Influenza vaccine uptake among at-risk adults (aged 16–64 years) in the UK: a retrospective database analysis

Abstract Background In the UK, annual influenza vaccination is currently recommended for adults aged 16–64 years who are in a clinical at-risk group. Despite recommendations, rates of vaccine uptake in the UK have historically been low and below national and international targets. This study aims to analyse vaccine uptake among adults in clinical at-risk groups from the 2015–2016 influenza season to the present. Methods A retrospective analysis of influenza vaccine coverage in the UK was conducted using data extracted from publicly available sources. Clinically at-risk individuals (as defined by Public Health England), including pregnant women, aged 16–64 years, were included in this study. Results Influenza vaccination coverage rates across the UK in adults aged 16–64 years in a clinical at-risk group have been consistently low over the past 5 years, with only 48.0, 42.4, 44.1 and 52.4% of eligible patients in England, Scotland, Wales and Northern Ireland receiving their annual influenza vaccination during the 2018–2019 influenza season. Influenza vaccine coverage was lowest in patients with morbid obesity and highest in patients with diabetes in 2018–2019. Coverage rates were below current national ambitions of ≥75% in all clinical risk groups. In these clinical at-risk groups, influenza vaccine coverage decreased between 2015 and 2019, and there was considerable regional variation. Conclusions Uptake of the influenza vaccine by adults aged 16–64 years in a clinical at-risk group was substantially below the national ambitions. As a result, many individuals in the UK remain at high risk of developing severe influenza or complications. Given that people who are vulnerable to COVID-19 are also at increased risk of complications from influenza, during the 2020–2021 season, there is a heightened need for healthcare professionals across the UK to address suboptimal vaccine uptake, particularly in at-risk patients. Healthcare professionals and policymakers should consider measures targeted at increasing access to and awareness of the clinical benefits of the influenza vaccine.

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Stagnating influenza vaccine coverage rates among high-risk groups in Poland and Sweden in 2003/4 and 2004/5

Eurosurveillance ◽

10.2807/esm.12.04.00696-en ◽

2007 ◽

Vol 12 (4) ◽

pp. 1-2 ◽

Cited By ~ 11

Author(s):

M Kroneman ◽

G A van Essen

Keyword(s):

High Risk ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Chronic Diseases ◽

Vaccine Coverage ◽

Risk Groups ◽

Vaccine Uptake ◽

World Health ◽

High Risk Population ◽

Coverage Rates

This paper examines influenza vaccine coverage rates (VCR) in Poland and Sweden during the 2003/4 and 2004/5 influenza seasons. An average sample of 2,500 persons was interviewed in each country and each season. Questions regarded age and possible chronic diseases, as well as information on whether they had had an influenza vaccination in the given season. Those who had not received the vaccine were also asked to give reasons for non-vaccination. About one in four (Sweden) to one in three (Poland) of the persons surveyed belonged to high-risk groups (>=65 years of age or suffering from chronic diseases). In the 2004/5 season, 17% (CI 12-19%) of the Polish elderly and 45% (CI 39-50%) of the Swedish elderly were vaccinated. In Poland, 9% (CI 7-12%) of respondents younger than 65 years of age with a chronic condition were vaccinated, whereas in Sweden the corresponding rate was 12% (CI 9-16%). In both countries, the VCR did not change significantly from the previous season. Personal invitations resulted in a higher VCR. In Sweden, the most frequently mentioned reasons for not being vaccinated were the assumption of not qualifying for a vaccination and perceived resistance. In Poland in both years, perceived resistance to flu and the cost of the vaccination were the most often mentioned reasons. The influenza vaccination rates in Poland and Sweden remain far below World Health Organization (WHO) recommendations for the high-risk population. No increase in VCR as demonstrated in this study may indicate that these two countries will not be able to meet the 2010 WHO target, if no further action is taken concerning vaccine uptake.

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Influenza vaccination coverage in a population-based cohort of Australian-born Aboriginal and non-Indigenous older adults

Communicable Diseases Intelligence ◽

10.33321/cdi.2019.43.30 ◽

2019 ◽

Vol 43 ◽

Author(s):

Amalie Dyda ◽

Surendra Karki ◽

Marlene Kong ◽

Heather F Gidding ◽

John M Kaldor ◽

...

