The role of health determinants in the influenza vaccination uptake among older adults (65+): a scope review

Abstract Background Although the burden of influenza infection is the highest in older adults, vaccination coverage remains low, despite this age group being more vulnerable than others. Aims Given the current pandemic of SARS-CoV-2, it was the aim of this scope review to update knowledge on factors affecting seasonal influenza vaccine uptake among older adults to strengthen prevention approaches in the context of an overall burden of infectious diseases. Methods We searched bibliographic databases from 2012 to 2019. All studies reviewed one or more social determinant of health listed by WHO, or factors affecting the decision-making process whether to accept influenza vaccine or not. Results Overall, 44 studies were included, 41 determinants were extracted and summarized into six categories. Older age and constitutional factors including multiple chronic diseases as well as preventive lifestyle and frequent routine healthcare utilization positively affected vaccination uptake (VU). Living and working conditions are also researched determinants of influenza vaccine uptake. A small number of studies explored the role of social inclusion and system-based interventions. Discussion and conclusions This scope review provides a comprehensive overview on factors affecting seasonal influenza vaccination uptake among older citizens. The review also clearly shows gaps for evidence on system-based level or political strategies to improve vaccination uptake.

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The role of health determinants in the influenza vaccination uptake among older adults (65+): a scope review

10.21203/rs.3.rs-84732/v1 ◽

2020 ◽

Author(s):

Regina Roller-Wirnsberger ◽

Sonja Lindner ◽

Lea Kolosovski ◽

Elisabeth Platzer ◽

Peter Dovjak ◽

...

Keyword(s):

Older Adults ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Seasonal Influenza ◽

Vaccine Uptake ◽

Health Determinants ◽

Bibliographic Databases ◽

Factors Affecting ◽

Vaccination Uptake

Abstract Background: Although the burden of influenza infection is the highest in older adults, vaccination coverage remains low, despite this age group being more vulnerable than others. Aims: Given the current pandemic of SARS-CoV-2, it was the aim of this scope review to update knowledge on factors affecting seasonal influenza vaccine uptake among older adults in order to strengthen prevention approaches in the context of an overall burden of infectious diseases.Methods: We searched bibliographic databases from 2012 to 2019. All studies reviewed one or more social determinant of health listed by WHO, or factors affecting the decision-making process whether to accept influenza vaccine or not.Results: Overall, 44 studies were included, 41 determinants were extracted and summarized into six categories. Older age and constitutional factors including multiple chronic diseases as well as preventive lifestyle and frequent routine healthcare utilization positively affected vaccination uptake (VU). Living and working conditions are also researched determinants of influenza vaccine uptake. A small number of studies explored the role of social inclusion and system-based interventions. Discussion and Conclusions: This scope review provides a comprehensive overview on factors affecting seasonal influenza vaccination uptake among older citizens. The review also clearly shows gaps for evidence on system-based level or political strategies to improve vaccination uptake.

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Knowledge, Attitude, and Barriers Influencing Seasonal Influenza Vaccination Uptake

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2020/7653745 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Mazin A. Barry ◽

Khalid I. Aljammaz ◽

Abdulaziz A. Alrashed

Keyword(s):

Saudi Arabia ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Seasonal Influenza ◽

