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Domnich A, Lapi F, Orsi A, Grattagliano I, Rossi A, Cricelli C, Icardi G. Declining number of general practitioners can impair influenza vaccination uptake among Italian older adults: Results from a panel analysis. BMC Health Serv Res 2024; 24:950. [PMID: 39164724 PMCID: PMC11334494 DOI: 10.1186/s12913-024-11443-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 08/14/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Seasonal influenza vaccination coverage in Italian older adults is insufficient and well below the minimum target of 75%. In Italy, most influenza vaccine doses are administered by general practitioners (GPs), whose number has been declining. In parallel, the number of patients per GP and GP workload increased dramatically, which theoretically may impair vaccination counselling. In this ecological study, we aimed to assess whether influenza vaccination coverage in older adults is associated with the density of GPs having high number of patients. METHODS The study outcome was the influenza vaccination coverage rate in adults aged ≥ 65 years and registered in 20 Italian regions over the last 23 years. The independent variable of interest was the proportion of GPs with more than 1,500 adult patients, which is an imposed normative ceiling. This latter variable was considered as a proxy of GP overload. By adopting a panel regression approach, different specifications of fixed- and random-effects models were run to assess the association of interest, when adjusted for several social structural, economic and healthcare-related variables. RESULTS Over the last two decades, most regions showed a negative association between influenza vaccination coverage rates and the density of GPs with a high number of patients. This latter negative association was confirmed (P < 0.05) in different panel model specifications. In particular, in the fully adjusted two-way fixed-effects model, each 10% increase in the number of GPs with more than 1,500 patients was associated with a 1.7% decrease in influenza vaccination coverage. However, this association was present only in region-years where at least 18% of GPs were deemed overloaded. CONCLUSIONS In the upcoming years, the number of Italian GPs is projected to decline further. At the same time, the aging Italian population will determine an even greater workload for GPs. This study demonstrated that increased GP workload may partially explain the spatiotemporal variation in influenza vaccination uptake in the Italian elderly. With the imperative of increasing or at least maintaining influenza vaccination coverage rates, several short- and mid-term initiatives should be implemented in order to optimize GP workload during seasonal immunization campaigns.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Francesco Lapi
- Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Centre On Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | | | - Alessandro Rossi
- Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Claudio Cricelli
- Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Centre On Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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Guo X, Li J, Qiu J, Zhang R, Ren J, Huang Z, Li Z, Liang X, Lan F, Chen J, Huang F, Sun X. Persistence of antibody to 23-valent pneumococcal polysaccharide vaccine: a 5-year prospective follow-up cohort study. Expert Rev Vaccines 2024; 23:237-245. [PMID: 38369970 DOI: 10.1080/14760584.2023.2296934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/15/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND Pneumococcal vaccines are effective in preventing pneumococcal diseases in adults. The evaluation of the antibodies persistence to the 23-valent pneumococcal polysaccharide vaccine (PPV23) could provide evidence on PPV23 revaccination. RESEARCH DESIGN AND METHODS Adults aged ≥ 60 years were selected and vaccinated with PPV23 in Shanghai, and followed up for 5 years with blood samples collection of a 1-year interval. The geometric mean concentrations (GMC) of the IgG against 23 pneumococcal serotypes covered by PPV23 were detected using enzyme-linked immunosorbent assay. The antibodies to 23 pneumococcal serotypes among different groups was analyzed using statistical analysis. RESULTS Overall, 517 participants completed all six visits over a 5-year period (2013-2018). The GMC of 23 serotypes in adults aged ≥ 60 years decreased slowly after PPV23 vaccination compared to baseline pre-vaccination (P < 0.05), except serotype 3. Additionally, the multiplicative increase in the antibody concentration after PPV23 vaccination was greater, and the antibody levels of serotypes 1 and 6B were significantly higher at visit 5 than at visit 4 (P < 0.05). CONCLUSIONS The pneumococcal antibodies in elderly after PPV23 vaccination could sustain high levels over long-term follow-up, which suggested that the interval of revaccination with PPV23 in elderly should be at least 5 years after the first vaccination.
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Affiliation(s)
- Xiang Guo
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Juan Li
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jing Qiu
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Rui Zhang
- Vaccine Engineering Research Center of Sichuan Province, Chengdu Institute of Biological Products Co, Ltd, Chengdu, China
| | - Jia Ren
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Zhuoying Huang
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Zhi Li
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiufang Liang
- Institute of Immunization, Yangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Fang Lan
- Vaccine Engineering Research Center of Sichuan Province, Chengdu Institute of Biological Products Co, Ltd, Chengdu, China
| | - Juan Chen
- Vaccine Engineering Research Center of Sichuan Province, Chengdu Institute of Biological Products Co, Ltd, Chengdu, China
| | - Fang Huang
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiaodong Sun
- Institute of Immunization, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
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Pestarino L, Domnich A, Orsi A, Bianchi F, Cannavino E, Brasesco PC, Russo G, Valbonesi S, Vallini G, Ogliastro M, Icardi G. Rollout of the 2022/2023 Seasonal Influenza Vaccination and Correlates of the Use of Enhanced Vaccines among Italian Adults. Vaccines (Basel) 2023; 11:1748. [PMID: 38140153 PMCID: PMC10747154 DOI: 10.3390/vaccines11121748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
In Italy, several types of seasonal influenza vaccines (SIVs) are available for older adults, but for the 2022/2023 season there were no guidelines on their specific use. This cross-sectional study assessed the frequency and determinants of the use of enhanced (adjuvanted and high-dose) SIVs in Italian older adults, as compared to standard-dose non-adjuvanted formulations. Of 1702 vaccines administered to a representative outpatient sample of adults aged ≥ 60 years and residing in Genoa, 69.5% were enhanced SIVs. Older age (adjusted odds ratio (aOR) for each 1-year increase 1.10; p < 0.001), and the presence of cardiovascular disease (aOR 1.40; p = 0.011) and diabetes (aOR 1.62; p = 0.005) were associated with the use of enhanced vaccines. Compared with the adjuvanted SIV, subjects immunized with the high-dose vaccine were older (aOR for each 1-year increase 1.05; p < 0.001) and had higher prevalence of respiratory diseases (aOR 1.85; p = 0.052). Moreover, usage of the enhanced SIVs was driven by the period of immunization campaign, place of vaccination and physician. Despite their superior immunogenicity and effectiveness, the adoption of enhanced SIVs in Italy is suboptimal, and should be increased. Enhanced formulations are mostly used in the oldest, and in subjects with some co-morbidities.
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Affiliation(s)
- Luca Pestarino
- Private General Practice, 16122 Genoa, Italy; (L.P.); (F.B.); (E.C.); (P.C.B.); (G.R.); (S.V.)
- Medicoop Liguria, 16122 Genoa, Italy;
| | - Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.I.)
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), 16132 Genoa, Italy
| | - Federico Bianchi
- Private General Practice, 16122 Genoa, Italy; (L.P.); (F.B.); (E.C.); (P.C.B.); (G.R.); (S.V.)
| | - Elisa Cannavino
- Private General Practice, 16122 Genoa, Italy; (L.P.); (F.B.); (E.C.); (P.C.B.); (G.R.); (S.V.)
| | - Pier Claudio Brasesco
- Private General Practice, 16122 Genoa, Italy; (L.P.); (F.B.); (E.C.); (P.C.B.); (G.R.); (S.V.)
- Medicoop Liguria, 16122 Genoa, Italy;
| | - Gianluca Russo
- Private General Practice, 16122 Genoa, Italy; (L.P.); (F.B.); (E.C.); (P.C.B.); (G.R.); (S.V.)
- Medicoop Liguria, 16122 Genoa, Italy;
| | - Simone Valbonesi
- Private General Practice, 16122 Genoa, Italy; (L.P.); (F.B.); (E.C.); (P.C.B.); (G.R.); (S.V.)
- Medicoop Liguria, 16122 Genoa, Italy;
| | | | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy;
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), 16132 Genoa, Italy
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Domnich A, Grassi R, Fallani E, Costantini G, Panatto D, Ogliastro M, Salvatore M, Cambiaggi M, Vasco A, Orsi A, Icardi G. Increasing Influenza Vaccination Uptake by Sending Reminders: A Representative Cross-Sectional Study on the Preferences of Italian Adults. Vaccines (Basel) 2023; 11:1601. [PMID: 37897002 PMCID: PMC10610822 DOI: 10.3390/vaccines11101601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/10/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
Evidence from countries that achieved a high seasonal influenza vaccination (SIV) coverage suggests that reminders to get vaccinated may increase SIV uptake. The goal of this study was to explore the experience and attitudes of Italian adults toward an active invitation to receive SIV, triggered by different sources and delivered via different communication channels, and to assess the projected benefits of this strategy. A cross-sectional survey on a representative sample of Italian adults was conducted by using computer-assisted web interviewing. Responses from 2513 subjects were analyzed. A total of 52.2% of individuals previously received invitations to undergo SIV and compared with people who did not receive any reminder were three times more likely (68.2% vs. 22.2%) to be vaccinated in the last season. Compared with other sources, reminders sent by general practitioners (GPs) were perceived as the most attractive. As for communication channels, most participants preferred text/instant messaging (24.6%) or email (27.2%), suggesting an acceleration in the Italian digital transformation triggered by the COVID-19 pandemic. Conversely, traditional postal letters or phone calls were preferred by only 17.0% and 8.6% of respondents, respectively. Reminders sent by GPs via text/instant messages or email are a valuable option for increasing SIV uptake among Italian adults.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.I.)
| | | | - Elettra Fallani
- CSL Seqirus, 53035 Monteriggioni, Italy; (E.F.); (M.S.); (M.C.); (A.V.)
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
| | | | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (M.O.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), 16132 Genoa, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (M.O.)
| | - Marco Salvatore
- CSL Seqirus, 53035 Monteriggioni, Italy; (E.F.); (M.S.); (M.C.); (A.V.)
| | - Maura Cambiaggi
- CSL Seqirus, 53035 Monteriggioni, Italy; (E.F.); (M.S.); (M.C.); (A.V.)
| | - Alessandro Vasco
- CSL Seqirus, 53035 Monteriggioni, Italy; (E.F.); (M.S.); (M.C.); (A.V.)