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Vaccination Coverage ◽

Torres Strait Islander ◽

Vaccine Coverage ◽

Vaccine Uptake ◽

P Value ◽

Healthy Weight ◽

Medical Risk ◽

Torres Strait

Background: There is limited information on vaccination coverage and characteristics associated with vaccine uptake in Aboriginal and/or Torres Strait Islander adults. We aimed to provide more current estimates of influenza vaccination coverage in Aboriginal adults. Methods: Self-reported vaccination status (n=559 Aboriginal and/or Torres Strait Islander participants, n=80,655 non-Indigenous participants) from the 45 and Up Study, a large cohort of adults aged 45 years or older, was used to compare influenza vaccination coverage in Aboriginal and/or Torres Strait Islander adults with coverage in non-Indigenous adults. Results: Of Aboriginal and non-Indigenous respondents aged 49 to <65 years, age-standardised influenza coverage was respectively 45.2% (95% CI 39.5–50.9%) and 38.5%, (37.9–39.0%), p-value for heterogeneity=0.02. Coverage for Aboriginal and non-Indigenous respondents aged ≥65 years was respectively 67.3% (59.9–74.7%) and 72.6% (72.2–73.0%), p-heterogeneity=0.16. Among Aboriginal adults, coverage was higher in obese than in healthy weight participants (adjusted odds ratio (aOR)=2.38, 95%CI 1.44–3.94); in those aged <65 years with a medical risk factor than in those without medical risk factors (aOR=2.13, 1.37–3.30); and in those who rated their health as fair/poor compared to those who rated it excellent (aOR=2.57, 1.26–5.20). Similar associations were found among non-Indigenous adults. Conclusions: In this sample of adults ≥65 years, self-reported influenza vaccine coverage was not significantly different between Aboriginal and non-Indigenous adults whereas in those <65 years, coverage was higher among Aboriginal adults. Overall, coverage in the whole cohort was suboptimal. If these findings are replicated in other samples and in the Australian Immunisation Register, it suggests that measures to improve uptake, such as communication about the importance of influenza vaccine and more effective reminder systems, are needed among adults.

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Factors associated with childhood influenza vaccination in Israel: a cross-sectional evaluation

Israel Journal of Health Policy Research ◽

10.1186/s13584-019-0349-x ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Aharona Glatman-Freedman ◽

Kanar Amir ◽

Rita Dichtiar ◽

Hila Zadka ◽

Ifat Vainer ◽

...

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Vaccine Coverage ◽

Population Group ◽

Vaccine Uptake ◽

Arab Population ◽

Cross Sectional ◽

Vaccine Acceptance ◽

Factors Associated ◽

Beneficial Effects

Abstract Background Vaccinating children against influenza has shown both direct and indirect beneficial effects. However, despite being offered free of charge, childhood influenza vaccine coverage in Israel has been low. Our objective was to evaluate the factors associated with childhood influenza vaccination in Israel. Methods A cross-sectional language-specific telephone survey was conducted among adults 18 years or older, to examine childhood influenza vaccination practices and their associations with socio-demographic and relevant health variables. We further explored the reasons for these practices among parents. Multivariate logistic regression was used to identify factors associated with childhood influenza vaccine acceptance. Results Of a total of 6518 individuals contacted by mobile phone, 1165 eligible parents, ≥18 years old with children 1–18 years of age, were interviewed, and 1040 of them completed the survey successfully. Overall, factors associated with childhood influenza vaccination were younger child’s age, influenza vaccination of other family members and belonging to the Arab population group. No association was found between childhood influenza vaccination and routine childhood vaccine uptake. Several of the parents’ reasons for vaccine acceptance - preventing influenza or its transmission, awareness regarding the need for influenza vaccination and receipt of invitation to get vaccinated - differed significantly between Jewish and Arab parents. Several reasons reported by parents for not vaccinating children against influenza, indicated a likelihood to accept influenza vaccine outreach efforts. Such reasons were reported by 27.5% of Jewish parents and 37.5% of Arab parents. Conclusions We found that certain demographic factors were associated with childhood influenza vaccination in Israel. Several reasons described by the parent for not vaccinating their children indicate that outreach efforts are likely to increase childhood influenza vaccination. Addressing population group-specific needs is recommended to optimize the success of influenza vaccine outreach efforts.

