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

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 286
Author(s):  
Roberto Tapia-Conyer ◽  
Miguel Betancourt-Cravioto ◽  
Alejandra Montoya ◽  
Jorge Abelardo Falcón-Lezama ◽  
Myrna María Alfaro-Cortes ◽  
...  

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.

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 188
Author(s):  
Miguel Betancourt-Cravioto ◽  
Jorge Abelardo Falcón-Lezama ◽  
Rodrigo Saucedo-Martínez ◽  
Myrna María Alfaro-Cortés ◽  
Roberto Tapia-Conyer

The Mexican influenza vaccination program does not include a recommendation for people aged 50–59 years without risk factors for influenza complications, and there are limited data regarding the cost-effectiveness of vaccinating this population. To explore the clinical and economic effects of including this population in the vaccination schedule, we performed a cross-sectional epidemiological study using records (2009–2018) from Mexico’s Influenza Surveillance System (SISVEFLU), death records (2010–2015) from the National Mortality Epidemiological and Statistical System, and discharge and hospitalization records (2010–2015) from the Automated Hospital Discharge System databases. A 1-year decision-analytic model was used to assess cost-effectiveness through a decision-tree based on data from SISVEFLU. The primary outcome was influenza cases avoided; with associated influenza-related events as secondary outcomes. Including the population aged 50–59 years without risk factors in Mexico’s influenza immunization program would have resulted in 199,500 fewer cases; 67,008 fewer outpatient consultations; 33,024 fewer emergency room consultations; 33,091 fewer hospitalizations; 12 fewer deaths. These reductions equate to a substantial public health benefit as well as an economic benefit; yielding net savings of 49.8 million US dollars over a typical influenza season. Expansion of the current Mexican vaccination schedule to include these people would be a cost-saving and dominant strategy.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Miskulin ◽  
A Vcev ◽  
M Matic Licanin ◽  
I Vcev ◽  
I Vukoja ◽  
...  

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.


Vaccines ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 327
Author(s):  
Silvia Portero de la Cruz ◽  
Jesús Cebrino

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.


2021 ◽  
Author(s):  
Sophie Vaux ◽  
Laure Fonteneau ◽  
Anne-Gaëlle Venier ◽  
Arnaud Gautier ◽  
Sophan Soing Altrach ◽  
...  

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%.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Tognetto ◽  
A Abbondanzieri ◽  
G Cerone ◽  
M Di Pumpo ◽  
A Nardi ◽  
...  

Abstract Background Seasonal influenza vaccination (SIV) of health care workers (HCWs) is well recognized as a public health measure that can protect both HCWs from infection and patients from the risk of influenza complications. Nevertheless, vaccination coverage rates among this specific population result generally lower than the recommended target. With our study, we aimed to describe the activities and the outcomes of four different SIV campaigns targeted at HCWs and organized during the season 2018/2019 in four hospitals in Rome. Methods A cross-sectional study involving four teaching hospitals was performed. The collected data were synthetized into a set of descriptors and indicators, validated through a previous study that had involved the same Centers. Results The Medical Directorates, in collaboration with the University Hygiene and Public Health Units of the four hospitals organized different strategies: Hospital 1, 3 and 4 realized educational courses for HCWs and actively promoted the campaigns through e-mail invitations to all HCWs. As for the access to vaccination, all the hospitals provided a dedicated unit for SIV; Hospital 1 and Hospital 4 organized also on-site vaccination sessions in the hospital wards, that required a large number of staff. The vaccination coverage rates resulted: 22.37% in Hospital 1, 18.10% in Hospital 4, 9.28% in Hospital 2 and 8,51% in Hospital 3. Conclusions Our results demonstrate that multi-activity campaigns, involving education, promotion and easy access to vaccination constitute an effective approach to reinforce the value of SIV. Our findings suggest that on-site vaccination may play a key role in determining a higher vaccination coverage. Key messages Multi-activity vaccination campaigns, involving education, promotion and easy access to vaccination constitute an effective approach to reinforce the value of seasonal influenza vaccination for HCWs. On-site vaccination may play a key role in determining a higher vaccination coverage.


BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e024018 ◽  
Author(s):  
Xiaolei Huang ◽  
Michael C Smith ◽  
Amelia M Jamison ◽  
David A Broniatowski ◽  
Mark Dredze ◽  
...  

