Attitudes and Beliefs on Influenza Vaccination during the COVID-19 Pandemic: Results from a Representative Italian Survey

The last 2019/20 northern hemisphere influenza season overlapped with the first wave of coronavirus disease 2019 (COVID-19) pandemic. Italy was the first western country where severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread to a significant extent. In this representative cross-sectional survey, we aimed to describe some opinions and attitudes of the Italian general population towards both influenza vaccination and the COVID-19 pandemic, and to identify potential modifiers of the decision-making process regarding the uptake of the 2020/21 influenza vaccine. A total of 2543 responses were analyzed. Although most (74.8%) participants valued influenza vaccination positively and declared that it should be mandatory, some misconceptions around influenza persist. The general practitioner was the main source of trusted information on influenza vaccines, while social networks were judged to be the least reliable. Younger and less affluent individuals, subjects not vaccinated in the previous season, and those living in smaller communities showed lower odds of receiving the 2020/21 season influenza vaccination. However, the COVID-19 pandemic may have positively influenced the propensity of being vaccinated against 2020/21 seasonal influenza. In order to increase influenza vaccination coverage rates multidisciplinary targeted interventions are needed. The role of general practitioners remains crucial in increasing influenza vaccine awareness and acceptance by effective counselling.

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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 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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Influenza Vaccination Rates and Motivators Among Healthcare Worker Groups

Infection Control and Hospital Epidemiology ◽

10.1086/511796 ◽

2007 ◽

Vol 28 (2) ◽

pp. 171-177 ◽

Cited By ~ 91

Author(s):

Amanda Banks Christini ◽

Kathleen A. Shutt ◽

Karin E. Byers

Keyword(s):

Medical Students ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Tertiary Care ◽

Teaching Hospitals ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Influenza Like Illness ◽

Vaccination Rates ◽

Nursing Aides

Background.The rate of influenza vaccination among healthcare workers (HCWs) is approximately 40%. Differences in vaccination rates among HCW groups and reasons for accepting or rejecting vaccination are poorly understood.Objectives.To determine vaccination rates and motivators among different HCW groups during the 2004-2005 influenza season.Design.Cross-sectional survey conducted between July 10 and September 30, 2005.Setting.Two tertiary care teaching hospitals in an urban center.Participants.Physicians, nurses, nursing aides, and other staff. Surveys were collected from 1,042 HCWs (response rate, 42%).Results.Sixty-nine percent of physicians (n = 282) and 63% of medical students (n = 145) were vaccinated, compared with 46% of nurses (n = 336), 42% of nursing aides (n = 135), and 29% of administrative personnel (n = 144). Physicians and medical students were significantly more likely to be vaccinated than all other groups (P < .0001). Pediatricians (84%) were more likely than internists (69%) and surgeons (43%) to be vaccinated (P < .0001). Among the HCWs who were vaccinated, 33.4% received the live attenuated influenza vaccine (LAIV) and 66.6% received trivalent inactivated influenza vaccine (TIV). Vaccinated HCWs were less likely than unvaccinated HCWs to report an influenza-like illness (P = .03). Vaccination with LAIV resulted in fewer episodes of influenza-like illness than did receiving no vaccine (P = .03). The most common reason for rejecting vaccination was a concern about availability. Understanding that HCWs may transmit the virus to patients correlated with vaccine acceptance (P = .0004).Conclusions.Significant differences in vaccination exist among physician specialties and employee groups, and there are inadequate vaccination rates among those with the greatest amount of patient contact, potentially providing a basis for group-specific interventions.

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Impact of Severe Acute Respiratory Syndrome and the Perceived Avian Influenza Epidemic on the Increased Rate of Influenza Vaccination Among Nurses in Hong Kong

Infection Control and Hospital Epidemiology ◽

10.1086/527507 ◽

2008 ◽

Vol 29 (3) ◽

pp. 256-261 ◽

Cited By ~ 20

Author(s):

Dennise K. P. Tam ◽

Shui-Shan Lee ◽

Sing Lee

Keyword(s):

Hong Kong ◽

Avian Influenza ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Influenza Infection ◽

Vaccination Rate ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Major Barrier ◽

