Reasons for low influenza vaccination coverage – a cross-sectional survey in Poland

Abstract Background The burden of influenza morbidity and mortality in nursing homes (NH) is high. Vaccination of residents and healthcare workers (HCW) is the main prevention strategy. Despite recommendations, HCW vaccination coverage is generally low. Methods We performed a nationwide cross-sectional survey of NH using a single-stage stratified random sampling design to estimate influenza vaccination coverage in nursing home HCW in France during the 2019-2020 season, and to identify measures likely to increase it. A multivariate analysis was performed using a negative binomial regression. Results Overall influenza vaccination coverage in HCW was 31.9% (95% CI [29.7-34.1]). It varied according to occupational category: 75.5% [69.3-81.7] for physicians, 42.9% [39.4-46.4] for nurses, 26.7% [24.5-29.0] for nursing assistants, and 34.0% [30.1-38.0] for other paramedical personnel. When considering all professionals (i.e., HCW and non-medical professionals), overall vaccination coverage was 30.6% [28.2-33.0]. Vaccination coverage was higher in private nursing homes, in i) small nursing homes, ii) when vaccination was offered free of charge (RRa: 1.4, [1.1-1.8]), iii) when vaccination promotion for professionals included individual (RRa: 1.6 [1.1-2.1]) or collective (RRa: 1.3 [1.1-1.5]) information sessions, videos or games (RRa: 1.4 [1.2-1.6], iv) when information on influenza vaccines was provided (RRa: 1.2 [1.0-1.3], and finally, vi) when a vaccination point of contact - defined as an HCW who could provide reliable information on vaccination - was nominated within the nursing home (RRa: 1.7 [1.3-2.2]). Conclusions Urgent and innovative actions are required to increase coverage in HCW. Vaccination programmes should include free vaccination and education campaigns, and particularly target nursing assistants. The results of this nationwide study provide keys for improving influenza vaccination coverage in HCW. Programmes should ensure that information on influenza vaccines is provided by a vaccination point of contact in NH using attractive media. Combining the different prevention measures proposed could increase coverage in NH nationwide by over 50%.

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Influenza vaccination coverage against seasonal and pandemic influenza and their determinants in France: a cross-sectional survey

BMC Public Health ◽

10.1186/1471-2458-11-30 ◽

2011 ◽

Vol 11 (1) ◽

Cited By ~ 78

Author(s):

Sophie Vaux ◽

Dieter Van Cauteren ◽

Jean-Paul Guthmann ◽

Yann Le Strat ◽

Véronique Vaillant ◽

...

Keyword(s):

Influenza Vaccination ◽

Vaccination Coverage ◽

Pandemic Influenza ◽

Cross Sectional Survey ◽

Cross Sectional

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Influenza Vaccination Coverage among Older Adults with Hypertension in Shenzhen, China: A Cross-Sectional Survey during the COVID-19 Pandemic

Vaccines ◽

10.3390/vaccines9101105 ◽

2021 ◽

Vol 9 (10) ◽

pp. 1105

Author(s):

Qiushuang Li ◽

Minyi Zhang ◽

Hongbiao Chen ◽

Fei Wu ◽

Juxian Xian ◽

...

Keyword(s):

Older Adults ◽

Older People ◽

Influenza Vaccination ◽

Vaccination Coverage ◽

Family Doctor ◽

Vaccination Status ◽

Older Individuals ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Influenza Vaccinations

Background: Older individuals with hypertension are at a high risk of being infected with influenza. However, there have been few studies investigating the influenza vaccination status among older people with hypertension. The present work aimed to estimate the vaccination coverage and determine the predictors of seasonal influenza vaccinations among hypertensive patients aged over 60 years in Shenzhen, China. Method: The study used data from an online cross-sectional survey that was conducted in Shenzhen City, China, in October 2020. Frequencies and proportions of all the variables including sociodemographic characteristics and health-related information were described and tabulated based on the influenza vaccination status. Bivariate and multivariable logistic regression analyses were used to identify independent predictors associated with the influenza vaccination. Results: A total of 5216 older people with hypertension aged above 60 years were recruited. Overall, only 4.7% had received an influenza vaccine in the latest influenza season. Using the action toward being vaccinated as the primary outcome, the multivariable regression analysis showed that participants aged over 80 years (aOR 2.957, 95% CI: 1.784–4.900), obtaining higher education levels (aOR 1.424, 95% CI: 1.060–1.914 for high school, aOR 1.681, 95% CI: 1.066–2.650 for college or above), living with a partner (aOR 1.432, 95% CI: 1.068–1.920), using a family doctor (aOR 2.275, 95% CI: 1.744–2.968), and taking a physical examination 1–2 and ≥3 times each year (aOR 2.107, 95% CI: 1.601–2.772 and aOR 2.118, 95% CI: 1.083–4.143, respectively) were more likely to be vaccinated. In contrast, smokers had less likelihood of having the influenza vaccination than non-smokers (aOR 1.829, 95% CI: 1.208–2.767). Conclusions: The coverage rate of influenza vaccinations is far away from optimistic among older adults with hypertension. Additional works should be undertaken immediately to improve the influenza vaccination status.

