{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T16:06:42Z","timestamp":1771949202988,"version":"3.50.1"},"reference-count":39,"publisher":"Mattioli1885","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,24]]},"abstract":"<jats:p>\u00a0 Backgrounds: Vaccination is a cornerstone of public health. While COVID-19 vaccination became globally prioritized during the pandemic, Hepatitis B immunization has remained a mandatory occupational requirement in Turkey, particularly among healthcare workers (HCWs). This study evaluated Hepatitis B immunization and factors associated with COVID-19 vaccination among Turkish HCWs. Methods: A retrospective cross-sectional study was conducted between February 1 and August 15, 2024, at Mersin City Training and Research Hospital. Employees and trainee students who underwent periodic health examinations were included. Participants were grouped as physicians, non-physician HCWs, and non-healthcare professionals. Data included demographics, vaccination history, hematological and biochemical parameters, and clinical characteristics. Logistic regression identified factors associated with COVID-19 vaccination status. Results: Of 4,048 participants, 92.1% received at least one COVID-19 vaccine dose and 90.0% were vaccinated against Hepatitis B. Physicians demonstrated the highest coverage for both vaccines. Male gender (OR=1.37, 95% CI: 1.04\u20131.80), non-physician HCW status (OR=2.51, 95% CI: 1.33\u20134.75), non-healthcare professional status (OR=2.99, 95% CI: 1.55\u20135.77), and behaviorally linked elevated platelet count (OR=1.54, 95% CI: 1.04\u20132.28) were independently associated with COVID-19 non-vaccination. A prior history of Hepatitis B vaccination showed a strong protective effect against COVID-19 non-vaccination (OR=0.30, 95% CI: 0.23\u20130.40). Conclusions: Vaccine uptake varied across occupational groups, with physicians achieving the highest rates. Prior compliance with mandatory Hepatitis B vaccination was positively associated with COVID-19 vaccine acceptance, emphasizing the role of previous immunization behavior in new vaccine adoption. Occupational health policies integrating vaccination counseling and follow-up are essential to improve coverage among non-physician HCWs. \u00a0<\/jats:p>","DOI":"10.23749\/mdl.2026.17965","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T15:41:21Z","timestamp":1771947681000},"page":"17965","source":"Crossref","is-referenced-by-count":0,"title":["Investigation of the Association Between COVID-19 and Hepatitis B Vaccination Among Healthcare Workers: A Cross-Sectional Study in Turkey"],"prefix":"10.23749","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7701-7826","authenticated-orcid":false,"given":"Seval M\u00fczeyyen","family":"Ecin","sequence":"first","affiliation":[{"name":"Clinic of Occupational Medicine and Internal Medicine, Mersin City Training and Research Hospital, Mersin, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9718-7769","authenticated-orcid":false,"given":"Abdulsamet","family":"Sandal","sequence":"first","affiliation":[{"name":"Clinic of Occupational Medicine, Ankara Gazi Mustafa Kemal Occupational and Environmental Diseases Hospital, Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"27750","reference":[{"key":"10.23749\/mdl.2026.17965_ref1","doi-asserted-by":"crossref","unstructured":"1- Tanriover MD, Alt\u0131nel S, Duman M, et al. Hepatitis B vaccination among internal medicine residents in Turkey: 90.5% coverage. J Hosp Infect. 2017;95(3):265\u2013268. Doi: 10.1016\/j.jhin.2016.12.002","DOI":"10.1016\/j.jhin.2016.12.002"},{"key":"10.23749\/mdl.2026.17965_ref2","unstructured":"2- World Health Organization. Global hepatitis report 2022. Geneva: World Health Organization; 2022."