IntroductionThe Centers for Disease Control and Prevention (CDC) spend significant time and resources to track influenza vaccination coverage each influenza season using national surveys. Emerging data from social media provide an alternative solution to surveillance at both national and local levels of influenza vaccination coverage in near real time.ObjectivesThis study aimed to characterise and analyse the vaccinated population from temporal, demographical and geographical perspectives using automatic classification of vaccination-related Twitter data.MethodsIn this cross-sectional study, we continuously collected tweets containing both influenza-related terms and vaccine-related terms covering four consecutive influenza seasons from 2013 to 2017. We created a machine learning classifier to identify relevant tweets, then evaluated the approach by comparing to data from the CDC’s FluVaxView. We limited our analysis to tweets geolocated within the USA.ResultsWe assessed 1 124 839 tweets. We found strong correlations of 0.799 between monthly Twitter estimates and CDC, with correlations as high as 0.950 in individual influenza seasons. We also found that our approach obtained geographical correlations of 0.387 at the US state level and 0.467 at the regional level. Finally, we found a higher level of influenza vaccine tweets among female users than male users, also consistent with the results of CDC surveys on vaccine uptake.ConclusionSignificant correlations between Twitter data and CDC data show the potential of using social media for vaccination surveillance. Temporal variability is captured better than geographical and demographical variability. We discuss potential paths forward for leveraging this approach.


2003 ◽  
Vol 26 (1) ◽  
pp. 76 ◽  
Author(s):  
Penny Smithers ◽  
Sally B Murray ◽  
Sophie Stewart ◽  
Sue Skull

The purpose of this study was to assess knowledge, attitudes, practices, and self-reported vaccination status of HCWs at a tertiary Australian hospital, one year after implementation of a HCW vaccination policy.Two cross-sectional telephone surveys were conducted with HCWs at the hospital prior to and one year after HCW vaccination policy implementation. There was a 95% (272/287) response rate from eligible HCWs in the follow-up survey.Despite 96% (260/272) of HCWs indicating a willingness to update their vaccination status, only 24% (65/272) reported being fully vaccinated. Successful policy implementation requires adequate resource allocation and organisational commitment. Ongoing evaluation can inform the success of this process.


2021 ◽  
Author(s):  
Raquel Muñoz-Miralles ◽  
Anna Bonet-Esteve ◽  
Anna Rufas Cebollero ◽  
Xavier Pelegrin Cruz ◽  
Josep Vidal Alaball

Abstract BackgroundInfluenza vaccination is the main measure of prevention against the epidemic flu, which annually produces a significant increase in the pressure on healthcare systems, in addition to influencing the absenteeism of health workers. Although it is recommended that health professionals be vaccinated, their vaccination coverage is low. The lack of knowledge about the evolution of influenza in the context of the SARS-CoV-2 coronavirus pandemic led to the continued recommendation of influenza vaccination to people at risk and to professionals. The aim of the study is to determine the intention to vaccinate against seasonal flu of health professionals in the 2020-21 campaign in the context of the SARS-CoV-2 pandemic, and to analyse the factors that influence it.MethodsCross-sectional study through a structured online survey aimed at Primary Care professionals in the region of central Catalonia.ResultsA total of 610 participants responded to the survey, 65.7% of whom intended to be vaccinated against the flu in this campaign and 11.1% did not yet know or did not answer. The intention to be vaccinated against flu is associated with the professional category, the years of professional practice, the fact of making face-to-face guards, and the perception of the risk of suffering from flu. It is also related to a history of influenza vaccination in the previous year and to having been vaccinated on another occasion. The profile of professionals who intend to be vaccinated against flu includes professionals with a history of vaccination, who were on duty and perceived that their staff were at risk of becoming ill with flu.ConclusionsDuring the SARS-CoV-2 pandemic, many professionals show a clear intention to get vaccinated against the flu, but there are still some who doubt it. In order to improve influenza vaccination coverage among health professionals, it is necessary to design strategies aimed at professionals who are hesitant or reluctant to vaccination.


2020 ◽  
Author(s):  
Tatiana Drummond ◽  
Isabel Marín ◽  
Anny Sánchez ◽  
Marianjosé Reyes ◽  
Jenny García ◽  
...  

Abstract In Venezuela, PAHO has reported an increase in vaccine-preventable diseases since 2016. The goal of this work was to assess vaccination coverage in children hospitalized in the Department of Pediatrics at the Hospital Universitario de Caracas (HUC). Methods: A descriptive cross-sectional study included 0 to 12 years old children hospitalized in HUC admitted between January 2015 and December 2019, and verified immunization scheme. The patient data were compared with the schedule of the Ministry of Health of Venezuela and analyzed by comparing immunization coverage by year of patient hospitalization and patient age. Results: A total of 2903 patients were surveyed, corresponding to 53.2% male, 37.4% infants. A coverage level above 95% was found only for BCG. Comparing vaccination coverage with the vaccination schedule vs year of patient hospitalization, it was observed a mean decrease in vaccine coverage of 21.5% in 2019 relative to 2015 (p = 0.0000). Vaccination rates in children under one year old were lower than in children older than 6 years for all vaccines (p = 0.0000) Conclusions: There is a decline in vaccination coverage in 2019 in relation to previous years, being the most affected children less than one year old


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