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Influenza vaccination coverage of healthcare workers and residents and their determinants in nursing homes for elderly people in France: a cross-sectional survey

BMC Public Health ◽

10.1186/1471-2458-10-159 ◽

2010 ◽

Vol 10 (1) ◽

Cited By ~ 28

Author(s):

Sophie Vaux ◽

Delphine Noël ◽

Laure Fonteneau ◽

Jean-Paul Guthmann ◽

Daniel Lévy-Bruhl

Keyword(s):

Nursing Homes ◽

Influenza Vaccination ◽

Elderly People ◽

Vaccination Coverage ◽

Healthcare Workers ◽

Cross Sectional Survey ◽

Cross Sectional

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A Call for a Reform of the Influenza Immunization Program in Mexico: Epidemiologic and Economic Evidence for Decision Making

Vaccines ◽

10.3390/vaccines9030286 ◽

2021 ◽

Vol 9 (3) ◽

pp. 286

Author(s):

Roberto Tapia-Conyer ◽

Miguel Betancourt-Cravioto ◽

Alejandra Montoya ◽

Jorge Abelardo Falcón-Lezama ◽

Myrna María Alfaro-Cortes ◽

...

Keyword(s):

Cost Effectiveness ◽

Influenza Vaccination ◽

Vaccination Coverage ◽

Decision Analytic Model ◽

Limited Information ◽

Vaccination Policy ◽

Cross Sectional ◽

Influenza Case ◽

One Year ◽

Effectiveness Studies

Limited information is available to determine the effectiveness of Mexico’s national influenza vaccination guidelines and inform policy updates. We aim to propose reforms to current influenza vaccination policies based on our analysis of cost-effectiveness studies. This cross-sectional epidemiological study used influenza case, death, discharge and hospitalization data from several influenza seasons and applied a one-year decision-analytic model to assess cost-effectiveness. The primary health outcome was influenza cases avoided; secondary health outcomes were influenza-related events associated with case reduction. By increasing vaccination coverage to 75% in the population aged 12–49 years with risk factors (diabetes, high blood pressure, morbid obesity, chronic renal failure, asthma, pregnancy), and expanding universal vaccination coverage to school-aged children (5–11 years) and adults aged 50–59 years, 7142–671,461 influenza cases; 1–15 deaths; 7615–262,812 healthcare visits; 2886–154,143 emergency room admissions and 2891–97,637 hospitalizations could be prevented (ranges correspond to separate age and risk factor groups), with a net annual savings of 3.90 to 111.99 million USD. Such changes to the current vaccination policy could potentially result in significant economic and health benefits. These data could be used to inform the revision of a vaccination policy in Mexico with substantial social value.

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Vaccination knowledge, attitudes and practices in patients with HIV: a cross-sectional survey

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.824 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

S Rousset ◽

G Voglino ◽

E Boietti ◽

A Corradi ◽

M R Gualano ◽

...

Keyword(s):

Public Health ◽

Infectious Diseases ◽

Health System ◽

Vaccination Coverage ◽

Public Health System ◽

Cross Sectional Survey ◽

Hiv Patients ◽

Cross Sectional ◽

Contagion Risk ◽

High Level

Abstract Background Infectious diseases are more common and severe in patients with HIV, which show different response to vaccines and a diminished protection. It is therefore very important to assess knowledge and attitudes towards vaccination in people with HIV, since precise vaccination coverage and vaccine hesitancy are not well established in this subgroup of patients. Methods A sample of 119 patients with HIV completed a cross-sectional survey. Patients were recruited during their routine medical examination at the infectious diseases clinic in Turin. The survey explored these main areas: demographics and history of HIV infection, vaccination history, attitudes towards vaccination, confidence in the public health system, contagion risk and disease seriousness perception. In this preliminary phase descriptive analysis were conducted. Results Preliminary data show that mean age of the participants was 49.51 years, 80% were males. The median of HIV infection duration was 10 years, while the median of the lymphocyte count was 762.50 cells/mm3. The disease with the highest vaccination coverage was tetanus (88.7%), considered a serious or very serious disease by 85.6% of the participants, despite low or very low contagion risk perception (84.1%). The disease with the lowest vaccination coverage was Herpes Zoster (7.3%), despite high or very high seriousness perception (70%). Furthermore, 99.1% of the participants showed high or very high confidence toward public health system professionals, and the majority of them (59.5%) stated that vaccines are more useful for the community than for the single person. Conclusions Vaccination coverage is still not fully satisfactory regarding diseases considered infrequent or mild. Considering the high level of confidence toward the public health system that has emerged, it is necessary to implement informative and operative strategies about vaccination for European HIV patients, which are particularly at risk regarding infectious diseases. Key messages Vaccination coverage and risk perception in HIV patients is not satisfactory for many diseases and an effort to implement informative strategies in Europe is needed. The role of vaccination in preventing infectious diseases in HIV patients should be recognized and strengthened by relying on the high level of confidence toward European public health systems.