Vaccination Rates

Objective.To determine the rate of influenza vaccination and the factors associated with the vaccination's acceptance among nurses in Hong Kong.Design.Cross-sectional survey.Participants.Nurses practicing between 2003 and 2007.Methods.A questionnaire was sent to all nurses registered with any of the 3 nursing associations that participated in this study.Results.A total of 941 completed questionnaires were available for analysis, though not all nurses responded to every question (response rate, 33.5%-36.3%). Vaccination rates in 2006 and 2007 were 57.2% and 46.2%, respectively. Nurses who were vaccinated in 2006 were more likely to get vaccinated in 2007 (P<.01); 56% of the nurses perceived influenza vaccine as being effective against influenza. The perceived effectiveness of influenza vaccine was a consistent predictor of rates of vaccination in 2006 (odds ratio [OR], 8.47 [95% confidence interval {CI}, 6.13-11.70];P<.01) and 2007 (OR, 6.05 [95% CI, 3.79-9.67];P<.01). Concern about contracting avian influenza was a predictor of the vaccination rate in 2006 but not in 2007 (OR, 1.47 [95% CI, 1.03-2.09];P<.05), as was the perceived lack of control over avian influenza infection (OR, 1.52 [95% CI, 1.06-2.18];P<.05).Conclusions.The overall influenza vaccination rate for nurses in Hong Kong was about 50%. It was affected by the perceived threat of an impending outbreak. The attitudes of nurses toward the effectiveness of and rationale for vaccination were a major barrier to increasing the rate of vaccination.

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Do Turkish Gynecologists and Obstetricians recommend pregnant women the influenza vaccine?

Infectious Diseases and Clinical Microbiology ◽

10.36519/idcm.2020.0005 ◽

2020 ◽

Vol 2 (1) ◽

pp. 16-23

Author(s):

Irem Akdemir Kalkan ◽

Ayşe Nur Usturalı Mut ◽

Gule Cinar ◽

Fatih Keskin ◽

Kemal Osman Memikoglu ◽

...

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Pregnant Women ◽

Social Insurance ◽

Viral Infections ◽

Multivariate Logistic Regression Analysis ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccination Rates ◽

Immunization Rates

Objective: Influenza is a systemic infectious disease. It is recommended that all pregnant women receive the influenza vaccine because the mortality of the disease is high during pregnancy. However, the rates of influenza vaccination in pregnant women are low. This study aims to estimate the rate at which Turkish gynecologists and obstetricians (GOs) recommend the influenza vaccine to their pregnant patients.. Materials and Methods: This study was designed as a cross-sectional survey. The sample size was calculated to be 364 based on 95% confidence interval and 5% margin of error. The data were collected through a questionnaire consisting of 17 questions, which was distributed through social media. The final study group included in the research consisted of 384 GOs. Results:The mean age of the GOs that participated in the study was 39.7 years (SD = 10.2). 43.5% of the GOs reported that they recommended the influenza vaccine to pregnant women who had consulted with them, while 62.8% reported that at least 50% of the pregnant women they had recommended the vaccine rejected it. According to multivariate logistic regression analysis, three factors increased the rate of GOs’ not to recommend influenza vaccination: the GOs’ age, not receiving influenza vaccination themselves, and not knowing the social insurance reimbursement for the vaccine. Conclusion: Vaccination of pregnant women is necessary because of the increased mortality risk of influenza during pregnancy. Even though GOs are not in charge of vaccinating their patients during their routine pregnancy follow-up, they can contribute to vaccination rates by recommending the vaccine. Physicians’ application of scientific knowledge and transferring it to their patients can contribute to increased adult immunization rates. Conclusion: Influenza, Influenza Vaccine, Pregnancy, Vaccination, Viral Infections

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Healthcare Workers’ Willingness to Receive Influenza Vaccination in the Context of the COVID-19 Pandemic: A Survey in Southern Italy

Vaccines ◽

10.3390/vaccines9070766 ◽

2021 ◽

Vol 9 (7) ◽

pp. 766

Author(s):

Gabriella Di Giuseppe ◽

Concetta P. Pelullo ◽

Andrea Paolantonio ◽

Giorgia Della Polla ◽

Maria Pavia

Keyword(s):

Side Effects ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Healthcare Workers ◽

