Perceptions of Seasonal Influenza Vaccine Among U.S. Army Civilians and Dependents in the Kaiserslautern Military Community: A Mixed-Methods Survey

ABSTRACT Introduction Influenza is a globally occurring viral respiratory infection that can lead to hospitalizations and death. An influenza outbreak can interfere with combat readiness in a military setting, as the infection can incapacitate soldiers. Vaccination remains the most effective tool to prevent and mitigate seasonal influenza. Although influenza vaccinations for U.S. Army soldiers can be monitored through military health systems, those systems cannot capture DoD civilians and Army dependents who may not use military health services. This study aims to gauge flu vaccine uptake and perceptions in U.S. Army civilians and dependents. Materials and Methods An online survey was e-mailed to civilian and dependent enrollees of Landstuhl Regional Medical Center. The survey contained 24 questions pertaining to demographics, vaccine history, history of the flu, and beliefs toward vaccines. Chi-square tests, t-tests, and logistic regressions were performed to investigate the association between demographic, behavior, and belief factors with vaccine uptake. Free-text answers were coded and categorized by themes. Results Over 70% of respondents were vaccinated for the flu. There were differences between vaccinated and unvaccinated respondents regarding their perceptions of barriers to vaccination, benefits of the flu vaccine, severity of flu symptoms, and personal risk of getting ill with the flu. After controlling for confounders, flu vaccination in the previous season and healthcare worker status were associated with increased vaccine uptake, while perceived barriers to influenza vaccination were associated with decreased vaccine uptake. Conclusions Flu vaccine uptake may be increased by increasing access to vaccination, promoting vaccination and addressing concerns at the provider level, and engaging positively framed public messaging. Increasing flu vaccine uptake is of particular importance as the flu season approaches during the COVID-19 (Coronavirus disease 2019) pandemic.

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Willingness to Receive the COVID-19 and Seasonal Influenza Vaccines among the Saudi Population and Vaccine Uptake During the Initial Stage of the National Vaccination Campaign: A Cross-Sectional Survey

Vaccines ◽

10.3390/vaccines9070765 ◽

2021 ◽

Vol 9 (7) ◽

pp. 765

Author(s):

Amel Ahmed Fayed ◽

Abeer Salem Al Shahrani ◽

Leenah Tawfiq Almanea ◽

Nardeen Ibrahim Alsweed ◽

Layla Mohammed Almarzoug ◽

...

Keyword(s):

Saudi Arabia ◽

Perceived Risk ◽

Online Survey ◽

Seasonal Influenza ◽

Vaccination Campaign ◽

Vaccine Uptake ◽

Influenza Vaccines ◽

Vaccine Hesitancy ◽

Cross Sectional ◽

To Receive

This study aimed to assess the willingness to receive the coronavirus disease 2019 (COVID-19) and seasonal influenza vaccines and vaccine uptake during the early stage of the national vaccination campaign in Saudi Arabia. A cross-sectional online survey was conducted among adult Saudis between 20 January and 20 March 2021. The questionnaire addressed vaccine hesitancy, perceived risk, willingness, and vaccine uptake. Approximately 39% of the participants expressed vaccine hesitancy, and 29.8% and 24% felt highly vulnerable to contracting COVID-19 and seasonal influenza, respectively. The majority (59.5%) were willing to receive the COVID-19 vaccine, although only 31.7% were willing to receive the flu vaccine. Adjusted analysis showed that vaccine hesitancy (OR 0.34, 95% CI 0.27–0.43) and the perception of being at high risk (OR 2.78, 95% CI 1.68–4.60) independently affected the intention to be vaccinated. Vaccine hesitancy was similar among those who were willing to be vaccinated (29.8%) and those who had already been vaccinated (33.1%). The perceived risk was significantly higher among those who had been vaccinated (48.1%) than among those who were willing to be vaccinated but had not yet been vaccinated (29.1%). In conclusion, the acceptance of the COVID-19 vaccine in Saudi Arabia is high. Saudis who received the vaccine had a similar level of vaccine hesitancy and a higher level of perceived risk.