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Influenza vaccination coverage rates in the general population and risk groups: A review of the current international situation

Postępy Higieny i Medycyny Doświadczalnej ◽

10.5604/01.3001.0012.8258 ◽

2018 ◽

Vol 72 ◽

pp. 1138-1147

Author(s):

Aneta Nitsch-Osuch ◽

Anna Jagielska ◽

Lidia B. Brydak

Keyword(s):

Health Care ◽

General Population ◽

Influenza Vaccination ◽

Vaccination Coverage ◽

Vaccine Coverage ◽

Risk Groups ◽

The Elderly ◽

Current Data ◽

Health Care Facilities ◽

Coverage Rates

Although several national and international recommendations have been published, influenza vaccinations are carried out too rarely and thus vaccine coverage rates, both in the general population and in risk groups, remain at an unsatisfactorily low level. The paper presents the current data describing influenza vaccine coverage rates in different countries, in the general population and risk groups (including patients with chronic diseases, pregnant women, children the elderly) and health care workers. It is emphasized that there are many limitations related to the estimation of coverage rates. Methods that are currently used for the assessment of influenza vaccination coverage rates include the following: an analysis of data from health care facilities or providers, from national health insurance records, from well-documented national or private vaccine programs targeting at specific smaller groups, evaluation of national vaccine register, and national surveys of individuals. The establishment of coverage rates among specific groups usually requires another approach with the use of individual web- or telephone- based surveys, which is why selection bias and recall bias should be taken into consideration while discussing the results. The most common drivers and barriers for influenza vaccination are also identified and presented in the review.

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An Internet-Based Survey of Influenza Vaccination Coverage in Healthcare Workers in China, 2018/2019 Season

Vaccines ◽

10.3390/vaccines8010006 ◽

2019 ◽

Vol 8 (1) ◽

pp. 6 ◽

Cited By ~ 4

Author(s):

Haitao Liu ◽

Yayun Tan ◽

Muli Zhang ◽

Zhibin Peng ◽

Jiandong Zheng ◽

...

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Vaccination Coverage ◽

Healthcare Workers ◽

Online Survey ◽

Vaccine Coverage ◽

National Level ◽

Influence Factors ◽

Multivariate Logistic Regression Analysis ◽

Vaccine Uptake

Influenza vaccination coverage was low among healthcare workers (HCWs) in China. In October 2018, the National Health Commission of China began to require all hospitals to provide free influenza vaccination for HCWs to increase vaccine uptake, and no study on vaccine coverage among HCWs at the national level after the announcement of new policy. This evaluation aims to investigate self-reported influenza vaccination coverage among HCWs and factors that may affect vaccine receipt during the 2018/2019 influenza season. We delivered an opt-in internet panel survey among registered HCWs of DXY forum (the biggest online forum for HCWs in China). The survey was self-administered using a standard questionnaire to collect information on demographics, occupational characteristics, policy implementation, influenza vaccination and influence factors. We conducted multivariate logistic regression analysis to assess factors associated with receipt of influenza vaccine. The response rate of this online survey was 3.6%. The seasonal influenza vaccine coverage reported among HCWs surveyed during the 2018/2019 season was 11.6% (472/4078). Only 19.0% (774/4078) of HCWs surveyed reported free policy in their workplace. Combing free policy and workplace requirement proved to be effective to improve influenza vaccination coverage in HCWs (PR = 6.90, 95% CI: 6.03–7.65). The influenza vaccination coverage among surveyed HCWs in China was low during the 2018/2019 season. To increase future vaccination uptake, we recommend a multi-faceted strategy that include free policy, workplace requirement and promotion, on-site vaccination, and monitoring.