Well Being ◽

Influenza Viruses ◽

Vaccine Uptake ◽

Severe Illness ◽

Seasonal Influenza Vaccination ◽

Vaccination Uptake

Background. Seasonal influenza is an acute respiratory infection caused by influenza viruses that are highly contagious and circulate in all parts of the world. It gives rise to an estimated 3 to 5 million cases of severe illness and about 250,000 to 500,000 deaths globally each year. Influenza tends to cause epidemics with serious illness and death among high-risk groups such as children aged 5 years and younger, pregnant women, elderly ≥65 years of age, and with chronic medical conditions. According to the Centers for Disease Prevention and Control (CDC), all people who are 6 months old and above are recommended to receive the seasonal influenza vaccine annually. Despite the fact that influenza vaccine is readily available, and the severity of the disease is known to adversely affect the individual’s quality of life and well-being, vaccination uptake rates are still low, contributing to the increased burden of the disease worldwide. Objectives. To measure the influenza vaccine uptake among residents of Riyadh Province, Saudi Arabia, that determines their attitude, knowledge, and beliefs regarding the vaccine. Methods. A cross-sectional study was conducted using a self-administered structured questionnaire distributed online targeting residents of Riyadh Province, Saudi Arabia, from 1st of August 2019 till 30th of September 2019. Participants were selected through volunteer sampling. The questionnaire included demographic data including age, gender, occupation, education level, marital status, and comorbidities. It also included questions regarding knowledge, attitude, and beliefs regarding influenza vaccine. After collection of data, statistical analyses were conducted by using Statistical Package for Social Sciences (SPSS) version 19.0. A P value of <0.05 was considered statistically significant. Results. Our study included 503 participants, with age ranging from 18 to 65 years old and 324 (64%) were females. 100 participants (19.9%) had comorbid conditions, and 223 (44.3%) have been vaccinated against influenza in the past. A large portion of participants (41.2%) were familiar with seasonal influenza vaccination from the media. The knowledge part of the questionnaire showed that 302 (60%) participants knew how often they should receive the vaccine and 313 (62.2%) participants knew that the vaccine is provided freely in all of Saudi Arabia. In terms of belief and attitude, 371 participants (73.8%) thought they were susceptible to the disease and 365 (73.8%) believed that influenza vaccine is beneficial, while 446 participants (88.7%) thought that the general public need more knowledge and awareness on the scientific facts of influenza vaccine. Regarding barriers, 295 participants (58.6%) wanted to avoid vaccines and 252 (50.1%) were concerned about the vaccine’s adverse effects. Participants with frequent health checkups and those who had previous knowledge on the availability of the vaccine for free were more likely to be vaccinated. Vaccinated participants (44.3%) were asked if they were willing to take the vaccine again when it is due, 158 (70.9%) answered yes. Those who elicited symptomatic reaction to the vaccine (26.0%) were less inclined to take it again P = 0.035 . Conclusion. We concluded that there is a low influenza vaccine uptake rate among our study population, considering that the barriers most commonly chosen by participants are solvable with health education and campaigns oriented towards delivering facts about the vaccine and dispelling misinformation; such measures are highly recommended and are postulated to carry a great benefit that should target common misconceptions identified in this study.

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Factors associated with influenza vaccine uptake in older adults living in the community in Singapore

Epidemiology and Infection ◽

10.1017/s0950268816002491 ◽

2016 ◽

Vol 145 (4) ◽

pp. 775-786 ◽

Cited By ~ 20

Author(s):

L. W. ANG ◽

J. CUTTER ◽

L. JAMES ◽

K. T. GOH

Keyword(s):

Older Adults ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Seasonal Influenza ◽

Medical Condition ◽

Family Doctor ◽

Community Dwelling ◽

Vaccine Uptake ◽

Factors Associated ◽

Health Related

SUMMARYIn Singapore, influenza vaccination is recommended for persons at higher risk of complications of seasonal influenza, including those with chronic medical conditions and the elderly (individuals aged ⩾65 years). We investigated the factors associated with influenza vaccine uptake based on a nationally representative sample of community-dwelling adults aged >50 years. The data for this study were obtained from the National Health Surveillance Survey (NHSS) 2013. The association between influenza vaccine uptake and socio-demographic and health-related variables was analysed using univariable and multivariable logistic regression models. Of 3700 respondents aged ⩾50 years in the NHSS, 15·2% had received seasonal influenza vaccination in the past year. Older age, single marital status and economic inactivity were the socio-demographic variables independently associated with vaccine uptake. Health-related factors which were predictive of influenza vaccine uptake were sufficient total physical activity, better self-rated health, having at least one medical condition at risk of influenza complications and a regular family doctor/general practitioner. Influenza vaccine uptake in community-dwelling older adults was low. Our findings are of relevance in the formulation of public health policies and targeted health promotion strategies to increase vaccine uptake in this population group.