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The development of a digital intervention to increase influenza vaccination amongst pregnant women

Digital Health ◽

10.1177/20552076211012128 ◽

2021 ◽

Vol 7 ◽

pp. 205520762110121

Author(s):

Joanne E Parsons ◽

Katie V Newby ◽

David P French ◽

Elizabeth Bailey ◽

Nadia Inglis

Keyword(s):

Pregnant Women ◽

Qualitative Methodology ◽

Intervention Mapping ◽

Vaccine Uptake ◽

Flu Vaccination ◽

Increased Risk ◽

Diverse Area ◽

Seasonal Flu ◽

Flu Vaccine ◽

The Uk

Objective Pregnant women and unborn babies are at increased risk of complications from influenza, including pneumonia, yet in the UK, uptake of flu vaccination amongst this population remains <50%. Pregnant women hold beliefs about risks of flu and efficacy of vaccination that consistently predict them to decline vaccination. This study aimed to develop a theory and evidence-based intervention addressing these beliefs to promote flu vaccine uptake. Methods The intervention was developed by behavioural scientists, pregnant women, midwives, clinicians and Public Health professionals, informed by Intervention Mapping. Six predefined steps were performed in line with Intervention Mapping. Results The intervention is an animation addressing beliefs about risks of flu and efficacy of vaccination. Preliminary testing using qualitative methodology indicates the information within the animation is appropriate, and the animation is acceptable to pregnant women. Conclusions This is the first known intervention for pregnant women, aiming to increase flu vaccination through addressing risk and efficacy appraisals. It has been implemented within seasonal flu vaccination campaigns during 2018/19 and 2019/20 within one geographically and ethnically diverse area of the UK.

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Tweeting the #flushot: Beliefs, Barriers, and Threats During Different Periods of the 2018 to 2019 Flu Season

Journal of Primary Care & Community Health ◽

10.1177/2150132720932722 ◽

2020 ◽

Vol 11 ◽

pp. 215013272093272

Author(s):

Jeanine P.D. Guidry ◽

Lucinda L. Austin ◽

Nicole H. O’Donnell ◽

Ioana A. Coman ◽

Alessandro Lovari ◽

...

Keyword(s):

Social Media ◽

Seasonal Influenza ◽

Health Belief ◽

Vaccine Uptake ◽

Health Organizations ◽

Conspiracy Theories ◽

Quantitative Content ◽

Public Health Organizations ◽

Flu Vaccine ◽

Belief Model

Influenza epidemics happen every year, with more than 8 million severe cases in 2017. The most effective way to prevent seasonal influenza is vaccination. In recent years, misinformation regarding vaccines abounds on social media, but the flu vaccine is relatively understudied in this area, and the current study is the first 1 to explore the content and nature of influenza information that is shared on Twitter, comparing tweets published in the early flu season with those posted in peak flu season. Using a quantitative content analysis, 1000 tweets from both parts of the flu season were analyzed for use of Health Belief Model (HBM) variables, engagement, and flu vaccine specific variables. Findings show several promising opportunities for health organizations and professionals: HBM constructs were present more frequently than in previous, related studies, and fewer vaccine-hesitant tweets appear to be present. However, the presence of high barriers to flu vaccine uptake increased significantly from early to peak season, including an increase in the mention of conspiracy theories. Flu vaccine related tweets appear to vary in misinformation level and density throughout the flu season. While this should be confirmed by further studies over multiple flu seasons, this a finding that should be considered by public health organizations when developing flu vaccine campaigns on social media.

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Freshman Flu Vaccination Behavior and Intention During a Nonpandemic Season

Health Promotion Practice ◽

10.1177/1524839917712731 ◽

2017 ◽

Vol 18 (5) ◽

pp. 662-671 ◽

Cited By ~ 5

Author(s):

Kendra L. Ratnapradipa ◽

Ryan Norrenberns ◽

J. Austin Turner ◽

Allison Kunerth

Keyword(s):

Online Survey ◽

College Freshmen ◽

Vaccine Coverage ◽

Health Belief ◽

Flu Vaccination ◽

Past Behavior ◽

Vaccination Behavior ◽

Vaccination History ◽

Flu Vaccine ◽

Belief Model

Objective. To examine predictors of flu vaccination and vaccination intention among college freshmen during a nonpandemic influenza season using the health belief model (HBM). Participants. A total of 184 college freshmen at a single institution participated in a mixed-mode (paper or online) survey in October-November 2015. Method. Flu vaccination and intention to vaccinate were predicted using binomial logistic regression on HBM constructs (perceived susceptibility, severity, benefits, barriers, cues to action, and availability), prior flu vaccination history, family and peer reference behaviors, and demographics. Results. Overall, 31.5% of participants received the seasonal flu vaccine by mid-November, and 25% intended to receive it. In full models, history of past flu vaccination (adjusted odds ratio [aOR] = 7.90; 95% confidence interval [CI] = 2.55-24.49) was significant for vaccination while availability (aOR = 2.00; 95% CI = 1.32-3.01) and family intention (aOR = 250.59; 95% CI = 3.77 to >999) were positively associated with intent to vaccinate. Significant confounding by past behavior and family intentions existed for both outcomes. Conclusions. Past flu vaccination behavior and family member intentions to vaccinate were better predictors of annual flu vaccination behavior and intention than HBM constructs among college freshmen. College campuses may enhance flu vaccine coverage by highlighting benefits and availability to students and families.