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An evaluation of influenza vaccine uptake in UK medical students

Occupational Medicine ◽

10.1093/occmed/kqab014 ◽

2021 ◽

Author(s):

G Gray ◽

J Cooper

Keyword(s):

Medical Students ◽

Influenza Vaccine ◽

Medical School ◽

Influenza Vaccination ◽

Service Evaluation ◽

Vaccination Status ◽

Vaccine Uptake ◽

Vaccination Rates ◽

Increased Risk ◽

The Uk

Abstract Background The annual influenza vaccination is recommended for all front-line healthcare workers in the UK and is a crucial way of reducing mortality for vulnerable patient groups. However, to date the UK government has never explicitly monitored influenza vaccine uptake in medical students. This is important to ascertain, as students regularly move between clinical areas and are both a perfect vector for the spread of influenza and at an increased risk of contracting influenza themselves. Aims This service evaluation was designed to evaluate the effectiveness of an influenza vaccination programme in one UK medical school and make recommendations to increase vaccination rates in the future. Methods This service evaluation collected data about medical student uptake of influenza vaccination in one UK medical school. Two hundred and fifty-one students at different course stages completed questionnaires, answering questions on vaccination status and Likert-scale ‘belief’ questions to assess the subjective reasons behind vaccine refusal. Results There was a substantial difference between year group cohorts (~20%), with significantly higher vaccination rates in the preclinical year group. Two significant negative predictors of vaccination were found (P < 0.001), related to scepticism over the effectiveness of the vaccine and lack of convenient access to the vaccination. Results indicated that integrating information about the influenza vaccine into the curriculum would reduce lack of knowledge over the efficacy of the vaccine. The centralization of vaccination programmes at mandatory university-based learning events would mitigate against the problem of diversity of vaccination locations and lack of central accountability. Conclusions The results of this service evaluation provide significant predictors of vaccination status for medical students and potential occupational health interventions to improve vaccine uptake in this group.

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2761. Interventions to Improve Influenza Vaccination Coverage in Children with Medical Comorbidities: A Meta-Analysis

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.2438 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S973-S974

Author(s):

Daniel Norman ◽

Rosanne Barnes ◽

Margie Danchin ◽

Holly Seale ◽

Hannah C Moore ◽

...

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Vaccination Coverage ◽

Vaccine Coverage ◽

Meta Analysis ◽

Parental Knowledge ◽

Vaccine Uptake ◽

Inclusion Criteria ◽

Cross Sectional ◽

Medical Comorbidities

Abstract Background Influenza vaccination is the most effective influenza prevention tool for children with medical comorbidities. Despite this, coverage remains inadequate. Numerous interventions to improve vaccination coverage have been assessed, yet there remains a paucity of data comparing the relative efficacy and effectiveness of different interventions. Methods We searched MEDLINE, PubMed, Scopus, Embase, CINAHL, CENTRAL, and Web of Science (1980 to March 2019) for studies evaluating interventions which sought to improve influenza vaccine coverage in children with medical comorbidities. Interventions were divided into those targeting parents, targeting vaccination providers, and targeting the hospital, clinic or ward. Screening and data extraction from publications meeting inclusion criteria was performed by two reviewers. Results were pooled and meta-analyses were performed using Mantel–Haenszel random-effects models in Review Manager 5. Results 35 articles met inclusion criteria; 14 cross-sectional, 12 randomized trials, and 9 cohort studies, 25 articles had sufficient data for pooled analysis. Of the included interventions, 17 were based within primary care or community-based settings, 17 were based in hospitals or tertiary clinics, and 1 intervention was conducted across both primary and tertiary settings. Interventions overall increased influenza vaccination likelihood by 33% (RR = 1.33: 95% CI 1.31, 1.35). Interventions targeting providers’ influenza vaccine knowledge increased vaccine coverage (RR = 1.42: 95% CI 1.36, 1.49) greater than those targeting parental knowledge (RR = 1.23: 95% CI 1.21, 1.26). Conversely, vaccination reminders targeting parents increased vaccine coverage (RR = 1.53: 95% CI 1.49, 1.58) greater than reminders targeting providers (RR = 1.23: 95% CI 1.20, 1.27). Interventions targeting hospitals, clinics or ward processes had the weakest impact on coverage (RR = 1.15: 95% CI 1.13, 1.17). Conclusion Interventions targeting parents, providers, and places individually have all shown to improve influenza vaccination in children with medical comorbidities. However, specifically targeting providers’ vaccine knowledge and parental reminders appear to have the greatest impact on vaccine uptake. Disclosures All authors: No reported disclosures.