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31. Influenza Vaccination During Pregnancy: A Descriptive Cross-sectional Survey of the Knowledge, Beliefs, and Attitudes of Mexican Gynecologists and Family Physicians

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.076 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S39-S39

Author(s):

Erika Z Lopatynsky-Reyes ◽

Sue Ann Costa-Clemens ◽

Enrique Chacon-Cruz ◽

Michael Greenberg

Keyword(s):

Influenza Vaccination ◽

Pregnant Women ◽

Latin American ◽

Vaccine Coverage ◽

Family Physicians ◽

Morbidity And Mortality ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Beliefs And Attitudes ◽

In Pregnancy

Abstract Background Influenza in pregnancy is associated with elevated morbidity and mortality. Influenza vaccines are both safe and effective in pregnancy, supporting routine use in this population. Even though influenza vaccination in Mexico is recommended for pregnant women, there are no publications of influenza vaccine coverage in pregnancy. This is the first Latin American survey done only in physicians aiming to assess the knowledge, beliefs, and attitudes that Mexican Obstetrics-Gynecologists (OBG) and Family Physicians (FP) have towards influenza and influenza immunization during pregnancy. Methods A cross-sectional survey was conducted, both paper-based and online. The questionnaire was composed of 35 questions, which addressed general knowledge of influenza, recommendations for vaccination during pregnancy, and beliefs and attitudes concerning the acceptability of the vaccine in pregnant women. Results A total of 206 completed surveys were available, 98 (47.6%) from OBG, 108 (52.4%) from FP. Regarding current practicing medical institutions, 76 (37%), 69 (34%), 31 (14.5%), 30 (14.5%) reported working for the Mexican Institute of Social Security, Private Sector, Secretariat of Health, or a combination of all respectively, representing an estimated 2,472 daily pregnancy consultations. About a quarter (26.2%) reported not having a notion that influenza is more severe among pregnant women. More than half (51.5%) ignored the potential side effects of influenza infection on the fetus. The majority (56.8%) did not know when vaccination during pregnancy should occur. Pregnancy as a risk factor for developing influenza complications was known only in 48.1%. Also, 46.1 % believed that vaccination only confers protection to the mother, but not to the fetus. Nevertheless, 96.1% considered that immunization against influenza during pregnancy is a safe and effective preventive intervention. A results’ summary is shown in Figure-1. Conclusion Based on this survey, current knowledge of OBG and FP for influenza morbidity and mortality during pregnancy, and the importance of influenza vaccination in pregnant women, is poor. Mandatory recommendations to educate medical providers regarding influenza vaccination during pregnancy in Mexico are necessary, even as imperative for CME credits. Disclosures All Authors: No reported disclosures

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Predictors of influenza vaccination uptake among elderly in Croatia

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1430 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Miskulin ◽

A Vcev ◽

M Matic Licanin ◽

I Vcev ◽

I Vukoja ◽

...

Keyword(s):

Influenza Vaccination ◽

Vaccination Coverage ◽

Median Number ◽

Cross Sectional ◽

Positive Correlation ◽

Positive Attitudes ◽

Significant Difference ◽

Vaccination History ◽

Study Population ◽

Effective Public Health

Abstract Background Influenza vaccination (IV) is recommended for elderly but vaccination coverage in this group remains unsatisfactory in Croatia. The aim of this study was to explore IV uptake among elderly from Eastern Croatia and predictors that influence this uptake. Methods This cross-sectional questionnaire study was conducted during 2018/2019 influenza season in convenient sample of older adults aged 65 years or more from Eastern Croatia at the primary health care setting. Results The study sample consisted of 816 subjects (48.0% males and 52.0% females). The median age of all subjects was 73.0 years (interquartile range (IQR) 69.5 - 79.0 years). The overall prevalence of IV uptake was 33.3%. The IV uptake was statistically more frequent among females (P < 0.001) and old-old subgroup (85 years and older) (P < 0.001). There was no statistically significant difference in IV uptake considering marital status of subjects (P > 0.999). The median number of positive attitudes towards IV was 4.0 (IQR 2.0 - 4.0) and the median number of correct answers was 6.0 (IQR 4.0 - 8.0). The study revealed fair positive correlation between attitudes and IV uptake (rho=0.477; P < 0.001) and poor positive correlation between knowledge and IV uptake (rho=0.242; P < 0.001). The study further showed poor positive correlation between presence of comorbidities and IV uptake (rho=0.187; P < 0.001) and moderate positive correlation between previous year vaccination history and IV uptake (rho=0.669; P < 0.001). Conclusions The study showed that observed IV uptake is far below EU target influenza vaccination coverage among elderly of 75%. The study revealed that fairly good predictors of IV uptake in study population were gender, older age group, and previous year vaccination history while attitudes, knowledge and presence of comorbidities were fairly poor predictors. The good predictors of IV uptake among elderly should be taken into account during influenza vaccination popularization strategies development. Key messages Understanding the factors that could improve the acceptance of vaccination is crucial to design effective public health interventions. The structured communication campaigns on influenza and influenza vaccines should be developed and directed specifically to elderly as one of target groups for vaccination.