},{"key":"10.23749\/mdl.2026.17965_ref3","unstructured":"3- Republic of T\u00fcrkiye Ministry of Health. National Immunization Schedule. Ankara; 2023."},{"key":"10.23749\/mdl.2026.17965_ref4","doi-asserted-by":"crossref","unstructured":"4- Karao\u011flu L, Polat H, Alata\u015f O, et al. Occupational vaccination coverage among healthcare workers in Turkey. Vaccine. 2019;37(15):2089\u20132095. Doi: 10.1016\/j.vaccine.2019.02.054","DOI":"10.1016\/j.vaccine.2019.02.054"},{"key":"10.23749\/mdl.2026.17965_ref5","unstructured":"5- Demirhindi H, \u00d6zkurt Z, Sucakl\u0131 MB, et al. Hepatitis B immunization status of healthcare workers in Turkey and booster policy. Turk J Med Sci. 2018;48(4):728\u2013734. Doi: 10.3906\/sag-1711-61"},{"key":"10.23749\/mdl.2026.17965_ref6","doi-asserted-by":"crossref","unstructured":"6- Atasoy H, G\u00fcnay U, Y\u0131ld\u0131r\u0131m A, et al. COVID-19 vaccination acceptance among Turkish healthcare workers: a qualitative examination. Int J Nurs Terminol Knowledge. 2022;33(4):136\u2013146. Doi: 10.1111\/2047-3095.12350","DOI":"10.1111\/2047-3095.12342"},{"key":"10.23749\/mdl.2026.17965_ref7","doi-asserted-by":"crossref","unstructured":"7- Pereira da Silva A, Oliveira L, Costa J, et al. COVID-19 vaccination acceptance and hesitancy in healthcare workers and the general population: a systematic review. Int J Environ Res Public Health. 2024;21(9):1134. Doi: 10.3390\/ijerph21091134","DOI":"10.3390\/ijerph21091134"},{"key":"10.23749\/mdl.2026.17965_ref8","doi-asserted-by":"crossref","unstructured":"8- Torun SD, Torun F. Vaccination against pandemic influenza A\/H1N1 among healthcare workers and reasons for refusing vaccination in Istanbul. Vaccine. 2010;28(35):5703\u20135710. Doi: 10.1016\/j.vaccine.2010.06.049","DOI":"10.1016\/j.vaccine.2010.06.049"},{"key":"10.23749\/mdl.2026.17965_ref9","unstructured":"9- Maltezou HC, Poland GA. Immunization of healthcare personnel. Curr Infect Dis Rep. 2014;16(10):366. Doi: 10.1007\/s11908-014-0366-5"},{"key":"10.23749\/mdl.2026.17965_ref10","doi-asserted-by":"crossref","unstructured":"10- Dub\u00e9 E, Laberge C, Guay M, et al. Vaccine hesitancy: an overview. Hum Vaccin Immunother. 2013;9(8):1763\u20131773. Doi: 10.4161\/hv.24657","DOI":"10.4161\/hv.24657"},{"key":"10.23749\/mdl.2026.17965_ref11","unstructured":"11- Ogunleye OO, Adejumo OA, Ojo TM, et al. Determinants of hepatitis B vaccination in healthcare workers in Nigeria. Hum Vaccin Immunother. 2021;17(5):1629\u20131636. Doi: 10.1080\/21645515.2020.1847580"},{"key":"10.23749\/mdl.2026.17965_ref12","doi-asserted-by":"crossref","unstructured":"12- Salali GD, Uysal MS. COVID-19 vaccine acceptance in Turkey: 66%. Public Health Nurs. 2023;40(2):87\u201394. Doi: 10.1111\/phn.13103","DOI":"10.1111\/phn.13103"},{"key":"10.23749\/mdl.2026.17965_ref13","doi-asserted-by":"crossref","unstructured":"13- Cengiz B, \u00c7elik Z, Kaya F, et al. COVID-19 vaccination rates in Turkish cities by education and income. Vaccines. 2022;10(11):1933. Doi: 10.3390\/vaccines10111933","DOI":"10.3390\/vaccines10111933"},{"key":"10.23749\/mdl.2026.17965_ref14","doi-asserted-by":"crossref","unstructured":"14- Syme MR, Sylvester R, O\u2019Connell K, et al. COVID-19 vaccination mandates and healthcare worker up-take. Vaccine. 2024;42(7):1128\u20131135. Doi: 10.1016\/j.vaccine.2023.12.031","DOI":"10.1016\/j.vaccine.2023.12.031"},{"key":"10.23749\/mdl.2026.17965_ref15","unstructured":"15- Poland GA. COVID-19 vaccine uptake trends. Lancet Infect Dis. 2021;21(5):642\u2013644. Doi: 10.1016\/S1473-3099(21)00110-9"},{"key":"10.23749\/mdl.2026.17965_ref16","doi-asserted-by":"crossref","unstructured":"16- Atik Biswas S, Afzali P, Shah R, et al. Healthcare workers\u2019 attitudes toward COVID-19 vaccination in Turkey. J Hosp Infect. 