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Correlates of Influenza Vaccination Among Underserved Latinx Middle-Aged and Older Adults: A Cross-sectional Survey

10.21203/rs.3.rs-366966/v1 ◽

2021 ◽

Author(s):

Mohsen Bazargan ◽

Adrienne Martinez-Hollingsworth ◽

Sharon Cobb ◽

Lucy Kibe

Keyword(s):

Older Adults ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Medical Care ◽

Chronic Conditions ◽

Vaccine Uptake ◽

Financial Strain ◽

Cross Sectional Survey ◽

Cross Sectional

Abstract Background: Vaccination is a powerful tool in the fight against seasonal influenza, among underserved, middle-age and older, Latinx adults. Yet, vaccine hesitancy and inconsistent uptake in this population continues to represent a substantial challenge to public health. A better understanding of factors impacting influenza vaccination behaviors in this group could result in more effective messaging and initiatives promoting universal vaccination among Latinx. Methods: In this cross-sectional survey, we explore correlates of influenza vaccination uptake among underserved, Latinx, older adults. Our focus was on the role of socio-demographics, living arrangements, financial strain, access and satisfaction with medical care, and the presence of major chronic conditions in terms of vaccine uptake. Middle-aged and older Latinx residents diagnosed with diabetes and/or hypertension (n=165), were recruited from the South Los Angeles Service Plan Area (SPA), a historically under-resourced community. Bi-variate and multi-variate logistical regression were performed on survey data to explore independent correlates of influenza vaccination.Results: Almost half of underserved Latinx older adults in our study (45%) reported influenza vaccination within the 12 months prior to the study. The majority (~85%) reported receiving this recommendation from their primary care provider. However, one-third (30%) of those receiving this advice did not get the vaccine. A decreased likelihood of vaccination was significantly associated with living alone (p=0.026), lacking Medicare coverage (0.028), or higher levels of financial strain (0.020). Difficulty accessing medical care (p=0.008) or dissatisfaction with these experiences (p=0.001) were also strongly associated with decreased likelihood of vaccination. Participants diagnosed with COPD had 9.5 (CI: 1.76 – 51.3) higher odds of being vaccinated compared to those without; no correlation was detected for other chronic conditions.Conclusion: The high number of unvaccinated Latinx participants receiving a vaccine recommendation from a provider is consistent with studies among other ethnic/racial minority older adults and highlights the pivotal role of the provider in influenza vaccine adoption. Additional findings reflect negative impact of Social Determinates of Health (SDoH) on preventive care efforts in this group. Further efforts to quantify these associations are needed to explore structural and human factors impacting influenza vaccine uptake.

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Influenza vaccine uptake among adults living with young children

Journal of Epidemiological Research ◽

10.5430/jer.v4n1p41 ◽

2018 ◽

Vol 4 (1) ◽

pp. 41 ◽

Cited By ~ 1

Author(s):

Nirma Khatri Vadlamudi ◽

Fawziah Marra

Keyword(s):

Young Children ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Perceived Health ◽

Canadian Community Health Survey ◽

Demographic Characteristics ◽

Vaccine Uptake ◽

Vaccination Programs ◽

Vaccination Rates ◽

Vaccination Uptake

Background: Many studies report vaccine uptake among young adults aged 18 to 49 years is low. In Canada, the National Advisory Committee on Immunization (NACI) recommends influenza vaccination for adults in contact with young children, however vaccination rates for this specific population are missing. An estimate is required to identify appropriate public health interventions. The objective of this study was to describe recent trends in influenza vaccination uptake among Canadian adults aged 18 to 49 years old living with or without young children.Methods: The Canadian Community Health Survey (2013-2014) dataset, available for public use was used after grouping individuals by influenza vaccination uptake within the past year in adults aged 18 to 49 years. The relationship between living in a household with young children and influenza vaccination uptake was examined using a multivariable logistic regression model.Results: Among Canadian adults aged 18 to 49 years, the influenza vaccination uptake was 24.1% in adult household contacts with young children compared to 18.2% in those without young children (p<.0001). After adjusting for socio-demographic characteristics and self-perceived health, we determined that vaccine uptake was associated with living in a household with young children (adjusted OR: 1.30 [95%CI: 1.17-1.44]). While socio-demographic characteristics and self-perceived health greatly influenced influenza vaccination uptake, we also found marital status was a strong influencer of influenza vaccine uptake (adjusted OR: 1.31 [95%CI: 1.16-1.48]). Conclusion: Overall, influenza vaccination uptake among caregiving adults is low. Increased vaccine uptake was associated with living in a household with one or more young children. Targeted education and vaccination programs are required to improve uptake of the influenza vaccine in this age group.

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Influenza Vaccination Hesitancy among Healthcare Workers in South Al Batinah Governorate in Oman: A Cross-Sectional Study

Vaccines ◽

10.3390/vaccines8040661 ◽

2020 ◽

Vol 8 (4) ◽

pp. 661

Author(s):

Salah T. Al Awaidy ◽

Zayid K. Al Mayahi ◽

Malak Kaddoura ◽

Ozayr Mahomed ◽

Nathalie Lahoud ◽

...