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (M.O.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), 16132 Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy; (A.O.); (G.I.)
- Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy; (D.P.); (M.O.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), 16132 Genoa, Italy
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Tharkar S, Alduraywish S, Nishat AA, Alsuwailem L, Alohali L, Kahtani MK, Aldakheel FM. The Influence of the COVID-19 Pandemic on Seasonal Influenza Vaccine Uptake Among Patients Visiting a University Hospital in Saudi Arabia. Cureus 2023; 15:e47042. [PMID: 38022082 PMCID: PMC10643639 DOI: 10.7759/cureus.47042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Influenza vaccination is a subject of importance in Saudi Arabia. The study measured the uptake of annual influenza vaccination from 2019 to 2021 among patients attending outpatient clinic of a University Hospital. Materials and methods: A cross-sectional study design was used, and the questionnaire was administered by trained interviewers. Descriptive and inferential statistics were done using the Statistical Package for the Social Sciences (SPSS) version 21 (IBM, Armonk, New York). Results: The three-year annual influenza vaccine uptake for 2019-2021 was 19.7%, 11.4%, and 14.2%, respectively. In the year 2022, only 28.2% of the patients were offered influenza vaccines by their physicians, and among those offered, 49.6% showed vaccine acceptance. Higher vaccine acceptance was significantly associated with past episodes of influenza infection (p<0.001) and vaccination history before the COVID-19 pandemic (p<0.001). Lower acceptance of the influenza vaccine was observed during the pandemic (p<0.001) and lower uptake among those who were not offered influenza vaccines (p=0.02). No association was found between influenza vaccine acceptance and smoking status, chronic illness, history of COVID-19 infection, or living with those susceptible to influenza. Reasons for vaccine denial include an assumption of not being at risk, a lack of information about the vaccine, and a fear of side effects. CONCLUSION The COVID-19 pandemic has had a detrimental effect on annual influenza vaccination. Efforts must be taken to increase influenza vaccination among vulnerable groups.
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Affiliation(s)
- Shabana Tharkar
- Prince Sattam bin Abdulaziz Research Chair for Epidemiology and Public Health, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Shatha Alduraywish
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Abdul Aziz Nishat
- Department of Biomedical Science, School of Biomedical, Nutritional and Sports Sciences, Newcastle University, Newcastle upon Tyne, GBR
| | | | - Lina Alohali
- College of Medicine, King Saud University, Riyadh, SAU
| | | | - Fahad M Aldakheel
- Department of Clinical Laboratory Science, College of Applied Medical Science, King Saud University, Riyadh, SAU
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Korolchuk O, Vasiuk N, Klymkova I, Shvets D, Piddubnyi O. COVID-19 Vaccination under Conditions of War in Ukraine. Asian Bioeth Rev 2023. [PMCID: PMC10071466 DOI: 10.1007/s41649-023-00248-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
The COVID-19 pandemic, which spread around the world in 2020, changed the lives of millions of people and affected the life and functioning of all countries and people without exception. With the emergence of the opportunity to be vaccinated against COVID-19, the problem of making a decision about vaccination also appeared. But it has become increasingly clear that the coronavirus is moving into the group of annual viral epidemic diseases that occur every year in different countries during the seasonal wave of acute respiratory viral infections. The ongoing COVID-19 pandemic against the background of the adoption of serious quarantine measures indicates the need for large-scale vaccination of the population as the most effective way to protect against COVID-19. In this article, we pay special attention to vaccination, as the main factor in ensuring health, reducing the morbidity and severity of the course of the COVID-19 disease, and an important task of the state and modern public administration.
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Affiliation(s)
- Olena Korolchuk
- grid.77512.360000 0004 0490 8008Department of Health Sciences, Faculty of Health and Physical Education, Uzhhorod National University, Uzhhorod, Ukraine
| | - Nataliia Vasiuk
- grid.445707.50000 0001 2180 4188Department of National Economy and Public Administration, Faculty of Economics and Management, Kyiv National Economic University Named After Vadym Hetman, Kiev, Ukraine
| | - Iryna Klymkova
- grid.445736.70000 0001 2180 329XDepartment of Philosophy and Social Diciplines, Interregional Academy of Personnel Management, Kiev, Ukraine
| | - Dmytro Shvets
- Odesa State University of Internal Affairs, Odesa, Ukraine
| | - Oleksii Piddubnyi
- grid.37677.320000 0004 0587 1016Department of Civil and Economic Law, National University of Life and Environmental Sciences of Ukraine, Kiev, Ukraine
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7
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Korolchuk O, Vasiuk N, Klymkova I, Shvets D, Piddubnyi O. Current aspects of vaccination against Covid-19 under conditions of war in Ukraine: Problems and prospects. JOURNAL OF IMMUNOLOGY AND REGENERATIVE MEDICINE 2023:100072. [PMID: 36855659 PMCID: PMC9949896 DOI: 10.1016/j.regen.2023.100072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023]
Abstract
The pandemic of the coronavirus infection Covid-19, which spread around the world in 2020, changed the lives of millions of people and negatively affected the life and functioning conditions of all countries, people and nations without exception. With the emergence of the opportunity to be vaccinated against Covid-19, the problem of making a decision about vaccination also appeared. But recently, it has become increasingly clear that the coronavirus disease in the world is moving into the group of annual viral epidemic diseases that occur every year in different countries during the seasonal wave of acute respiratory viral infections. The ongoing Covid-19 pandemic against the background of the adoption of serious quarantine measures indicates the need for large-scale vaccination of the population as the most effective way to protect against Covid-19. In this article, we pay special attention to vaccination, as the main factor in ensuring health, reducing the morbidity and severity of the course of the Covid-19 disease, and an important task of the state and modern public administration. Plans regarding vaccination, under the conditions of the war in Ukraine, will not be implemented in full - this all the more requires attention to this issue.
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Affiliation(s)
- Olena Korolchuk
- Department of Health Sciences, Faculty of Health and Physical Education, Uzhhorod National Unіversity, 88000, 27 Mytna Str., Uzhhorod, Ukraine
| | - Nataliia Vasiuk
- Department of National Economy and Public Administration, Faculty of Economics and Management, Kyiv National Economic University Named After Vadym Hetman, 03057, 54/1 Peremogy Ave., Kyiv, Ukraine
| | - Iryna Klymkova
- Department of Philosophy and Social Diciplines, Interregional Academy of Personnel Management, 03039, 2 Frometivska Str., Kyiv, Ukraine
| | - Dmytro Shvets
- Odesa State University of Internal Affairs, 65014, 1 Uspenska Str., Odesa, Ukraine
| | - Oleksii Piddubnyi
- Department of Civil and Economic Law, National University of Life and Environmental Sciences of Ukraine, 03041, 15 Heroiv Oborony Str., Kyiv, Ukraine
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Kirubarajan A, Lynch M, Nasreen S, Gebretekle GB, Fadel SA, Crowcroft NS, Allin S. Increasing pneumococcal vaccine uptake in older adults: a scoping review of interventions in high-income countries. BMC Geriatr 2023; 23:2. [PMID: 36593474 PMCID: PMC9807101 DOI: 10.1186/s12877-022-03653-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 11/25/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND There is low uptake of the pneumococcal vaccination in eligible older adults, even in high-income countries that offer routine and universal vaccination programs. OBJECTIVE To systematically characterize interventions aimed at improving pneumococcal vaccine uptake in older adults. DESIGN We conducted a scoping review following PRISMA-SCr guidelines of five interdisciplinary databases: Medline-Ovid, Embase, CINAHL, PsychInfo, and Cochrane Library. Databases were searched from January 2015 until April 2020. The interventions were summarized into three pillars according to the European Union Conceptional Framework for Action: information campaigns, prioritization of vaccination schemes, and primary care interventions. RESULTS Our scoping review included 39 studies that summarized interventions related to pneumococcal vaccine uptake for older adults, encompassing 2,481,887 study participants (945 healthcare providers and 2,480,942 older adults) across seven countries. Examples of interventions that were associated with increased pneumococcal vaccination rate included periodic health examinations, reminders and decision-making tools built into electronic medical records, inpatient vaccination protocols, preventative health checklists, and multimodal educational interventions. When comparing the three pillars, prioiritization of vaccination schemes had the highest evidence for improved rates of vaccination (n = 14 studies), followed by primary care interventions (n = 8 studies), then information campaigns (n = 5 studies). CONCLUSION Several promising interventions were associated with improved outcomes related to vaccine uptake, although controlled study designs are needed to determine which interventions are most effective.
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Affiliation(s)
- Abirami Kirubarajan
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada
| | - Meghan Lynch
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada
| | - Sharifa Nasreen
- Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Gebremedhin B Gebretekle
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Canada
| | - Shaza A Fadel
- Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Natasha S Crowcroft
- Centre for Vaccine Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sara Allin
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada.
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Kim M, Yang B, Gu S, Kim EG, Kim SR, Oh KS, Yoon WS, Bae DH, Lee JH, Kim SM, Choi WG, Bae JW, Hwang KK, Kim DW, Cho MC, Lee H, Lee DI. Secular trends and determinants of influenza vaccination uptake among patients with cardiovascular disease in Korea: Analysis using a nationwide database. Front Cardiovasc Med 2022; 9:961688. [PMID: 36267638 PMCID: PMC9576870 DOI: 10.3389/fcvm.2022.961688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022] Open
Abstract
Background Influenza vaccination reduces cardiovascular events in patients with cardiovascular disease (CVD). Identifying the factors that affect influenza vaccination uptake can help improve the prognosis in patients with CVD. This study aimed to evaluate the secular trends of influenza vaccination uptake and factors associated with lack of vaccination in individuals with CVD. Materials and methods We analyzed the annual trends and factors associated with influenza vaccination among 3,264 patients with CVD, included from the Korea National Health and Nutrition Examination Survey which reflect the health and nutritional status of the nationwide population of Korea conducted between 2007/2008 and 2018/2019. We used a stratified, multistage sampling method. Results The influenza vaccination rate was greater in patients with CVD (53-74%) than in those without CVD (28-40%). Multivariable logistic regression analysis showed that age <50 years [odds ratio (OR), 16.22; 95% confidence interval (CI), 7.72-34.07], 50-64 years (OR, 6.71; 95% CI, 4.37-10.28), male sex (OR, 1.45; 95% CI, 1.14-1.65), and asthma (OR, 0.45; 95% CI, 0.22-0.92) were independently associated with a lack of influenza vaccination. Among patients aged <65 years, smoking (OR, 2.30; 95% CI, 1.31-4.04), college graduation status (OR, 1.81; 95% CI, 1.16-2.82), and hypertension (OR, 0.70; 95% CI, 0.51-0.95) were independently associated with influenza vaccination. For individuals aged 65years, there was no significant determinant of lack of vaccination. Conclusion In patients with CVD, a continuous increase in the secular trend of influenza vaccination was demonstrated in Korea. Young age, male sex, and non-asthma status were independently associated with lack of influenza vaccination uptake.