2021;114:109\u2013116. Doi: 10.1016\/j.jhin.2021.03.010","DOI":"10.1016\/j.jhin.2021.03.010"},{"key":"10.23749\/mdl.2026.17965_ref17","doi-asserted-by":"crossref","unstructured":"17- Schmid P, Rauber D, Betsch C. Barriers to healthcare worker vaccination. Vaccine. 2017;35(44):5907\u20135916. Doi: 10.1016\/j.vaccine.2017.08.003","DOI":"10.1016\/j.vaccine.2017.08.003"},{"key":"10.23749\/mdl.2026.17965_ref18","unstructured":"18- Papagiannis D, Rachiotis G, Malli F, et al. Hepatitis B vaccination coverage among Greek healthcare stu-dents. BMC Public Health. 2016;16:1056. Doi: 10.1186\/s12889-016-3712-3"},{"key":"10.23749\/mdl.2026.17965_ref19","doi-asserted-by":"crossref","unstructured":"19- Larson HJ, Jarrett C, Eckersberger E, et al. Understanding vaccine hesitancy from a global perspective. Vaccine. 2014;32(19):2150\u20132159. Doi: 10.1016\/j.vaccine.2014.01.081","DOI":"10.1016\/j.vaccine.2014.01.081"},{"key":"10.23749\/mdl.2026.17965_ref20","doi-asserted-by":"crossref","unstructured":"20- Gray R, Sargsyan Z, Papadopoulos A, et al. Nursing students\u2019 hepatitis B knowledge and attitudes in Greece. Int J Environ Res Public Health. 2024;21(1). Doi: 10.3390\/ijerph21010089","DOI":"10.3390\/ijerph21010089"},{"key":"10.23749\/mdl.2026.17965_ref21","doi-asserted-by":"crossref","unstructured":"21- Betsch C, B\u00f6hm R, Chapman GB. Using behavioral insights to increase vaccine uptake. Vaccine. 2015;33(34):4219\u20134225. Doi: 10.1016\/j.vaccine.2015.06.085","DOI":"10.1016\/j.vaccine.2015.06.085"},{"key":"10.23749\/mdl.2026.17965_ref22","doi-asserted-by":"crossref","unstructured":"22- Larson HJ, Schulz WS, Tucker JD, et al. Vaccine hesitancy: definition and determinants. Vaccine. 2015;33(34):4161\u20134164. Doi: 10.1016\/j.vaccine.2015.06.081","DOI":"10.1016\/j.vaccine.2015.04.036"},{"key":"10.23749\/mdl.2026.17965_ref23","doi-asserted-by":"crossref","unstructured":"23- Paterson P, Meurice F, Stanberry LR, et al. Vaccine hesitancy and healthcare providers. Vaccine. 2016;34(52):6700\u20136706. Doi: 10.1016\/j.vaccine.2016.10.042","DOI":"10.1016\/j.vaccine.2016.10.042"},{"key":"10.23749\/mdl.2026.17965_ref24","doi-asserted-by":"crossref","unstructured":"24- Verger P, Scronias D, Dauby N, et al. Determinants of COVID-19 vaccine uptake among healthcare workers: a systematic review. Vaccine. 2022;40(10):1333\u20131345. Doi: 10.1016\/j.vaccine.2021.12.083","DOI":"10.3389\/fpubh.2022.941206"},{"key":"10.23749\/mdl.2026.17965_ref25","doi-asserted-by":"crossref","unstructured":"25- Betsch C, Schmid P, Heinemeier D, et al. Past behavior as a predictor of future vaccination. Vaccine. 2019;37(39):5872\u20135878. Doi: 10.1016\/j.vaccine.2019.08.038","DOI":"10.1016\/j.vaccine.2019.08.038"},{"key":"10.23749\/mdl.2026.17965_ref26","unstructured":"26- Wang Q, Yang L, Jin H, et al. Association between past vaccination behavior and COVID-19 vaccine ac-ceptance among healthcare workers. Front Public Health. 2021;9:782558. Doi: 10.3389\/fpubh.2021.782558"},{"key":"10.23749\/mdl.2026.17965_ref27","doi-asserted-by":"crossref","unstructured":"27- Qunaibi E, Helmy M, Basheti I, et al. COVID-19 vaccine hesitancy in healthcare workers. Int J Infect Dis. 2021;107:215\u2013221. Doi: 10.1016\/j.ijid.2021.04.052","DOI":"10.1016\/j.ijid.2021.04.052"},{"key":"10.23749\/mdl.2026.17965_ref28","unstructured":"28- Murphy J, Valli\u00e8res F, Bentall RP, et al. Psychological characteristics of vaccine hesitancy. Psychol Med. 2021;51(10):1898\u20131909. Doi: 10.1017\/S003329172000173X"},{"key":"10.23749\/mdl.2026.17965_ref29","doi-asserted-by":"crossref","unstructured":"29- Kwok KO, Li KK, Wei WI, et al. Vaccine attitudes and trust among healthcare workers. Vaccine. 