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Healthcare Workers ◽

Seasonal Influenza ◽

General Medicine ◽

Knowledge Score ◽

Vaccine Uptake ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Increased Risk

Background: Seasonal influenza infections are a major cause of morbidity and mortality worldwide. Healthcare workers (HCWs) are an important target group for vaccination against influenza due to their increased risk of infection and their potential to transmit the infection to their patients, families and communities. The aim of this study was to assess the potential hesitancy and its associated factors towards influenza vaccination amongst HCWs in the South Al Batinah governorate in Oman. Methods: A cross-sectional survey of 390 HCWs with direct or indirect patient contact was conducted in May and June 2019 using a self-administered questionnaire. Associations between HCW characteristics and vaccination status were examined using bivariate and multivariate analyses to identify the likelihood of vaccination against seasonal influenza among HCWs. Results: Overall, 60% of HCWs were vaccinated in the 2018/2019 season; vaccine uptake among nurses was 52% and uptake was higher among women. Self-protection and protection of the community were the most cited reasons for vaccine acceptance, with side effects being the main reason for hesitancy. Vaccinated respondents had a higher mean knowledge score (7.18; standard deviation SD: 2.14) than unvaccinated respondents (6.30; SD: 2.2). Odds of vaccination were highest among respondents who believed influenza vaccine should be mandatory for HCWs (Odds ratio (OR): 2.04 [1.30–3.18]), those working in the general medicine, emergency medicine, or intensive care units (OR: 1.92 [1.20–3.10]), nurses and doctors (OR: 1.75 [1.09–2.79]) and those who believe that HCWs should receive an influenza vaccine (OR: 1.35 [1.07–2.77]). Conclusions: The study provides valuable insights into the enablers and barriers of influenza vaccination practices among HCWs and may inform interventions to increase acceptance of vaccination.

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Seasonal Influenza Vaccination and Recommendation: The Difference between General Practitioners and Public Health Workers in China

Vaccines ◽

10.3390/vaccines8020265 ◽

2020 ◽

Vol 8 (2) ◽

pp. 265 ◽

Cited By ~ 1

Author(s):

Hongguo Rong ◽

Xiaozhen Lai ◽

Xiaochen Ma ◽

Zhiyuan Hou ◽

Shunping Li ◽

...

Keyword(s):

Public Health ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

General Practitioners ◽

Seasonal Influenza ◽

Health Workers ◽

The Elderly ◽

Vaccine Uptake ◽

Knowledge And Attitudes ◽

Public Health Workers

Seasonal influenza vaccination for healthcare workers (HCWs) is critical to the protection of HCWs and their patients. This study examined whether the separation of public health workers and general practitioners could affect the influenza vaccine uptake and recommendation behaviors among HCWs in China. A survey was conducted from August to October 2019, and HCWs from 10 provinces in China were recruited. A self-administered and anonymous questionnaire was used to assess HCWs’ demographic information, knowledge, and attitudes toward influenza vaccination, as well as vaccine uptake and recommendation behaviors. The primary outcome was HCWs’ vaccination and recommendation status of seasonal influenza vaccine. Multivariate logistic regression models were used to identify the influence factors of influenza vaccine uptake and recommendation among HCWs. Of the 1159 HCWs in this study, 25.3% were vaccinated against influenza in the previous season. “No need to get vaccinated” was the primary reason for both unvaccinated public health workers and general practitioners. Multivariate logistic regression showed that public health workers were more likely to get vaccinated against influenza (OR = 2.20, 95% CI 1.59–3.05) and recommend influenza vaccination to children (OR = 2.10, 95% CI 1.57–2.80) and the elderly (OR = 1.69, 95% CI 1.26–2.25) than general practitioners. Besides, the knowledge and perceived risk of influenza can give rise to HCWs’ vaccination and recommendation behaviors, and HCWs who got vaccinated in the past year were more likely to recommend it to children and the elderly in their work. The influenza vaccine coverage and recommendation among HCWs are still relatively low in China, especially for general practitioners. Further efforts are needed to improve the knowledge and attitudes toward influenza and influenza vaccination among HCWs, and coherent training on immunization for both public health workers and general practitioners might be effective in the face of separated public health and clinical services in China.