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Affiliation(s)
- Min Kim
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Bumhee Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Seonhye Gu
- Department of Epidemiology and Health Informatics, Korea University, Seoul, South Korea
| | - Eung-Gook Kim
- Department of Biochemistry, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - So Rae Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Kyeong Seok Oh
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Woong-Su Yoon
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Dae-Hwan Bae
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Ju Hee Lee
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Sang Min Kim
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Woong Gil Choi
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jang-Whan Bae
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Kyung-Kuk Hwang
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Dong-Woon Kim
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Myeong-Chan Cho
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Dae-In Lee
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
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Schieferdecker D, Pfuhl G, Kothari A. The Authorization of the First COVID-19 Vaccines Changed the Level and Nature of Intend to Get Vaccinated. JOURNAL OF HEALTH COMMUNICATION 2022; 27:633-643. [PMID: 36412127 DOI: 10.1080/10810730.2022.2148021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Despite the abundance of literature on vaccine hesitancy, how public opinion changes during and after the authorization of a new vaccine remains an open question. The COVID-19 pandemic offers a unique case since the development and roll-out of the first generation of vaccines happened at unprecedented speed. To understand how the public's intent to get vaccinated changed around the emergency authorizations of the first COVID-19 vaccines, we ran a secondary analysis of survey data that consisted of rolling cross-sections of Facebook users in 23 countries (N = 375,627) between July 2020 and April 2021. In contrast to prior longitudinal work, we did not only investigate the change in levels of the intent to get vaccinated but also in the nature of it, i.e., the change in the influence of core predictors. Moreover, our data span a longer phase than prior work and included various countries in the Global South. We found that the intent to get vaccinated decreased around the time of the authorization of the first COVID-19 vaccines before it increased again. In the composition of people who refused vaccination or were undecided, notable differences were found for age, gender, and, most importantly, trust in health authorities as information sources before, around, and after the authorization of the vaccines. We conclude that the importance of trust-inducing communication in the early phase of a vaccination campaign cannot be overstated.
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Affiliation(s)
- David Schieferdecker
- Institute for Media and Communication Studies, Freie Universität Berlin, Berlin, Germany
| | - Gerit Pfuhl
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ammina Kothari
- Harrington School of Communication and Media, University of Rhode Island, Kingston, Rhode Island, USA
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11
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Huang J, Mak FY, Wong YY, Ko S, Chong MKC, Wang Z, Hon KL, Wong ELY, Yeoh EK, Wong MCS. Enabling Factors, Barriers, and Perceptions of Pneumococcal Vaccination Strategy Implementation: A Qualitative Study. Vaccines (Basel) 2022; 10:vaccines10071164. [PMID: 35891327 PMCID: PMC9315707 DOI: 10.3390/vaccines10071164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/13/2022] [Accepted: 07/19/2022] [Indexed: 02/01/2023] Open
Abstract
Invasive pneumococcal disease (IPD) is a leading cause of disability and mortality worldwide, particularly in the elderly population. With the implementation of the Government Vaccination Programme (GVP) and the Vaccination Subsidy Scheme (VSS), enabling factors and barriers in service provider scheme participation and vaccination uptake were examined in 32 interviews with doctors and 16 interviews with vaccine recipients. Interview data were analysed in NVivo 11.0 with reference to the Consolidated Framework for Implementation Research (CFIR) and the REAIM Framework to develop codes and themes. Barriers to pneumococcal vaccination uptake included concerns on vaccine efficacy and poor understanding of the disease and vaccine schemes, whilst service provider participation was hindered by ill-defined parameters for patient eligibility and time, location, and logistical constraints. Enabling factors to improve intervention implementation were involvement of the government and physicians to encourage participation, clarifying eligibility criteria, and improving individual knowledge of IPD and vaccination schemes. As participation rates in the GVP and VSS remains low in Hong Kong, efforts concentrating on health promotion strategies encouraging pneumococcal vaccination amongst the elderly population are recommended.
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Affiliation(s)
- Junjie Huang
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong 999077, China; (J.H.); (F.-Y.M.); (Y.-Y.W.); (S.K.); (M.K.C.C.); (Z.W.); (K.-L.H.); (E.L.Y.W.); (E.-K.Y.)
| | - Fung-Yu Mak
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong 999077, China; (J.H.); (F.-Y.M.); (Y.-Y.W.); (S.K.); (M.K.C.C.); (Z.W.); (K.-L.H.); (E.L.Y.W.); (E.-K.Y.)
| | - Yuet-Yan Wong
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong 999077, China; (J.H.); (F.-Y.M.); (Y.-Y.W.); (S.K.); (M.K.C.C.); (Z.W.); (K.-L.H.); (E.L.Y.W.); (E.-K.Y.)
| | - Samantha Ko
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong 999077, China; (J.H.); (F.-Y.M.); (Y.-Y.W.); (S.K.); (M.K.C.C.); (Z.W.); (K.-L.H.); (E.L.Y.W.); (E.-K.Y.)
| | - Marc K. C. Chong
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong 999077, China; (J.H.); (F.-Y.M.); (Y.-Y.W.); (S.K.); (M.K.C.C.); (Z.W.); (K.-L.H.); (E.L.Y.W.); (E.-K.Y.)
| | - Zixin Wang
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong 999077, China; (J.H.); (F.-Y.M.); (Y.-Y.W.); (S.K.); (M.K.C.C.); (Z.W.); (K.-L.H.); (E.L.Y.W.); (E.-K.Y.)
| | - Kam-Lun Hon
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong 999077, China; (J.H.); (F.-Y.M.); (Y.-Y.W.); (S.K.); (M.K.C.C.); (Z.W.); (K.-L.H.); (E.L.Y.W.); (E.-K.Y.)
| | - Eliza L. Y. Wong
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong 999077, China; (J.H.); (F.-Y.M.); (Y.-Y.W.); (S.K.); (M.K.C.C.); (Z.W.); (K.-L.H.); (E.L.Y.W.); (E.-K.Y.)
| | - Eng-Kiong Yeoh
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong 999077, China; (J.H.); (F.-Y.M.); (Y.-Y.W.); (S.K.); (M.K.C.C.); (Z.W.); (K.-L.H.); (E.L.Y.W.); (E.-K.Y.)
| | - Martin C. S. Wong
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong 999077, China; (J.H.); (F.-Y.M.); (Y.-Y.W.); (S.K.); (M.K.C.C.); (Z.W.); (K.-L.H.); (E.L.Y.W.); (E.-K.Y.)
- School of Public Health, Peking Union Medical College, Beijing 100005, China
- School of Public Health, Peking University, Beijing 100191, China
- Correspondence: ; Tel.: +852-2252-8782
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12
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Key predictors of COVID-19 vaccine hesitancy in Malaysia: An integrated framework. PLoS One 2022; 17:e0268926. [PMID: 35604921 PMCID: PMC9126375 DOI: 10.1371/journal.pone.0268926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background As the vaccination drive against the coronavirus disease (COVID-19) in Malaysia progresses rapidly, the main challenge will gradually shift from procuring and distributing vaccines to ensuring the broadest possible acceptance among all population segments. Therefore, this study used the integrated framework of the health belief model (HBM) and the theory of reasoned action (TRA) to investigate the predictors of intention to receive COVID-19 vaccines in Malaysia. Methodology A market research company in Malaysia was engaged to collect data during June 11–20, 2021 using self-administered questionnaires via its online panel, ensuring a nationwide random sample of 804 respondents. A logistic regression was subsequently estimated to determine the significant predictors of vaccination intention. Results The predictors that significantly affect COVID-19 vaccine hesitancy in Malaysia are age, susceptibility, religious beliefs, attitude, subjective norms, and trust in the vaccine. In particular, those who are more inclined to get vaccinated are older individuals, have a higher perceived risk of infection and social pressure to get vaccinated, have a positive attitude, and have high levels of trust in the vaccine. Individuals’ who perceive that their religious beliefs are against vaccination are more likely to exhibit uncertainty toward it. Conclusion This study showed that although a large proportion of respondents indicated that they were willing to be vaccinated against COVID-19, there are concerns about religious barriers and trust in the vaccine that the relevant stakeholders should address. Campaigns should also focus on shaping the nation’s attitude toward COVID-19 vaccines, in parallel with encouraging people to use their social influence in helping those in their close circle who are unsure of vaccination to cross the line. These measures will prove to be pertinent as the nation begins to administer booster vaccines to tackle the waning effects of COVID-19 vaccines.
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13
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Galizzi MM, W. Lau K, Miraldo M, Hauck K. Bandwagoning, free-riding and heterogeneity in influenza vaccine decisions: An online experiment. HEALTH ECONOMICS 2022; 31:614-646. [PMID: 34989067 PMCID: PMC9305895 DOI: 10.1002/hec.4467] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 08/17/2021] [Accepted: 10/26/2021] [Indexed: 05/29/2023]
Abstract
'Nudge'-based social norms messages conveying high population influenza vaccination coverage levels can encourage vaccination due to bandwagoning effects but also discourage vaccination due to free-riding effects on low risk of infection, making their impact on vaccination uptake ambiguous. We develop a theoretical framework to capture heterogeneity around vaccination behaviors, and empirically measure the causal effects of different messages about vaccination coverage rates on four self-reported and behavioral vaccination intention measures. In an online experiment, N = 1365 UK adults are randomly assigned to one of seven treatment groups with different messages about their social environment's coverage rate (varied between 10% and 95%), or a control group with no message. We find that treated groups have significantly greater vaccination intention than the control. Treatment effects increase with the coverage rate up to a 75% level, consistent with a bandwagoning effect. For coverage rates above 75%, the treatment effects, albeit still positive, stop increasing and remain flat (or even decline). Our results suggest that, at higher coverage rates, free-riding behavior may partially crowd out bandwagoning effects of coverage rate messages. We also find significant heterogeneity of these effects depending on the individual perceptions of risks of infection and of the coverage rates.