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Likelihood of COVID-19 Vaccination Among Individuals Living With Psoriatic Disease: Results From a Large Real-World Survey

Journal of Psoriasis and Psoriatic Arthritis ◽

10.1177/24755303211067822 ◽

2021 ◽

pp. 247553032110678

Author(s):

George C. Gondo ◽

Megan H. Noe ◽

Stacie J. Bell ◽

Christopher T. Ritchlin

Keyword(s):

Cross Sectional Study ◽

Individual Characteristics ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Annual Household Income ◽

Chi Square ◽

Cross Sectional ◽

Psoriatic Disease ◽

Flu Vaccine ◽

To Receive

Introduction: Development and dissemination of novel COVID-19 vaccines represent an opportunity to end the COVID-19 pandemic by vaccinating an estimated 80% of the population. Objectives: This study examines perceptions, and demographic and clinical factors influencing the likelihood of adults with psoriasis receiving a novel COVID-19 vaccine. Methods: A cross sectional study conducted from October–November 2020 of 1405 adults with psoriatic disease with prior contact to a patient advocacy organization. The main outcome of interest was the likelihood of receiving a COVID-19 vaccine. Chi-square tests and logistic regression examined the relationship between individual characteristics and likelihood of receiving a COVID-19 vaccine. Results: Most participants (65%) received a flu vaccination in the last 12 months and were (64.2%) likely to receive a COVID-19 vaccine, while 35.9% reported being unlikely receive a vaccine. Likelihood of COVID-19 vaccination was associated with receiving the flu vaccine, race, ethnicity, sex, BMI, age, income, severity of PsO and PsA. When controlling for ethnicity, race, male sex, overweight/obese status, age, biologic use, disease type, comorbidities linked with worse COVID-19 outcomes, PsA symptoms, and skin disease severity, individuals who received the flu vaccine and those with annual household income over $75,000 were most likely to receive a COVID-19 vaccine. Conclusions: Vaccine hesitancy among individuals with psoriatic disease is considerable. Dermatologists and rheumatologists can increase COVID-19 vaccine uptake by actively engaging their patients on this topic using guidance published by the National Psoriasis Foundation on the management of psoriatic disease during the COVID-19 pandemic.

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Understanding Flu Vaccination in a Competitive Context

Social Marketing Quarterly ◽

10.1177/1524500417718141 ◽

2017 ◽

Vol 23 (4) ◽

pp. 320-334 ◽

Cited By ~ 1

Author(s):

Alec Ulasevich ◽

Samantha Jacobs ◽

Djass Mbangdadji ◽

Max van Over ◽

Lani Steffens

Keyword(s):

The United States ◽

Vaccine Uptake ◽

Perceived Effectiveness ◽

Prevention Strategies ◽

Preventable Hospitalizations ◽

Healthy Behaviors ◽

Flu Vaccination ◽

Lower Likelihood ◽

Seasonal Flu ◽

Flu Vaccine

The flu causes a significant number of largely vaccine-preventable hospitalizations and deaths each year. Previous studies show that efficacy beliefs about other flu prevention strategies may be barriers to flu vaccine uptake. The purpose of this study was to assess attitudes and behaviors regarding flu vaccination and other flu prevention strategies and to examine the decision to get a flu vaccine within a competitive context. Two independent surveys were administered in 2013 (general population, n = 1,158) and 2015 (millennial panel, n = 1,574) among adults in the United States, which generated propensity models to get flu vaccines. Compared to the vaccine, participants considered many strategies to be more effective at preventing seasonal flu, particularly behaviors related to maintaining a strong immune system. Propensity models demonstrate that perceived effectiveness of some alternative “healthy behaviors” in a competitive set were associated with a lower likelihood of vaccine uptake. Results suggest that adults’ engagement in alternative strategies may be at the expense of getting vaccinated. Social marketers should consider competition not just from unhealthy behaviors but from alternative healthy behaviors when designing programs and campaigns to ensure effectiveness of their messages.

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Willingness of healthcare workers to recommend seasonal influenza vaccine to patients- Tunisia, 2019

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1435 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Cherif ◽

G Kharroubi ◽

L Bouabid ◽

A Gharbi ◽

A Boukthir ◽

...

