years of employment.

Results:
206 questionnaires were administered among HCWs,143 (69.4%) were medical doctors. 71 (34,47%) HCWs received the Tdap booster. Those who had worked 5-9 years at the hospital had a 78% lower likelihood of being vaccinated with the Tdap booster (5-9 years - OR: 0.22, CI: 0.06 | 0.85) as compared with newly hired HCWs. No other variable was significant in the model. Medical doctors had a greater attitude towards vaccination than non-medical HCWs (Other - Coef. -2.15 on 30; CI: -4.14 | -0.15). Compared with HCWs in clinical departments, those in diagnostic-therapeutic and public health organizational departments considered vaccination less useful as prevention tool (diagnostic-therapeutic - Coef. -3.12 on 30, CI: -5.13 | -1.12; public health – Coef. -1.98 on 30, CI: - 3.41 | -0.56).

Conclusion:
The study findings support the need to implement public health strategies to improve information and awareness toward vaccinations, and specifically the highlight importance of Tdap booster every 10 years as prevention tool to protect high-risk populations.