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Improving influenza vaccine coverage in at‐risk groups

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1993.tb138009.x ◽

1993 ◽

Vol 159 (8) ◽

pp. 542-547 ◽

Cited By ~ 15

Author(s):

John C B Litt ◽

Peter B Lake

Keyword(s):

At Risk ◽

Influenza Vaccine ◽

Vaccine Coverage ◽

Risk Groups

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Risk groups and uptake of influenza and pneumococcal vaccine in Ireland

Eurosurveillance ◽

10.2807/esm.12.12.00756-en ◽

2007 ◽

Vol 12 (12) ◽

pp. 13-14 ◽

Cited By ~ 6

Author(s):

J Mereckiene ◽

J O’Donnell ◽

C Collins ◽

S Cotter ◽

D Igoe ◽

...

Keyword(s):

Influenza Vaccine ◽

Pneumococcal Vaccine ◽

Healthcare Workers ◽

Risk Group ◽

Family Doctor ◽

Risk Groups ◽

Vaccine Uptake ◽

Pneumococcal Vaccines ◽

Factors Influencing ◽

Care Facilities

In Ireland, influenza and pneumococcal vaccines are recommended for adults aged 65 years and over and for those with chronic illness or immunosuppression. Influenza vaccine is recommended for healthcare workers (HCWs) and residents of long stay care facilities. Influenza vaccine uptake is only available for those aged 65 years and over. We conducted a survey to estimate the size of risk groups between 18 and 64 years of age, influenza and pneumococcal vaccine uptake in this group, and to determine possible factors influencing vaccine uptake to improve targeted immunisation programmes. Among respondents aged 18-64 years, 136 of 1,218 (11%) belonged to a health risk group; uptake of influenza and pneumococcal vaccine in these risk groups was 28% (95% CI: 20.9-35.4) and 11% (95% CI: 6.7-17.2) respectively. Uptake among persons aged over 65 years was 69% (95% CI: 62.2-74.4) and 41% (95% CI: 35.0-47.9) for influenza and pneumococcal vaccine, respectively. Influenza vaccine uptake among HCWs was 20% (95% CI: 13.1-28.7). Half (47.6%) of influenza-vaccinated respondents reported that their family doctor had recommended it; 60% of non-vaccinated respondents, for whom influenza vaccine was indicated, saw themselves at low risk of influenza.

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A Tool for Early Estimation of Influenza Vaccination Coverage in Spanish General Population and Healthcare Workers in The 2018-19 Season. The Gripómetro

10.21203/rs.3.rs-737111/v1 ◽

2021 ◽

Author(s):

Javier Díez-Domingo ◽

Esther Redondo Marguello ◽

Raúl Ortiz Lejarazu Leonardo ◽

Ángel Gil Miguel ◽

José María Guillén Ortega ◽

...

Keyword(s):

General Population ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Real Time ◽

Vaccination Coverage ◽

Health Care Professionals ◽

Vaccine Coverage ◽

Vaccination Campaign ◽

Risk Groups ◽

Time Data

Abstract Background: Electronic vaccine registries are not yet widely established. There is a need to real-time monitor influenza vaccine coverage, which may raise awareness to risk groups and professionals, and eventually allow to adopt tailored measures during the vaccination campaign. To evaluate the utility of the “Gripómetro”, a demographic study designed to monitor national and regional influenza vaccine coverage on a weekly basis in Spain. Methods: Quantitative study based on surveys of the Spanish population between 18-80 years and a sample of primary care doctors and nurses randomly selected. Pre-proportional fixation has been established by Autonomous Communities and age group to guarantee the representativeness of all the autonomies. Results: Interviews were conducted in 3400 households of general population and 807 respondents among health care professionals. We found that the results of influenza vaccination coverage obtained by the Gripómetro for 2018-2019 season were mostly comparable with the official data presented by the Ministry of Health after the end of the vaccination campaign. Conclusions: The Gripómetro is a robust research method that provides real-time data and trends for influenza vaccine coverage along with other useful information related to vaccination such as intention to vaccinate, motivation and barriers to vaccination.

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