Keyword(s):

Influenza Vaccine ◽

Healthcare Workers ◽

Seasonal Influenza ◽

Eastern Mediterranean Region ◽

Vaccine Uptake ◽

Severe Illness ◽

Seasonal Influenza Vaccine ◽

History Of ◽

Flu Vaccine ◽

Willingness To Recommend

Abstract Background Most countries of the Eastern Mediterranean Region have low influenza vaccination coverage mainly among high risk groups. Advice to receive the influenza vaccine by healthcare workers (hcws) seems to be an important motivator for vaccine acceptance among patients. In this study, we aimed to describe the willingness of Tunisian hcws to recommend the seasonal influenza vaccine to patients and to assess its determinants. Methods A cross-sectional questionnaire-based study was conducted in Tunisian primary and secondary healthcare facilities during the 2018-2019 influenza season. A multivariate logistic regression was used to assess the factors associated with the willingness of hcws to recommend the influenza vaccine to patients. Results In the present study, 1231 hcws were included with a mean age of 44.5±9.3 and a sex ratio (Male/Female) equal to 0.25. Among respondents, more than three quarter (79.1%, 95% CI: [76.7-81.3]) declared their willingness to recommend the influenza vaccine to patients if available. In multivariate analysis, belief that influenza vaccine is a severe illness that may lead to death (adj.OR = 2.9, 95% CI: [1.9-4.1]) and previous influenza vaccine uptake among health professionals (adj.OR = 2.4, 95% CI: [1.5-3.9]) were independently associated with the willingness of hcws to recommend the flu vaccine to patients. Conclusions This study showed that hcws with a history of influenza immunization and those who were aware of influenza severity were more likely to be willing to recommend the influenza vaccine to patients. These findings should be considered in future educational programs to enhance hcws' recommendation of influenza vaccine. Key messages Majority of Tunisian healthcare workers declared their willingness to recommend the influenza vaccine to patients. Healthcare workers’ awareness of influenza severity and history of influenza vaccine uptake were associated with a higher willingness to recommend the flu vaccine.

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Effects of Vaccine Health and Safety Perceptions on COVID-19 Vaccine Uptake in Ghana: Implications for Implementing Rollout Programs

10.21203/rs.3.rs-952497/v1 ◽

2021 ◽

Author(s):

Simon Appah Aram ◽

John Elvis Hagan ◽

George Kweku Afriyie Mansoh ◽

Benjamin M. Saalidong ◽

Patrick Osei Lartey ◽

...

Keyword(s):

Online Survey ◽

Health And Safety ◽

Binary Logistic Regression ◽

Vaccine Safety ◽

Decision Makers ◽

Vaccine Uptake ◽

Health Perceptions ◽

Chi Square ◽

Cross Sectional ◽

Vaccination Programs

Abstract Background A major component of rolled-out COVID-19 pandemic response and preparedness is the administration of vaccines. Globally, resistance towards vaccination programs are well known and documented. This study sought to evaluate the effects of general vaccine health perceptions and the confidence in COVID-19 vaccine safety towards uptake in Ghana. MethodsA cross sectional online survey involving 620 Ghanaians was conducted. The data was subjected to both descriptive (frequency, percentages, and chi-square tests) and inferential (nested binary logistic regression) analyses. Results The preliminary findings showed that 80.32% of participants believed that vaccines were healthy and 73.06% had confidence in a COVID-19 vaccine safety, although 81.19% of the respondents were particularly concerned about the source of the vaccine. Other evidence revealed that 78.55% and 71.45% of respondents indicated their willingness for mandatory and voluntary COVID-19 vaccine uptake or shot respectively. In all operationalized regression models, Ghanaians who believed that vaccines are healthy and those who had confidence in a COVID-19 vaccine safety were more likely to take a mandatory or voluntary COVID-19 vaccine compared to those who thought and believed otherwise. ConclusionIndividual preferences and/or intentions toward COVID-19 vaccine uptake and uptake route (i.e., mandatory, voluntary) were influenced by multifaceted determinants: biosocial (age, marital status, education), socio-cultural (religion) and contextual (geographical zone, source of vaccine as a concern) factors. To consolidate and possibly increase vaccine uptake in response to the COVID-19 pandemic in Ghana, health education and promotion programs should aim at creating awareness on the benefits of vaccine uptake while addressing the health and safety concerns on the potential side effects through evidence-based community messaging from credible sources. It is important to show speciﬁc commitment to transparency and reliable information to build public trust by decision-makers.

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Influenza vaccine among future health care workers: a cohort study on Italian medical students

European Journal of Public Health ◽

10.1093/eurpub/ckz186.497 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

A Corradi ◽

F Bert ◽

E Pompili ◽

D Catozzi ◽

A Hordila ◽

...