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Affiliation(s)
- Matteo M. Galizzi
- Department of Psychological and Behavioral ScienceLSE Behavioral Science HubLSE Global Health InitiativeLondon School of EconomicsLondonUK
| | - Krystal W. Lau
- Department of Economics and Public PolicyCentre for Health Economics & Policy InnovationImperial College Business SchoolLondonUK
| | - Marisa Miraldo
- Department of Economics and Public PolicyCentre for Health Economics & Policy InnovationImperial College Business SchoolLondonUK
| | - Katharina Hauck
- MRC Centre for Global Infectious Disease AnalysisJameel Institute for Disease and Emergency AnalyticsSchool of Public Health, Imperial College LondonLondonUK
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An Independent Study to Compare Compliance, Attitudes, Knowledge, and Sources of Knowledge about Pneumococcal Vaccinations among an Italian Sample of Older Adults. Vaccines (Basel) 2022; 10:vaccines10040490. [PMID: 35455239 PMCID: PMC9030078 DOI: 10.3390/vaccines10040490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Streptococcus pneumoniae is one of the leading causes of pneumoniae deaths, especially among elderly individuals, with the vaccine being the primary prevention instrument. However, information on national vaccine coverage among the elderly population is scarce and sparse. Methods: A survey involved a representative sample of Italians older than 65 years (n = 600), who agreed to participate in the study through a phone interview. Participants’ self-reported pneumococcal vaccination status, vaccine literacy, information source, and risk perception related to the infection and to vaccines-adverse reactions were assessed. Results: The reported vaccination status is very low (11.2%), with respondents largely uninformed about vaccination opportunities. The results also show that the predominant (and most effective) source of information is healthcare providers, with vaccine hesitancy being positively linked to risk perception related to disease and negatively linked to risk perception of vaccine adverse reactions. Conclusions: This study suggests the need to collect data to systematically monitor vaccination coverage and calls for information campaigns to improve elderly literacy to increase vaccination uptake.
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15
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Influenza Vaccination Uptake in the General Italian Population during the 2020–2021 Flu Season: Data from the EPICOVID-19 Online Web-Based Survey. Vaccines (Basel) 2022; 10:vaccines10020293. [PMID: 35214751 PMCID: PMC8877796 DOI: 10.3390/vaccines10020293] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 12/16/2022] Open
Abstract
To assess influenza vaccine uptake during the 2020/2021 flu season and compare it with that of the 2019/2020 flu season among respondents to the second phase of the web-based EPICOVID-19 survey, we performed an observational web-based nationwide online survey (January–February 2021) in which respondents to the first survey (April–June 2020) were contacted and asked to complete a second questionnaire. Factors associated with vaccine uptake in the 2020/2021 flu season were assessed by applying a multivariable multinomial logistic regression model. Out of the 198,822 respondents to the first survey, 41,473 (20.9%) agreed to fill out the follow-up questionnaire; of these, 8339 (20.1%) were vaccinated only during the 2020/2021 season, 8828 (21.3%) were vaccinated during both seasons and 22,710 (54.8%) were vaccinated in neither season. Educational level (medium (aOR 1.33 95%CI 1.13–1.56) and high (aOR 1.69 95%CI 1.44–1.97) vs. low) and socio-economic deprivation according to SES scoring (1 point aOR 0.83 (95%CI 0.78–0.89), 2 aOR 0.68 (95%CI 0.60–0.77) points or ≥3 points aOR 0.42 (95%CI 0.28–0.45) vs. 0 points) were found to be associated with flu vaccine uptake. Our study shows that social determinants seemed to affect flu vaccination uptake and identifies specific categories of the population to target during future influenza vaccination campaigns.
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Shiloh S, Peleg S, Nudelman G. Vaccination Against COVID-19: A Longitudinal Trans-Theoretical Study to Determine Factors that Predict Intentions and Behavior. Ann Behav Med 2021; 56:357-367. [PMID: 34864833 DOI: 10.1093/abm/kaab101] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the clear benefits of vaccination, their uptake against common infectious diseases is suboptimal. In December 2020, vaccines against COVID-19 became available. PURPOSE To determine factors that predict who will take the COVID-19 vaccine based on a conceptual model. METHODS An online survey was administered twice: prior to public vaccination, and after vaccinations were available. Participants were 309 Israelis with initial data and 240 at follow-up. Baseline questionnaires measured intentions to be vaccinated and hypothesized predictors clustered in four categories: background, COVID-19, vaccination, and social factors. Self-reported vaccination uptake was measured at follow-up. RESULTS Sixty-two percent of the sample reported having been vaccinated. Intentions were strongly associated with vaccination uptake and mediated the effects of other predictors on behavior. Eighty-six percent of the variance in vaccination intentions was explained by attitudes toward COVID-19 vaccination, regret for having declined vaccination, trust in vaccination, vaccination barriers, past flu vaccination, perceived social norms, and COVID-19 representations. CONCLUSIONS Beliefs related directly to the COVID-19 vaccine explained most of the variance in intentions to vaccinate, which in turn predicted vaccination uptake.
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Affiliation(s)
- Shoshana Shiloh
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Shira Peleg
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
| | - Gabriel Nudelman
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv, Israel
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Konstantinou N, Nicolaou SA, Petrou C, Pieri M. Trust in Authorities and Demographic Factors Affect Vaccine Acceptance During the COVID-19 Pandemic in Cyprus. EUROPEAN JOURNAL OF PSYCHOLOGY OPEN 2021. [DOI: 10.1024/2673-8627/a000006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. The COVID-19 pandemic has had a devastating impact on all aspects of human life. Accurately measuring vaccine acceptance and understanding the factors that influence vaccine attitudes and behaviors is crucial to designing public-health interventions to reduce the impact of COVID-19 through vaccinations. The current study adapted the vaccine acceptance scale ( Sarathchandra et al., 2018 ) to the Greek language and assessed the relationship between key components of vaccine acceptance to COVID-19 vaccine beliefs and attitudes, personal and family vaccination history and attitudes, and demographic variables (age, sex, education, and having children). The adapted vaccine acceptance instrument was found to have high internal consistency reliability. Further analyses indicated that younger and less-educated individuals are more vaccine-hesitant, and that vaccine acceptance is influenced by trust in authorities. These findings may have implications for understanding vaccine hesitancy and for the design and implementation of vaccine-related public health policies.
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Affiliation(s)
- Nikos Konstantinou
- Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
| | | | - Christos Petrou
- Department of Life & Health Sciences, University of Nicosia, Cyprus
| | - Myrtani Pieri
- Department of Life & Health Sciences, University of Nicosia, Cyprus
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Minimising missed opportunities to promote and deliver immunization services to middle and older age adults: Can hospital-based programs be a solution? Vaccine 2021; 39:3467-3472. [PMID: 34024659 DOI: 10.1016/j.vaccine.2021.05.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 05/07/2021] [Accepted: 05/09/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND There has been a recent recognized shift towards a whole-of-life or life-course approach to immunisation. However, coverage amongst at-risk adults for recommended vaccines continues to be suboptimal. This study examined the perceptions of middle and older aged Australian adults towards hospital-based immunization programs and their previous exposures to receiving vaccines via tertiary care. METHODS A cross-sectional survey was conducted with Australian adults 45 years and older in late 2019 to capture influenza and pneumococcal vaccine uptake, exposure to hospital-based immunization programs, missed opportunities to vaccinate and receptiveness towards the promotion and/or delivery of vaccines in the hospital setting. RESULTS Only 13 respondents reported receiving a vaccine at hospital, yet 72.2% (931/1292) indicated that they were willing to be vaccinated in that setting. Amongst those who attended hospital during 2019 and were eligible for vaccination, 57.2% and 28.3% of respondents were not immunized for pneumococcal and influenza, respectively. Missed opportunities for both vaccines were significantly higher amongst those at low-risk for influenza (≤65 years (low-risk): 52.9%, ≤65 years (high-risk): 18.3%, >65 years: 15.1%; p < 0.001) and pneumococcal (≤65 years (low-risk): 79.1%, ≤65 years (high-risk): 52.4%, >65 years: 44%; p < 0.001). Among those with a missed opportunity for hospital-based vaccination, the most common reason for not getting immunized was a lack of recommendation. Most (86.4%) reported that their general practitioner was the person or group they trusted most to receive vaccine information from. CONCLUSIONS The findings from this Australian study support international work that shows very low rates of opportunistic vaccination in hospitals despite national recommendations to vaccinate prior to discharge. Considering the need for high levels of uptake of the COVID-19 vaccine, hospitals may need to be considered to opportunistically capture those not accessing the vaccine in other settings.
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19
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Wang M, Li M, Dong X. The Associations Between Sociodemographic Characteristics and Trust in Physician With Immunization Service Use in U.S. Chinese Older Adults. Res Aging 2021; 44:164-173. [PMID: 33938299 DOI: 10.1177/01640275211011048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated sociodemographic factors for immunization care use and the relationship between trust in physician (TIP) and immunization service use in older Chinese Americans. Data were collected through the Population Study of Chinese Elderly, including survey information of 3,157 older adults in the Greater Chicago area. Regression results showed that the odds of getting vaccinated were higher for those who were older, female, and had higher education and income. After adjusting for the covariates, higher TIP was associated with greater immunization service use. The highest tertile of TIP was associated with higher odds of using immunization service (OR 2.19, 95% CI [1.76, 2.72]), especially for flu and pneumonia vaccines. Findings suggests that immunization service use may be increased by improving TIP and promoting targeted health care management plans for racial/ethnic minorities, which is highly relevant to increase the vaccination rate and contain the pandemic as the COVID-19 vaccine is available.