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Determinants of influenza vaccine uptake and willingness to be vaccinated by pharmacists among the active adult population in Hungary: a cross-sectional exploratory study

BMC Public Health ◽

10.1186/s12889-021-10572-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Githa Fungie Galistiani ◽

Mária Matuz ◽

Nikolett Matuszka ◽

Péter Doró ◽

Krisztina Schváb ◽

...

Keyword(s):

Logistic Regression ◽

Risk Factor ◽

Influenza Vaccine ◽

Health Risk ◽

Influenza Vaccination ◽

Influenza Season ◽

Adult Population ◽

Vaccine Uptake ◽

Cross Sectional ◽

Vaccination Uptake

Abstract Background Many studies have addressed influenza vaccine uptake in risk-group populations (e.g. the elderly). However, it is also necessary to assess influenza vaccine uptake in the active adult population, since they are considered to be a high-transmitter group. In several countries pharmacists are involved in adult vaccination in order to increase uptake. This study therefore aimed to investigate the determinants of influenza vaccination uptake and examine the willingness to be vaccinated by pharmacists. Methods A cross-sectional study was conducted among Hungarian adults using a self-administered online questionnaire distributed via social media (Facebook). The questionnaire included five domains: demographics, vaccine uptake, factors that motivated or discouraged vaccination, knowledge and willingness of participants to accept pharmacists as influenza vaccine administrators. Descriptive statistics were applied and logistic regression was conducted to assess the possible determinants of vaccination uptake. Results Data from 1631 participants who completed the questionnaires were analysed. Almost 58% of respondents (944/1631) had occupational and/or health risk factors for influenza. Just over one-tenth (12.3%;200/1631) of participants were vaccinated during the 2017/18 influenza season, 15.4% (145/944) of whom had a risk factor for influenza. Approximately half of the participants (47.4%) believed that influenza vaccination can cause flu, and just over half of them (51.6%), were not knowledgeable about the safety of influenza vaccine ingredients. Logistic regression found that age, sex, health risk factor and knowledge on influenza/influenza vaccination were associated with influenza vaccination uptake (p < 0.05). The most frequently cited reason for having an influenza vaccination was self-protection (95.0%). The most common reason given for refusing the influenza vaccine was that the respondent stated they rarely had an infectious disease (67.7%). The number of participants who were willing to be vaccinated by pharmacists was two-times higher than the number of participants who were actually vaccinated during the 2017/18 influenza season. Conclusion Influenza vaccine uptake in the active adult population is low in Hungary. Public awareness and knowledge about influenza vaccination and influenza disease should be increased. The results also suggest a need to extend the role played by pharmacists in Hungary.

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Pay-it-forward to improve influenza vaccine uptake and public engagement among children and older adults in China: A three-arm quasi-experimental study

10.21203/rs.3.rs-1067881/v1 ◽

2021 ◽

Author(s):

Dan Wu ◽

Chenqi Jin ◽

Khaoula Bessame ◽

Fanny Tang ◽

Jason Ong ◽

...

Keyword(s):

Older Adults ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Primary Outcome ◽

Pragmatic Trial ◽

Standard Of Care ◽

Vaccine Uptake ◽

Vaccination Rates ◽

Quasi Experimental ◽

Vaccine Confidence

Abstract China has low seasonal influenza vaccination rates among children and older adults. This quasi-experimental pragmatic trial examined the effectiveness of a pay-it-forward intervention on influenza vaccination compared to standard of care (user-paid vaccination) and free vaccination strategies among children and older people in China (ChiCTR2000040048). In pay-it-forward, people receive a free influenza vaccine from a local group and are offered an opportunity to donate financially to support vaccination among future individuals. The primary outcome was pre-specified as influenza vaccine uptake. Secondary outcomes included vaccine confidence and associated costs. Among 450 participants enrolled, 55/150 (36.7%) in the standard of care arm, 111/150 (74.0%) in the pay-it-forward arm, and 114/150 (76.0%) in the free vaccination arm received an influenza vaccine. The pay-it-forward arm had significantly higher vaccine confidence when compared to the standard of care arm. In the pay-it-forward arm, 107/111 (96.4%) of participants donated money for subsequent vaccinations and 19 of 60 invited (31.7%) created postcard messages.

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