Southern Italy ◽

Hospitalized Patients ◽

Cross Sectional Survey ◽

Enabling Factors ◽

Cross Sectional ◽

To Receive

This cross-sectional survey was designed to evaluate hospital healthcare workers’ (HCWs) willingness to receive the influenza vaccination during the COVID-19 pandemic and to identify the related determinants, since it is plausible that the two epidemics will coexist in future winters. Overall, 68% out of 490 participants expressed their willingness to receive influenza vaccination in the 2020/21 season, with 95% of those ever and 45.8% of those never vaccinated in the previous six influenza seasons. Belief that influenza vaccine is useful in distinguishing influenza symptoms from those of COVID-19 and that the influenza vaccine is useful to prevent influenza in hospital settings, willingness to receive COVID-19 vaccination, having no concern about influenza vaccine side effects, concern about the possibility to transmit influenza to hospitalized patients, and influenza vaccination in previous years were all predictors of willingness to receive influenza vaccination. In the context of the COVID-19 pandemic, a relevant increase in the willingness to undergo influenza vaccination was reported. Therefore, interventions focused primarily on enabling factors are needed to promote the adherence to influenza vaccination in future seasons among HCWs.

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Flu vaccine experiences and beliefs influence vaccination decision making more than knowledge

F1000Research ◽

10.12688/f1000research.3018.2 ◽

2014 ◽

Vol 3 ◽

pp. 224

Author(s):

Dara Whalen ◽

David Molnar ◽

Faye Milne ◽

Lauren Schwal ◽

Virginia Hackett ◽

...

Keyword(s):

Decision Making ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Direct Effect ◽

Nursing Faculty ◽

Role Models ◽

Attitudes And Beliefs ◽

Cross Sectional Survey ◽

Personal Experiences ◽

Vaccine Decision Making

Mass immunization programs have proven to be a primary preventive measure to limit the spread of many infectious diseases worldwide. Nurses are trained to be leaders in preventing potential global health problems, but they are one of the groups with the lowest rates of compliancy in receiving influenza vaccination. Since nursing faculty are important role models in molding attitudes and behaviors of future nurses (their students), we set out to explore the knowledge, attitudes and beliefs of the nursing faculty and their students regarding influenza vaccine decision making. Our study included an assessment of the knowledge, attitudes and beliefs (KABs) of the nursing faculty and students related to influenza vaccination and whether their KABs influence the decision to receive or decline the vaccination. A cross-sectional survey was conducted using an anonymous questionnaire and our study indicated that personal experiences—either positive or negative—had a direct effect on influenza vaccine decision-making. Additionally, personal experiences influenced beliefs, and beliefs were shown to influence decision-making regarding vaccination. While beliefs and personal experiences had a direct effect on vaccine decision-making, knowledge had only an indirect effect through beliefs. Our study demonstrated that even though nursing practice is supposed to be driven by evidence-based medical practices, personal practices by nurses may be more influenced by personal beliefs than medical knowledge.

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Attitudes and Perception of Healthcare Workers Concerning Influenza Vaccination during the 2019/2020 Season: A Survey of Sicilian University Hospitals

Vaccines ◽

10.3390/vaccines8040686 ◽

2020 ◽

Vol 8 (4) ◽

pp. 686

Author(s):

Claudio Costantino ◽

Caterina Ledda ◽

Raffaele Squeri ◽

Vincenzo Restivo ◽

Alessandra Casuccio ◽

...

Keyword(s):

Influenza Vaccination ◽

Perceived Risk ◽

Healthcare Workers ◽

Multivariable Analysis ◽

University Hospitals ◽

Cross Sectional Survey ◽

Cross Sectional ◽

European Guidelines ◽

Public Health Institutions ◽

Coverage Rates

Influenza is an infectious disease with a high impact on the population in terms of morbidity and mortality, but despite International and European guidelines, vaccination coverage rates among healthcare workers (HCWs) remain very low. The aim of the present study was to evaluate influenza vaccination adherence in the three Sicilian University Hospitals of Catania, Messina, and Palermo and to understand the attitudes and perceptions of vaccinated healthcare workers and the main reasons for vaccination refusal. A cross-sectional survey through a self-administered questionnaire was conducted during the 2019/2020 influenza season. Overall, 2356 vaccinated healthcare workers answered the questionnaire. The main reason reported for influenza vaccination adherence during the 2019/2020 season was to protect patients. Higher self-perceived risk of contracting influenza and a positive attitude to recommending vaccination to patients were significantly associated with influenza vaccination adherence during the last five seasons via multivariable analysis. Fear of an adverse reaction was the main reason for influenza vaccine refusal. In accordance with these findings, Public Health institutions should develop and tailor formative and informative campaigns to reduce principal barriers to the immunization process and promote influenza vaccination adherence among HCWs.