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Affiliation(s)
- Mengxiao Wang
- School of Public Administration, 12603Southwestern University of Finance and Economics, Chengdu, China
| | - Mengting Li
- Institute for Health, Health Care Policy and Aging Research, 242612Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.,School of Nursing, 242612Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, 242612Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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20
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Fridman A, Gershon R, Gneezy A. COVID-19 and vaccine hesitancy: A longitudinal study. PLoS One 2021; 16:e0250123. [PMID: 33861765 PMCID: PMC8051771 DOI: 10.1371/journal.pone.0250123] [Citation(s) in RCA: 314] [Impact Index Per Article: 104.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/14/2021] [Indexed: 12/03/2022] Open
Abstract
How do attitudes toward vaccination change over the course of a public health crisis? We report results from a longitudinal survey of United States residents during six months (March 16 –August 16, 2020) of the COVID-19 pandemic. Contrary to past research suggesting that the increased salience of a disease threat should improve attitudes toward vaccines, we observed a decrease in intentions of getting a COVID-19 vaccine when one becomes available. We further found a decline in general vaccine attitudes and intentions of getting the influenza vaccine. Analyses of heterogeneity indicated that this decline is driven by participants who identify as Republicans, who showed a negative trend in vaccine attitudes and intentions, whereas Democrats remained largely stable. Consistent with research on risk perception and behavior, those with less favorable attitudes toward a COVID-19 vaccination also perceived the virus to be less threatening. We provide suggestive evidence that differential exposure to media channels and social networks could explain the observed asymmetric polarization between self-identified Democrats and Republicans.
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Affiliation(s)
- Ariel Fridman
- Rady School of Management, University of California San Diego, La Jolla, California, United States of America
- * E-mail:
| | - Rachel Gershon
- Rady School of Management, University of California San Diego, La Jolla, California, United States of America
| | - Ayelet Gneezy
- Rady School of Management, University of California San Diego, La Jolla, California, United States of America
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21
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Knowledge, attitudes, and practices of seasonal influenza vaccination in healthcare workers, Honduras. PLoS One 2021; 16:e0246379. [PMID: 33539428 PMCID: PMC7861374 DOI: 10.1371/journal.pone.0246379] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 01/16/2021] [Indexed: 11/19/2022] Open
Abstract
Background Seasonal influenza is a highly contagious vaccine-preventable disease that may cause high morbidity and mortality in susceptible populations. Healthcare workers are a priority group for seasonal influenza vaccination to protect them from contracting influenza and prevent nosocomial transmission to patients. This study aimed to evaluate knowledge, attitudes, and practices (KAP) of seasonal influenza vaccination among healthcare workers in Honduras. Method From August 24 to October 21, 2018, we conducted a cross-sectional KAP survey regarding seasonal influenza vaccination to a random sample of healthcare workers who attended patients in hospitals of the Ministry of Health of Honduras (SESAL) and Honduran Social Security Institute (IHSS). We reported frequency distributions of demographics, vaccination KAP, sources of information, and reasons for non-vaccination. We used principal components factor analysis to create knowledge and attitude scores. We used linear regression to analyze associations between demographics and sources of information about the influenza vaccine, and knowledge and attitude scores. We used logistic regression to analyze associations between demographics, sources of information, knowledge scores, and attitude scores, and influenza vaccination. Result We surveyed 947 healthcare workers who attended patients in 13 SESAL hospitals and two IHSS hospitals. Only 4.6% of participants knew the seasonal influenza vaccine was composed of inactivated viruses, 94.7% believed vaccination causes flu-like symptoms, and 52.0% were vaccinated for influenza in 2018. Knowledge scores were lower for nursing assistants and other healthcare professionals compared to doctors, and higher for healthcare workers who attended a healthcare facility training (P-values≤0.030). Attitude scores were higher for healthcare workers who attended ≥11 patients per day having ≤10 patients per day as reference, self-reported influenza vaccination in previous year, and cited trainings and informal information at the healthcare facility as sources of information for influenza vaccination (P-values≤0.030). Factors associated with self-reported vaccination were self-reported influenza vaccination in previous year (aOR: 7.61; 95% CI: 5.24–11.04), attitude score (aOR: 1.14; 95% CI: 1.07–1.21), and worked in a SESAL hospital (aOR: 1.73; 95% CI: 1.12–2.68) having IHSS as reference. Conclusion Although influenza vaccination is required by law in Honduras and available for free in public health centers, coverage of healthcare workers in 2018 was half that reported in 2017. Lower coverage may be attributed to misconceptions of vaccination side effects.
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22
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Domnich A, Cambiaggi M, Vasco A, Maraniello L, Ansaldi F, Baldo V, Bonanni P, Calabrò GE, Costantino C, de Waure C, Gabutti G, Restivo V, Rizzo C, Vitale F, Grassi R. Attitudes and Beliefs on Influenza Vaccination during the COVID-19 Pandemic: Results from a Representative Italian Survey. Vaccines (Basel) 2020; 8:E711. [PMID: 33266212 PMCID: PMC7712959 DOI: 10.3390/vaccines8040711] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 11/18/2020] [Accepted: 11/27/2020] [Indexed: 01/06/2023] Open
Abstract
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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Affiliation(s)
| | | | | | | | - Filippo Ansaldi
- Azienda Ligure Sanitaria, 16121 Genoa, Italy;
- Planning and Prevention Unit, IRCCS San Martino Hospital, 16132 Genoa, Italy
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy
| | - Vincenzo Baldo
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Public Health Section, University of Padua, 35131 Padua, Italy;
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50134 Florence, Italy;
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Claudio Costantino
- Section of Hygiene, Department of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90133 Palermo, Italy; (C.C.); (V.R.); (F.V.)
| | - Chiara de Waure
- Department of Experimental Medicine, University of Perugia, 06132 Perugia, Italy;
| | - Giovanni Gabutti
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Vincenzo Restivo
- Section of Hygiene, Department of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90133 Palermo, Italy; (C.C.); (V.R.); (F.V.)
| | - Caterina Rizzo
- Predictive and Preventive Medicine Research Unit, Multifactorial and Complex Disease Research Area, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Francesco Vitale
- Section of Hygiene, Department of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90133 Palermo, Italy; (C.C.); (V.R.); (F.V.)
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Or PPL, Wong BYM, Chung JWY. To investigate the association between the health literacy and hand hygiene practices of the older adults to help them fight against infectious diseases in Hong Kong. Am J Infect Control 2020; 48:485-489. [PMID: 32037202 PMCID: PMC7132680 DOI: 10.1016/j.ajic.2019.12.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/14/2019] [Accepted: 12/17/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Proper hand hygiene helps prevent infectious diseases, while health literacy plays a critical role in preventive health behaviors. It remains unclear as to why proper hand hygiene practices cannot be sustained and what role health literacy plays in older adults fight against infectious diseases. METHODS A convenience sample of 433 old adults aged 65 and above was recruited. Their hygiene practices and health literacy were evaluated using a structured questionnaire adopted from the Centre for Health Protection and the Chinese version of the HLS-Asia-Q questionnaire. RESULTS The percentage distribution of the hand hygiene performance, from always to never, was 18%-10%. A majority 63.28% (274) of them were classified as having inadequate health literacy (0-25), while a meager 1.62% (7) of them as having excellent health literacy (42.01-50). The Spearman correlation showed a significant positive relationship (P < 0.05) between the participants' health literacy and their hand hygiene practices. CONCLUSIONS Health literacy and hand hygiene are positively related in helping the older adults fight against infectious diseases. To sustain proper hand hygiene practices is to provide frequent hand hygiene training to the older adults.
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Affiliation(s)
- Peggy Pui-Lai Or
- Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, Hong Kong.
| | - Bonny Yee-Man Wong
- Li Ka Shing Faculty of Medicine, School of Public Health, The University of Hong Kong, Hong Kong
| | - Joanne Wai-Yee Chung
- Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, Hong Kong
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Bricout H, Torcel-Pagnon L, Lecomte C, Almas MF, Matthews I, Lu X, Wheelock A, Sevdalis N. Determinants of shingles vaccine acceptance in the United Kingdom. PLoS One 2019; 14:e0220230. [PMID: 31369608 PMCID: PMC6675065 DOI: 10.1371/journal.pone.0220230] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 07/11/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The United Kingdom (UK) was the first European country to introduce a national immunisation program for shingles (2013-2014). That year, vaccination coverage ranged from 50 to 64% across the UK, but uptake has declined ever since. This study explored determinants of the acceptance of the shingles vaccine in the UK. METHODS Vaccinated and unvaccinated individuals, who were eligible for the last catch-up cohort of the 2014-2015 shingles vaccination campaign, were identified using the Clinical Practice Research Datalink (the National Health Service data research service) and invited to participate by their general practitioner (GP). An anonymised self-administered questionnaire was developed using the Health Belief Model as a theoretical framework, to collect data on demographic and socio-economic characteristics, health status, knowledge, influences, experiences and attitudes to shingles and the shingles vaccine. Multivariable logistic regression was used to identify the factors associated with vaccination. Physicians' views concerning perceived barriers to vaccination were also assessed. RESULTS Of the 2,530 questionnaires distributed, 536 were returned (21.2%) from 69 general practices throughout the UK. The majority of responders were female (58%), lived in care homes (56%) and had completed secondary or higher education (88%). There were no differences between vaccinated and unvaccinated responders. Being offered the shingles vaccine by a GP/nurse (odds ratio (OR) = 2.3), and self-efficacy (OR = 1.2) were associated with being vaccinated (p<0.05). In contrast, previous shingles history (OR = 0.4), perceived barriers to vaccination (OR = 0.7) and perceived control of the disease (OR = 0.7) were associated with not being vaccinated against shingles (p<0.05). Less than half (44.0%) of GPs were aware of the local communication campaigns regarding shingles and the shingles vaccine. CONCLUSIONS Socio-psychological factors largely influence shingles vaccination acceptance in this study. The results add to existing evidence that healthcare providers (HCPs) have a pivotal role against vaccine hesitancy. Campaigns focusing on GPs and accessible information offered to eligible members of the public can further enhance shingles vaccine uptake.