Keyword(s):

At Risk ◽

Cohort Study ◽

Medical Students ◽

Influenza Vaccine ◽

Health Workers ◽

Medical Schools ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Flu Vaccination ◽

Flu Vaccine

Abstract Background Flu vaccination rates among health workers remain low and very variable between European countries despite the recommendations. Medical schools could be the best phase to educate health workers toward flu vaccine. This study aims to evaluate flu vaccine “prejudice” and vaccine hesitancy in medical students (MSs). Methods In 2018/19 flu season a cohort study was conducted at the School of Medicine of Turin, parallel to the flu vaccination campaign. Students were surveyed for sociodemographic variables, knowledge, attitudes and practices toward vaccination, adverse reactions, overall satisfaction toward received vaccination. Data was collected from 377 students. Multivariable logistic regressions were performed. The significance level was p ≤ 0.05. Results Females were 70% and median age was 24 (IQR 22.5-25). The 73.2% of the sample was vaccinated in the campaign, although the 60% of this had never been vaccinated before. Poor knowledge on flu vaccine, both self- and objectively assessed, was associated with lower vaccination rate (OR 0.23, p = 0.006; OR 0.15, p < 0.001 respectively). Vaccination was more likely in those who had been vaccinated in the last 3 years (OR 9.14, p < 0.001). Among non-vaccinated students, most frequent reasons to not undergo vaccination was not feeling at risk of contagion (48%). Vaccine decreased flu prevalence (OR 0.33, p = 0.039). Among vaccinated students, the persuasion that vaccination should be mandatory for health workers (OR 5.91, p = 0.039) was associated with higher vaccine satisfaction score while self-diagnosis of flu was associated with a lower score (OR 0.009, p < 0.001). Conclusions Lack of flu vaccination among health workers increases flu prevalence and multiplies possible carriers in health facilities. European Medical Schools should start yearly vaccination campaigns to promote good habits in MSs. In parallel, more must be done to teach MSs the benefits of flu vaccination and thus increasing willingness to being vaccinated. Key messages Feeling poorly informed and being poorly informed about influenza vaccine significatively decrease likeliness of vaccination in medical students. Students do not feel at risk of contagion. Influenza vaccine uptake is a habitual behavior that should be promoted as early as possible among European health workers, possibly during Medical School.

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Evaluation of Flu Vaccination Coverage among Healthcare Workers during a 3 Years’ Study Period and Attitude towards Influenza and Potential COVID-19 Vaccination in the Context of the Pandemic

Vaccines ◽

10.3390/vaccines9070769 ◽

2021 ◽

Vol 9 (7) ◽

pp. 769

Author(s):

Giuditta Scardina ◽

Luca Ceccarelli ◽

Virginia Casigliani ◽

Sara Mazzilli ◽

Marco Napoletano ◽

...

Keyword(s):

Healthcare Workers ◽

Health Care Services ◽

Seasonal Influenza ◽

Vaccine Coverage ◽

University Hospital ◽

Staff Members ◽

Care Services ◽

Flu Vaccination ◽

Flu Vaccine ◽

Potential Vaccine

(1) Background: vaccination of healthcare workers (HCWs) against seasonal influenza is considered the most effective way to protect HCWs, ensure patient’s safety and to maintain essential health care services during influenza epidemics. With the present study we aimed to evaluate the efficacy of incremental bundles of measures implemented during the last three flu campaigns and to assess the attitudes towards influenza vaccination and a potential vaccine against COVID-19 among HCWs, in a large university hospital in Pisa, Italy. (2) Methods: We described measures implemented during 2018/2019, 2019/2020 and 2020/2021 and assessed their impact on flu vaccine coverage (VC) among employees and residents in Pisa university hospital. We considered sex, profession and ward to investigate differences in uptake. In addition, in 2020 a survey was developed and distributed to all employees to evaluate flu and COVID-19 vaccines attitudes. (3) Results: during the 2018/19 and 2019/20 flu campaigns the overall VC rate among HCWs was, respectively, 10.2% and 11.9%. In 2020/21 the overall VC rate jumped to 39.3% (+230.6%). Results from the survey indicated a more positive attitude towards flu vaccine as compared to COVID-19 vaccines among the 10.6% of the staff members who responded to the survey. In addition, 70.97% of HCWs totally agreed that being vaccinated against influenza would be more important than the previous years because of COVID-19 emergency. (4) Conclusions: a significant increase in VC was observed in 2020/21, especially among those sub-groups with consistently lower uptake in previous years. The COVID-19 pandemic positively influenced flu vaccination uptake during the 2020/21 season.

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