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Trends, Coverage and Influencing Determinants of Influenza Vaccination in the Elderly: A Population-Based National Survey in Spain (2006–2017)

Vaccines ◽

10.3390/vaccines8020327 ◽

2020 ◽

Vol 8 (2) ◽

pp. 327

Author(s):

Silvia Portero de la Cruz ◽

Jesús Cebrino

Keyword(s):

Influenza Vaccination ◽

Chronic Diseases ◽

Vaccination Coverage ◽

Public Health Problem ◽

Risk Groups ◽

The Elderly ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Significant Public Health

Influenza is a significant public health problem and the elderly are at a greater risk of contracting the disease. The vaccination coverage of the elderly is below the Spanish target of 65% for each influenza season. The aims of this study were to report the coverage of influenza vaccination in Spain among the population aged ≥65 years and high-risk groups for suffering chronic diseases, to analyze the time trends from 2006 to 2017 and to identify the factors which affect vaccination coverage. A nationwide cross-sectional study was conducted including 20,753 non-institutionalized individuals aged ≥65 years who had participated in the Spanish National Health Surveys in 2006, 2011/2012, and 2017. Sociodemographic, health-related variables, and influenza vaccination data were used. A logistic regression analysis was performed to determine the variables associated with influenza vaccination. Influenza vaccination coverage was 60%. By chronic condition, older people with high cholesterol levels and cancer had the lowest vaccination coverage (62.41% and 60.73%, respectively). This coverage declined from 2006 to 2017 in both groups. Higher influenza vaccination was associated with males, Spanish nationality, normal social support perceived, polypharmacy, worse perceived health, participation in other preventive measures, and increasing age and the number of chronic diseases.

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Influenza Vaccination Among Registered Nurses: Information Receipt, Knowledge, and Decision-Making at an Institution With a Multifaceted Educational Program

Infection Control and Hospital Epidemiology ◽

10.1086/526431 ◽

2008 ◽

Vol 29 (2) ◽

pp. 99-106 ◽

Cited By ~ 72

Author(s):

Cori L. Ofstead ◽

Sharon J. Tucker ◽

Timothy J. Beebe ◽

Gregory A. Poland

Keyword(s):

Influenza Vaccination ◽

Registered Nurses ◽

Educational Program ◽

Medical Center ◽

Vaccine Safety ◽

Educational Interventions ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccination Rates ◽

To Receive

Objective.To evaluate the receipt of information and knowledge about influenza and vaccination, as well as influenza vaccination status and reasons for declining vaccination, among registered nurses.Design.Cross-sectional survey of registered nurses (RNs).Setting.A large tertiary medical center with a long-standing, multifaceted influenza vaccination program and relatively high vaccination rates among employees overall (76.5%).Participants.Randomly selected group of 990 RNs employed as inpatient staff nurses at the institution.Results.The survey was completed by 513 (51.8%) of 990 RNs. Most RNs (86.7%) had received an influenza vaccination in the past, and 331 (64.5%) intended to receive vaccination during the 2005-2006 influenza season. More than 90% of RNs acknowledged exposure to educational bulletins, and most had received information about influenza severity (383 [74.7%]), transmission (398 [77.6%]), vaccine safety (416 [81.1%]), and the time and location of free vaccination (460 [89.7%]). A majority (436 [85.0%]) felt they had received all the information they needed to make good decisions about vaccination. However, only 49 RNs (9.6%) gave correct answers to more than 85% of the knowledge questions on the survey. The reasons most frequently reported for declining vaccination were doubts about the risk of influenza and the need for vaccination, concerns about vaccine effectiveness and side effects, and dislike of injections.Conclusions.RNs exposed to a longstanding, multifaceted educational program had received information about influenza vaccination, but misconceptions were common and only 331 (64.5%) intended to receive vaccination. Strategies other than educational interventions are needed to increase influenza vaccination rates and thereby to ensure healthcare worker and patient safety.

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