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Affiliation(s)
| | | | | | | | | | | | - Ana Wheelock
- Department of Surgery and Cancer, National Institute for Health Research Imperial Patient Safety Translational Research Centre, Imperial College London, London, United Kingdom
| | - Nick Sevdalis
- Centre for Implementation Science, King’s College London, London, United Kingdom
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Boccalini S, Tacconi FM, Lai PL, Bechini A, Bonanni P, Panatto D. Appropriateness and preferential use of different seasonal influenza vaccines: A pilot study on the opinion of vaccinating physicians in Italy. Vaccine 2019; 37:915-918. [PMID: 30651199 DOI: 10.1016/j.vaccine.2018.12.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 02/03/2023]
Abstract
In Italy, several types of influenza vaccine are on the market. Available evidence suggests that no single vaccine type is universally appropriate; rather, different types may be more appropriate for different population strata. However, while the concept of appropriateness/preferential use of single vaccines is usually adopted at the central level, little is known about the attitudes of physicians on the matter. A pilot survey of Italian physicians (N = 372) revealed that most (about 90%) were aware that the available vaccines were different, and that particular vaccines were more appropriate for specific groups. The availability of explicit guidelines on which vaccine to administer to a given population group was deemed desirable by 93.2% of respondents. The results were consistent with the 2018 Italian and UK normative documents, which indicate adjuvanted vaccines as the most appropriate choice for the elderly, and quadrivalent formulations for the younger age-classes. Public health policy implications are discussed.
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Affiliation(s)
- S Boccalini
- Department of Health Sciences, University of Florence, Florence, Italy.
| | - F Mandò Tacconi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Piero Luigi Lai
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - A Bechini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - P Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - D Panatto
- Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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Travers JL, Schroeder KL, Blaylock TE, Stone PW. Racial/Ethnic Disparities in Influenza and Pneumococcal Vaccinations Among Nursing Home Residents: A Systematic Review. THE GERONTOLOGIST 2018; 58:e205-e217. [PMID: 28329831 PMCID: PMC6044397 DOI: 10.1093/geront/gnw193] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Indexed: 11/13/2022] Open
Abstract
This systematic review analyzes research examining racial/ethnic disparities in influenza and pneumococcal vaccination coverage between White and racial/ethnic minority (Black and Hispanic) nursing home residents. A review of the literature for years 1966-2014 using Medline, Web of Science, and PubMed was conducted. The Epidemiological Appraisal Instrument was used to appraise the quality of the 13 included studies. Overall, articles were strong in reporting and data analysis, but weak in sample selection and measurement quality. Disparities between vaccination coverage among racial/ethnic minorities versus Whites ranged from 2% to 20% for influenza and 6% to 15% for pneumococcal vaccination. Researchers reported racial/ethnic minorities were more likely to refuse vaccinations and less likely to have vaccinations offered and their vaccination status tracked compared to Whites. Policies/strategies that focus on ensuring racial/ethnic minorities are offered influenza and pneumococcal vaccinations and their vaccination status are tracked in nursing homes are warranted. Updated evaluation on vaccination disparities is also needed.
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Affiliation(s)
- Jasmine L Travers
- NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia
| | | | - Thomas E Blaylock
- Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, New York
| | - Patricia W Stone
- Center for Health Policy, Columbia University School of Nursing, New York, New York
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Impact of Race on Immunization Status in Long-Term Care Facilities. J Racial Ethn Health Disparities 2018; 6:153-159. [DOI: 10.1007/s40615-018-0510-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 06/20/2018] [Accepted: 06/22/2018] [Indexed: 11/26/2022]
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Baron G, Gosselin V, Petit G, Guay M, Gagneur A. Determinants of influenza vaccination among a large adult population in Quebec. Hum Vaccin Immunother 2018; 14:2722-2727. [PMID: 29883242 PMCID: PMC6314416 DOI: 10.1080/21645515.2018.1486155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 05/11/2018] [Accepted: 05/29/2018] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVES Very low uptake has been noted for influenza vaccination in the province of Quebec. This study aimed to identify the determinants of influenza vaccination among a large regional population. METHODS A telephone survey was administered to a random digit sample in the Eastern Townships region (Quebec, Canada). Respondents were asked questions on several health topics such as perceived knowledge and beliefs about influenza immunization, medical consultations, perceived health status and life habits. Significant variables in the univariate analysis were introduced into a multivariate logistic regression model to determine independent factors for having received the influenza vaccine (aOR and 95% CI) among adults aged ≥60 years and younger adults with ≥1 chronic condition. RESULTS A total of 4,620 interviews were analyzed. Among the target groups, 55.4% of adults aged ≥60 and 32.2% of adults aged 18-59 with at least one chronic disease had received the influenza vaccine during the 2013-2014 season. Several determinants were significantly associated with influenza vaccination in both groups such as having received a recommendation from a healthcare professional. Among adults aged ≥60, not having consulted a chiropractor over the last 12 months (aOR = 2.37; 1.09-5.19), non-smokers (aOR = 1.78; 1.22-2.59) and self-perceived poor health status (aOR = 1.45; 1.01-2.06) were significantly linked to flu vaccination. In the younger group, influenza vaccination was independently associated to low alcohol consumption (aOR = 2.14; 1.13-4.05) and being overweight (aOR = 1.63; 1.12-2.38). CONCLUSIONS Many determinants influence the decision to get vaccinated against influenza. Specific messages should be tailored for high-risk groups to effectively increase influenza vaccine coverage.
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Affiliation(s)
- Geneviève Baron
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Direction de santé publique du CIUSSS de l'Estrie – CHUS, Sherbrooke, Québec, Canada
- Institut universitaire en première ligne en santé et services sociaux, Sherbrooke, Québec, Canada
| | | | - Geneviève Petit
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Direction de santé publique du CIUSSS de l'Estrie – CHUS, Sherbrooke, Québec, Canada
| | - Maryse Guay
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Institut national de santé publique du Québec, Québec, Québec, Canada
- Centre de recherche – Hôpital Charles-Le Moyne, Longueuil, Québec, Canada
| | - Arnaud Gagneur
- Centre de recherche du CHUS, Sherbrooke, Québec, Canada
- Département de pédiatrie, Université de Sherbrooke, Sherbrooke, Québec, Canada
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Matthews I, Dawson H. The impact of dosing schedules on the success of vaccination programmes in elderly populations: A summary of current evidence. Hum Vaccin Immunother 2018; 14:1957-1962. [PMID: 29683764 PMCID: PMC6149931 DOI: 10.1080/21645515.2018.1467200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Vaccines are an established means of preventing and eliminating communicable diseases. Whilst their efficacy in some settings is well studied, the impact of multi-dose vaccinations programmes in elderly populations is not well documented. A literature review was conducted in order to collate and analyse existing publications to provide a summary of current thinking and support identification of key factors that impact on the success of vaccination programmes. Having returned little information to provide a comprehensive understanding of the subject area, two short surveys were undertaken to supplement the findings and further examine the attitudes and opinions of the elderly and healthcare professionals. Combining the results from all three research methodologies suggests that vaccination programmes with fewer doses are associated with improved course completion rates and a lower logistical and economic burden. Whilst it is acknowledged that this study has limitations, it provides relevant insights in a space where there is little research to inform the work programmes of vaccines in development and support optimisation of ongoing programmes. It also highlights the need for further research to fully understand the factors influencing successful vaccination programmes in this specific patient population.
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Affiliation(s)
- Ian Matthews
- a Merck Sharp & Dohme Limited, Mallards Reach , Bridge Avenue, Maidenhead , UK
| | - Hazel Dawson
- a Merck Sharp & Dohme Limited, Mallards Reach , Bridge Avenue, Maidenhead , UK
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Thomas RE, Lorenzetti DL. Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database Syst Rev 2018; 5:CD005188. [PMID: 29845606 PMCID: PMC6494593 DOI: 10.1002/14651858.cd005188.pub4] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The effectiveness of interventions to increase influenza vaccination uptake in people aged 60 years and older varies by country and participant characteristics. This review updates versions published in 2010 and 2014. OBJECTIVES To assess access, provider, system, and societal interventions to increase the uptake of influenza vaccination in people aged 60 years and older in the community. SEARCH METHODS We searched CENTRAL, which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE, Embase, CINAHL, and ERIC for this update, as well as WHO ICTRP and ClinicalTrials.gov for ongoing studies to 7 December 2017. We also searched the reference lists of included studies. SELECTION CRITERIA Randomised controlled trials (RCTs) and cluster-randomised trials of interventions to increase influenza vaccination in people aged 60 years or older in the community. DATA COLLECTION AND ANALYSIS We used standard methodological procedures as specified by Cochrane. MAIN RESULTS We included three new RCTs for this update (total 61 RCTs; 1,055,337 participants). Trials involved people aged 60 years and older living in the community in high-income countries. Heterogeneity limited some meta-analyses. We assessed studies as at low risk of bias for randomisation (38%), allocation concealment (11%), blinding (44%), and selective reporting (100%). Half (51%) had missing data. We assessed the evidence as low-quality. We identified three levels of intervention intensity: low (e.g. postcards), medium (e.g. personalised phone calls), and high (e.g. home visits, facilitators).Increasing community demand (12 strategies, 41 trials, 53 study arms, 767,460 participants)One successful intervention that could be meta-analysed was client reminders or recalls by letter plus leaflet or postcard compared to reminder (odds ratio (OR) 1.11, 95% confidence interval (CI) 1.07 to 1.15; 3 studies; 64,200 participants). Successful interventions tested by single studies were patient outreach by retired teachers (OR 3.33, 95% CI 1.79 to 6.22); invitations by clinic receptionists (OR 2.72, 95% CI 1.55 to 4.76); nurses or pharmacists educating and nurses vaccinating patients (OR 152.95, 95% CI 9.39 to 2490.67); medical students counselling patients (OR 1.62, 95% CI 1.11 to 2.35); and multiple recall questionnaires (OR 1.13, 95% CI 1.03 to 1.24).Some interventions could not be meta-analysed due to significant heterogeneity: 17 studies tested simple reminders (11 with 95% CI entirely above unity); 16 tested personalised reminders (12 with 95% CI entirely above unity); two investigated customised compared to form letters (both 95% CI above unity); and four studies examined the impact of health risk appraisals (all had 95% CI above unity). One study of a lottery for free groceries was not effective.Enhancing vaccination access (6 strategies, 8 trials, 10 arms, 9353 participants)We meta-analysed results from two studies of home visits (OR 1.30, 95% CI 1.05 to 1.61) and two studies that tested free vaccine compared to patient payment for vaccine (OR 2.36, 95% CI 1.98 to 2.82). We were unable to conduct meta-analyses of two studies of home visits by nurses plus a physician care plan (both with 95% CI above unity) and two studies of free vaccine compared to no intervention (both with 95% CI above unity). One study of group visits (OR 27.2, 95% CI 1.60 to 463.3) was effective, and one study of home visits compared to safety interventions was not.Provider- or system-based interventions (11 strategies, 15 trials, 17 arms, 278,524 participants)One successful intervention that could be meta-analysed focused on payments to physicians (OR 2.22, 95% CI 1.77 to 2.77). Successful interventions tested by individual studies were: reminding physicians to vaccinate all patients (OR 2.47, 95% CI 1.53 to 3.99); posters in clinics presenting vaccination rates and encouraging competition between doctors (OR 2.03, 95% CI 1.86 to 2.22); and chart reviews and benchmarking to the rates achieved by the top 10% of physicians (OR 3.43, 95% CI 2.37 to 4.97).We were unable to meta-analyse four studies that looked at physician reminders (three studies with 95% CI above unity) and three studies of facilitator encouragement of vaccination (two studies with 95% CI above unity). Interventions that were not effective were: comparing letters on discharge from hospital to letters to general practitioners; posters plus postcards versus posters alone; educational reminders, academic detailing, and peer comparisons compared to mailed educational materials; educational outreach plus feedback to teams versus written feedback; and an intervention to increase staff vaccination rates.Interventions at the societal levelNo studies reported on societal-level interventions.Study funding sourcesStudies were funded by government health organisations (n = 33), foundations (n = 9), organisations that provided healthcare services in the studies (n = 3), and a pharmaceutical company offering free vaccines (n = 1). Fifteen studies did not report study funding sources. AUTHORS' CONCLUSIONS We identified interventions that demonstrated significant positive effects of low (postcards), medium (personalised phone calls), and high (home visits, facilitators) intensity that increase community demand for vaccination, enhance access, and improve provider/system response. The overall GRADE assessment of the evidence was moderate quality. Conclusions are unchanged from the 2014 review.