2021;39(9):1278\u20131284. Doi: 10.1016\/j.vaccine.2021.01.033","DOI":"10.1016\/j.vaccine.2021.01.033"},{"key":"10.23749\/mdl.2026.17965_ref30","unstructured":"30- World Health Organization. Strategies for healthcare worker immunization programs. WHO Guide-lines; 2022."},{"key":"10.23749\/mdl.2026.17965_ref31","unstructured":"31- World Health Organization. Interim recommendations for use of the inactivated COVID-19 vaccine, CoronaVac. Geneva: WHO; 2021."},{"key":"10.23749\/mdl.2026.17965_ref32","unstructured":"32- European Medicines Agency. Comirnaty COVID-19 vaccine: Summary of product characteristics. EMA; 2021."},{"key":"10.23749\/mdl.2026.17965_ref33","doi-asserted-by":"crossref","unstructured":"33- Inker LA, Eneanya ND, Coresh J, et al. New creatinine- and cystatin C\u2013based equations to estimate GFR without race. N Engl J Med. 2021;385:1737\u20131749. Doi: 10.1056\/NEJMoa2102953","DOI":"10.1056\/NEJMoa2102953"},{"key":"10.23749\/mdl.2026.17965_ref34","doi-asserted-by":"crossref","unstructured":"34- Tomljenovic N, Babi\u0107 D, Peitl V, et al. Comparative COVID-19 vaccine hesitancy among Croatian nurses. Vaccine. 2021;39(15):2196\u20132205. Doi: 10.1016\/j.vaccine.2021.03.013","DOI":"10.1016\/j.vaccine.2021.05.085"},{"key":"10.23749\/mdl.2026.17965_ref35","unstructured":"35- Karafillakis E, Dinca I, Apfel F, et al. Healthcare workers as vaccination messengers. Lancet. 2016;388(10060):795. doi: 10.1016\/S0140-6736(16)31552-3"},{"key":"10.23749\/mdl.2026.17965_ref36","doi-asserted-by":"crossref","unstructured":"36- Gagneux-Brunon A, Detoc M, Bruel S, et al. COVID-19 vaccine hesitancy among French nurses. Clin Mi-crobiol Infect. 2021;27(4):602.e9\u2013602.e15. Doi: 10.1016\/j.cmi.2020.11.023","DOI":"10.1016\/j.cmi.2020.11.023"},{"key":"10.23749\/mdl.2026.17965_ref37","unstructured":"37- Sridharan M, Sahu R. Platelets as inflammatory biomarkers in systemic disorders. Inflammopharma-cology. 2021;29(2):413\u2013428. Doi: 10.1007\/s10787-020-00778-9"},{"key":"10.23749\/mdl.2026.17965_ref38","doi-asserted-by":"crossref","unstructured":"38- Boekholdt SM, Hack CE, Sandhu MS, et al. Inflammatory markers and increased risk of thrombosis. Eur Heart J. 2004;25(11):952\u2013960. Doi: 10.1016\/j.ehj.2004.04.010","DOI":"10.1016\/j.ehj.2004.04.010"},{"key":"10.23749\/mdl.2026.17965_ref39","doi-asserted-by":"crossref","unstructured":"39- Yuen CYS, Tarrant M. Determinants of COVID-19 vaccine hesitancy in healthcare workers: a systematic review. Vaccine. 2020;38(49):7580\u20137591. Doi: 10.1016\/j.vaccine.2020.09.040","DOI":"10.1016\/j.vaccine.2020.09.040"}],"container-title":["La Medicina del Lavoro"],"original-title":[],"link":[{"URL":"https:\/\/www.mattioli1885journals.com\/index.php\/lamedicinadellavoro\/article\/download\/17965\/13115","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mattioli1885journals.com\/index.php\/lamedicinadellavoro\/article\/download\/17965\/13115","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T15:41:55Z","timestamp":1771947715000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mattioli1885journals.com\/index.php\/lamedicinadellavoro\/article\/view\/17965"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":39,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.23749\/mdl.2026.17965","relation":{"has-manifestation":[{"id-type":"other","id":"4-1025-17965-g13115","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"4-1025","asserted-by":"subject"}]},"ISSN":["2532-1080","0025-7818"],"issn-type":[{"value":"2532-1080","type":"electronic"},{"value":"0025-7818","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,24]]},"article-number":"6"}}