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Intention to have the seasonal influenza vaccination during the COVID-19 pandemic among eligible adults in the UK: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2021-049369 ◽

2021 ◽

Vol 11 (7) ◽

pp. e049369

Author(s):

Susan M Sherman ◽

Julius Sim ◽

Richard Amlôt ◽

Megan Cutts ◽

Hannah Dasch ◽

...

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Positive Attitude ◽

Online Survey ◽

Seasonal Influenza ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Seasonal Influenza Vaccination ◽

The Uk ◽

To Receive

ObjectiveTo investigate the likelihood of having the seasonal influenza vaccination during the COVID-19 pandemic in individuals who were eligible to receive it.DesignWe conducted a cross-sectional online survey in July 2020. We included predictors informed by previous research, in the following categories: sociodemographic variables; uptake of influenza vaccine last winter and beliefs about vaccination.Participants570 participants (mean age: 53.07; 56.3% female, 87.0% white) who were eligible for the free seasonal influenza vaccination in the UK.Results59.7% of our sample indicated they were likely to have the seasonal influenza vaccination, 22.1% reported being unlikely to have the vaccination and 18.2% were unsure. We used logistic regression to investigate variables associated with intention to receive a seasonal influenza vaccine in the 2020–2021 season. A positive attitude to vaccination in general predicted intention to have the influenza vaccine in 2020–2021 (OR 1.45, 95% CI 1.19 to 1.77, p<0.001) but the strongest predictor of intention was previous influenza vaccination behaviour (OR 278.58, 95% CI 78.04 to 994.46, p<0.001).ConclusionsPrevious research suggests that increasing uptake of the influenza vaccination may help contain a COVID-19 outbreak, so steps need to be taken to convert intention into behaviour and to reach those individuals who reported being unlikely or unsure about having the vaccine.

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Seasonal Influenza Vaccination among Saudi Children: Parental Barriers and Willingness to Vaccinate Their Children

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16214226 ◽

2019 ◽

Vol 16 (21) ◽

pp. 4226 ◽

Cited By ~ 1

Author(s):

Abdullah Alolayan ◽

Bdoor Almotairi ◽

Shouq Alshammari ◽

Malak Alhearri ◽

Mohammed Alsuhaibani

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Seasonal Influenza ◽

Risk Groups ◽

Cross Sectional Survey ◽

Severe Condition ◽

Cross Sectional ◽

Seasonal Influenza Vaccine ◽

Awareness Campaigns ◽

Knowledge And Attitudes

Influenza is an acute respiratory infection. It is a contagious viral illness which can cause moderate to severe symptoms. However, high-risk groups, including children, can develop a severe condition requiring hospitalization that may, in severe cases, result in death. This study aimed to assess the knowledge and attitudes of Saudi parents toward the influenza vaccine and identify potential barriers to receiving the influenza vaccination. A cross-sectional survey was conducted using a questionnaire comprising 27 validated questions to assess parental awareness, knowledge, and attitudes toward the influenza vaccine. The overall attitude of the participants was positive (94.7%). However, their knowledge was generally poor (61.7%). Most participants were aware of the seasonal influenza vaccine (85.5%) and their children were up-to-date with the child national vaccination program vaccines (92.7%). Medical staff and awareness campaigns were the commonest sources of vaccine information. Significant predictors for knowledge about and attitudes toward the influenza vaccine included educational level, working in the medical field, monthly income, awareness of the seasonal influenza vaccine, having received the vaccine as parent, and having a child already vaccinated. Adherence to the influenza vaccination regimen for parents and their children was low. More educational campaigns are needed to increase knowledge about the vaccine.

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