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Affiliation(s)
- Roger E Thomas
- University of CalgaryDepartment of Family Medicine, Faculty of MedicineHealth Sciences Centre3330 Hospital Drive NWCalgaryABCanadaT2N 4N1
| | - Diane L Lorenzetti
- Faculty of Medicine, University of CalgaryDepartment of Community Health Sciences3rd Floor TRW3280 Hospital Drive NWCalgaryABCanadaT2N 4Z6
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Nakashima K, Aoshima M, Ohfuji S, Yamawaki S, Nemoto M, Hasegawa S, Noma S, Misawa M, Hosokawa N, Yaegashi M, Otsuka Y. Immunogenicity of simultaneous versus sequential administration of a 23-valent pneumococcal polysaccharide vaccine and a quadrivalent influenza vaccine in older individuals: A randomized, open-label, non-inferiority trial. Hum Vaccin Immunother 2018; 14:1923-1930. [PMID: 29561248 PMCID: PMC6150043 DOI: 10.1080/21645515.2018.1455476] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
It is unclear whether simultaneous administration of a 23-valent pneumococcal polysaccharide vaccine (PPSV23) and a quadrivalent influenza vaccine (QIV) produces immunogenicity in older individuals. This study tested the hypothesis that the pneumococcal antibody response elicited by simultaneous administration of PPSV23 and QIV in older individuals is not inferior to that elicited by sequential administration of PPSV23 and QIV. We performed a single-center, randomized, open-label, non-inferiority trial comprising 162 adults aged ≥65 years randomly assigned to either the simultaneous (simultaneous injections of PPSV23 and QIV) or sequential (control; PPSV23 injected 2 weeks after QIV vaccination) groups. Pneumococcal immunoglobulin G (IgG) titers of serotypes 23F, 3, 4, 6B, 14, and 19A were assessed. The primary endpoint was the serotype 23F response rate (a ≥2-fold increase in IgG concentrations 4–6 weeks after PPSV23 vaccination). With the non-inferiority margin set at 20% fewer patients, the response rate of serotype 23F in the simultaneous group (77.8%) was not inferior to that of the sequential group (77.6%; difference, 0.1%; 90% confidence interval, −10.8% to 11.1%). None of the pneumococcal IgG serotype titers were significantly different between the groups 4–6 weeks after vaccination. Simultaneous administration did not show a significant decrease in seroprotection odds ratios for H1N1, H3N2, or B/Phuket influenza strains other than B/Texas. Additionally, simultaneous administration did not increase adverse reactions. Hence, simultaneous administration of PPSV23 and QIV shows an acceptable immunogenicity that is comparable to sequential administration without an increase in adverse reactions. (This study was registered with ClinicalTrials.gov [NCT02592486]).
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Affiliation(s)
- Kei Nakashima
- a Department of Pulmonology , Kameda Medical Center , Chiba , Japan
| | - Masahiro Aoshima
- a Department of Pulmonology , Kameda Medical Center , Chiba , Japan
| | - Satoko Ohfuji
- b Department of Public Health , Osaka City University Graduate School of Medicine , Osaka , Japan
| | - Satoshi Yamawaki
- a Department of Pulmonology , Kameda Medical Center , Chiba , Japan
| | - Masahiro Nemoto
- a Department of Pulmonology , Kameda Medical Center , Chiba , Japan
| | - Shinya Hasegawa
- c Department of General Internal Medicine , Kameda Medical Center , Chiba , Japan
| | - Satoshi Noma
- a Department of Pulmonology , Kameda Medical Center , Chiba , Japan
| | - Masafumi Misawa
- a Department of Pulmonology , Kameda Medical Center , Chiba , Japan
| | - Naoto Hosokawa
- d Department of Infectious Disease , Kameda Medical Center , Chiba , Japan
| | - Makito Yaegashi
- c Department of General Internal Medicine , Kameda Medical Center , Chiba , Japan
| | - Yoshihito Otsuka
- e Department of Laboratory Medicine , Kameda Medical Center , Chiba , Japan
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Maisonneuve AR, Witteman HO, Brehaut J, Dubé È, Wilson K. Educating children and adolescents about vaccines: a review of current literature. Expert Rev Vaccines 2018; 17:311-321. [PMID: 29569498 DOI: 10.1080/14760584.2018.1456921] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Until recently, research on vaccine hesitancy has focused primarily on parent populations. Although adolescent knowledge and views are gaining momentum within the literature, particularly with regards to the human papillomavirus and influenza, children remain a virtually unstudied population with regards to vaccine hesitancy. AREAS COVERED This review focuses on the lack of literature in this area and argues for more vaccine hesitancy research involving child and adolescent populations. It also outlines special issues to consider when framing health promotion messages for children and adolescents. Finally, we explore the use of new and existing technologies as delivery mechanisms for education on vaccines and immunizations in populations of children and adolescents. EXPERT COMMENTARY Children undergo cognitive development and experiences with vaccines (e.g. pain or education) have the potential to create future attitudes toward vaccines. This can influence future vaccine behaviour, including their participation in decision-making around adolescent vaccines, their decisions to vaccinate themselves when they are adults, and their decisions to vaccinate their own children. Interventions aimed at children, such as education, can create positive attitudes toward vaccines. These can also potentially influence parental attitudes toward vaccines as children convey this knowledge to them. Both of these impacts require further study.
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Affiliation(s)
| | - Holly O Witteman
- b Department of Family and Emergency Medicine , Université Laval , Québec , QC , Canada
| | - Jamie Brehaut
- c Ottawa Hospital Research Institute , Ottawa , ON , Canada
| | - Ève Dubé
- d Institut national de santé publique du Québec , Québec , QC , Canada
| | - Kumanan Wilson
- c Ottawa Hospital Research Institute , Ottawa , ON , Canada
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Mutlu HH, Coşkun FO, Sargın M. The Incidence and Awareness of Vaccination Among People Aged 65 and over Applied to a Family Medicine Outpatient Clinic. ANKARA MEDICAL JOURNAL 2018. [DOI: 10.17098/amj.408968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Kan T, Zhang J. Factors influencing seasonal influenza vaccination behaviour among elderly people: a systematic review. Public Health 2018; 156:67-78. [PMID: 29408191 PMCID: PMC7111770 DOI: 10.1016/j.puhe.2017.12.007] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/24/2017] [Accepted: 12/11/2017] [Indexed: 10/29/2022]
Abstract
OBJECTIVES To explore the behaviour-related factors influencing influenza vaccination among elderly people using a framework derived from the Health Belief Model (HBM) and the Theory of Reasoned Action (TRA). STUDY DESIGN Systematic review. METHODS Five databases were searched using predetermined strategies in March 2016, and 1927 citations were identified. Articles were selected according to inclusion and exclusion criteria. Key information was extracted from selected studies using a predesigned sheet. Both authors assessed study quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) or Critical Appraisal Skills Programme (CASP) checklist. RESULTS Thirty-six articles were selected. A new framework was proposed that contributes to shared understanding of factors influencing health behaviour. Possible determinants of influenza vaccination among elderly people were knowledge, health promotion factors, all constructs of the HBM, and some concepts of the TRA. Key factors were threat perception, behavioural beliefs, subjective norms, recommendations, past behaviour and perceived barriers. CONCLUSIONS This is the first systematic review to analyse the factors influencing influenza vaccination behaviour of elderly people using a framework integrating the HBM and the TRA. The framework identified key factors of influenza vaccination and presented the inter-relation of behaviour-related variables. However, further well-designed studies are required to explore the inter-relationships accurately and comprehensively.
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Affiliation(s)
- T Kan
- School of Nursing, Second Military Medical University, Shanghai, China
| | - J Zhang
- School of Nursing, Second Military Medical University, Shanghai, China.
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Bock JO, Hajek A, König HH. Psychological determinants of influenza vaccination. BMC Geriatr 2017; 17:194. [PMID: 28851282 PMCID: PMC5576319 DOI: 10.1186/s12877-017-0597-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 08/23/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies investigated the determinants of individuals' decision to vaccinate against influenza primarily focusing on social as well as certain proximal determinants, for example, behavioral beliefs. Thus, so far, the analysis of psychological factors as determinants of influenza vaccination was mainly limited to beliefs, attitudes or perceptions that were directly related to influenza vaccination and its perceived impact. However, considering general psychological factors, like general self-efficacy, optimism or subjective well-being, might further enhance the understanding of why certain people vaccinate while others do not. The aim was to investigate the relationship between various general psychological factors and older people's decision to vaccinate against seasonal flu. METHODS The data of individuals aged 60 or older (n = 5037; in 2014) were used from the Germany Ageing Survey. The data were collected in face-to-face interviews and in self-administered questionnaires. They include questions on the use of influenza vaccination and the psychological factors of optimism, self-efficacy, self-esteem, perceived stress, self-regulation, life satisfaction, and negative affect as well as positive affect. The psychological determinants of regular influenza vaccination were investigated using multiple logistic regressions. RESULTS 53.2% of all participants were regular users of influenza vaccination. There were significant bivariate correlations of all cited psychological factor with influenza vaccination except for life satisfaction and negative affect. After controlling for numerous potential socio-demographic, morbidity- and lifestyle-related confounders, regular influenza vaccination was still positively associated with lower levels of self-esteem and a higher level of perceived stress. CONCLUSIONS There are significant associations of general individual psychological constructs with the decision to vaccinate against influenza. Future research might determine the impact of psychological factors on the decision to vaccinate in longitudinal research designs. This might be helpful to understand the causal mechanisms behind this relationship, which could help to design interventions that increase vaccination rates in certain target groups.
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Affiliation(s)
- Jens-Oliver Bock
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
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Wheelock A, Miraldo M, Thomson A, Vincent C, Sevdalis N. Evaluating the importance of policy amenable factors in explaining influenza vaccination: a cross-sectional multinational study. BMJ Open 2017; 7:e014668. [PMID: 28706088 PMCID: PMC5734251 DOI: 10.1136/bmjopen-2016-014668] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Despite continuous efforts to improve influenza vaccination coverage, uptake among high-risk groups remains suboptimal. We aimed to identify policy amenable factors associated with vaccination and to measure their importance in order to assist in the monitoring of vaccination sentiment and the design of communication strategies and interventions to improve vaccination rates. SETTING The USA, the UK and France. PARTICIPANTS A total of 2412 participants were surveyed across the three countries. OUTCOME MEASURES Self-reported influenza vaccination. METHODS Between March and April 2014, a stratified random sampling strategy was employed with the aim of obtaining nationally representative samples in the USA, the UK and France through online databases and random-digit dialling. Participants were asked about vaccination practices, perceptions and feelings. Multivariable logistic regression was used to identify factors associated with past influenza vaccination. RESULTS The models were able to explain 64%-80% of the variance in vaccination behaviour. Overall, sociopsychological variables, which are inherently amenable to policy, were better at explaining past vaccination behaviour than demographic, socioeconomic and health variables. Explanatory variables included social influence (physician), influenza and vaccine risk perceptions and traumatic childhood experiences. CONCLUSIONS Our results indicate that evidence-based sociopsychological items should be considered for inclusion into national immunisation surveys to gauge the public's views, identify emerging concerns and thus proactively and opportunely address potential barriers and harness vaccination drivers.
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Affiliation(s)
- Ana Wheelock
- National Institute for Health Research Imperial Patient Safety Translational Research Centre (PSTRC), Imperial College London, London, UK
| | | | | | - Charles Vincent
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, King’s College London, London, UK
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ANG LW, CUTTER J, JAMES L, GOH KT. Factors associated with influenza vaccine uptake in older adults living in the community in Singapore. Epidemiol Infect 2017; 145:775-786. [PMID: 27927253 PMCID: PMC9507716 DOI: 10.1017/s0950268816002491] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 07/30/2016] [Accepted: 10/09/2016] [Indexed: 11/06/2022] Open
Abstract
In Singapore, influenza vaccination is recommended for persons at higher risk of complications of seasonal influenza, including those with chronic medical conditions and the elderly (individuals aged ⩾65 years). We investigated the factors associated with influenza vaccine uptake based on a nationally representative sample of community-dwelling adults aged >50 years. The data for this study were obtained from the National Health Surveillance Survey (NHSS) 2013. The association between influenza vaccine uptake and socio-demographic and health-related variables was analysed using univariable and multivariable logistic regression models. Of 3700 respondents aged ⩾50 years in the NHSS, 15·2% had received seasonal influenza vaccination in the past year. Older age, single marital status and economic inactivity were the socio-demographic variables independently associated with vaccine uptake. Health-related factors which were predictive of influenza vaccine uptake were sufficient total physical activity, better self-rated health, having at least one medical condition at risk of influenza complications and a regular family doctor/general practitioner. Influenza vaccine uptake in community-dwelling older adults was low. Our findings are of relevance in the formulation of public health policies and targeted health promotion strategies to increase vaccine uptake in this population group.
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Affiliation(s)
- L. W. ANG
- Epidemiology & Disease Control Division, Ministry of Health, Singapore, College of Medicine Building, Singapore, Singapore
| | - J. CUTTER
- Communicable Diseases Division, Ministry of Health, Singapore, College of Medicine Building, Singapore, Singapore
| | - L. JAMES
- Epidemiology & Disease Control Division, Ministry of Health, Singapore, College of Medicine Building, Singapore, Singapore
| | - K. T. GOH
- Communicable Diseases Division, Ministry of Health, Singapore, College of Medicine Building, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Chang YC, Tung HJ, Hsu SW, Chen LS, Kung PT, Huang KH, Chiou SJ, Tsai WC. Use of Seasonal Influenza Vaccination and Its Associated Factors among Elderly People with Disabilities in Taiwan: A Population-Based Study. PLoS One 2016; 11:e0158075. [PMID: 27336627 PMCID: PMC4919006 DOI: 10.1371/journal.pone.0158075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 06/09/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Influenza immunization among elderly people with disabilities is a critical public health concern; however, few studies have examined the factors associated with vaccination rates in non-Western societies. METHODS By linking the National Disability Registration System and health service claims dataset from the National Health Insurance program, this population-based study investigated the seasonal influenza vaccination rate among elderly people with disabilities in Taiwan (N = 283,172) in 2008. A multivariate logistic regression analysis was conducted to adjust for covariates. RESULTS Nationally, only 32.7% of Taiwanese elderly people with disabilities received influenza vaccination. The strongest predictor for getting vaccinated among older Taiwanese people with disabilities was their experience of receiving an influenza vaccination in the previous year (adjusted odds ratio [AOR] = 6.80, 95% confidence interval [CI]: 6.67-6.93). Frequent OPD use (AOR = 1.85, 95% CI: 1.81-1.89) and undergoing health examinations in the previous year (AOR = 1.66, 95% CI: 1.62-1.69) also showed a moderate and significant association with receiving an influenza vaccination. CONCLUSIONS Although free influenza vaccination has been provided in Taiwan since 2001, influenza immunization rates among elderly people with disabilities remain low. Policy initiatives are required to address the identified factors for improving influenza immunization rates among elderly people with disabilities.
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Affiliation(s)
- Yu-Chia Chang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan, ROC
| | - Ho-Jui Tung
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC
| | - Shang-Wei Hsu
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan, ROC
| | - Lei-Shin Chen
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas, United States of America
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC
| | - Kuang-Hua Huang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan, ROC
| | - Shang-Jyh Chiou
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan, ROC
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Panatto D, Domnich A, Gasparini R, Bonanni P, Icardi G, Amicizia D, Arata L, Bragazzi NL, Signori A, Landa P, Bechini A, Boccalini S. Development and preliminary data on the use of a mobile app specifically designed to increase community awareness of invasive pneumococcal disease and its prevention. Hum Vaccin Immunother 2016; 12:1080-4. [PMID: 26795065 PMCID: PMC4962929 DOI: 10.1080/21645515.2015.1114196] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 10/09/2015] [Accepted: 10/26/2015] [Indexed: 12/04/2022] Open
Abstract
Given the growing use and great potential of mobile apps, this project aimed to develop and implement a user-friendly app to increase laypeople's knowledge and awareness of invasive pneumococcal disease (IPD). Despite the heavy burden of IPD, the documented low awareness of IPD among both laypeople and healthcare professionals and far from optimal pneumococcal vaccination coverage, no app specifically targeting IPD has been developed so far. The app was designed to be maximally functional and conceived in accordance with user-centered design. Its content, layout and usability were discussed and formally tested during several workshops that involved the principal stakeholders, including experts in IPD and information technology and potential end-users. Following several workshops, it was decided that, in order to make the app more interactive, its core should be a personal "checker" of the risk of contracting IPD and a user-friendly risk-communication strategy. The checker was populated with risk factors identified through both Italian and international official guidelines. Formal evaluation of the app revealed its good readability and usability properties. A sister web site with the same content was created to achieve higher population exposure. Seven months after being launched in a price- and registration-free modality, the app, named "Pneumo Rischio," averaged 20.9 new users/day and 1.3 sessions/user. The first in-field results suggest that "Pneumo Rischio" is a promising tool for increasing the population's awareness of IPD and its prevention through a user-friendly risk checker.
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Affiliation(s)
| | | | | | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Lucia Arata
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Alessio Signori
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Paolo Landa
- Department of Economics, University of Genoa, Genoa, Italy
| | - Angela Bechini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, Florence, Italy
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Lv M, Fang R, Wu J, Pang X, Deng Y, Lei T, Xie Z. The free vaccination policy of influenza in Beijing, China: The vaccine coverage and its associated factors. Vaccine 2016; 34:2135-40. [PMID: 26917011 DOI: 10.1016/j.vaccine.2016.02.032] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 01/17/2016] [Accepted: 02/10/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND In order to improve influenza vaccination coverage, the coverage rate and reasons for non-vaccination need to be determined. In 2007, the Beijing Government published a policy providing free influenza vaccinations to elderly people living in Beijing who are older than 60. This study examines the vaccination coverage after the policy was carried out and factors influencing vaccination among the elderly in Beijing. METHODS A cross-sectional survey was conducted through the use of questionnaires in 2013. A total of 1673 eligible participants were selected by multistage stratified random sampling in Beijing using anonymous questionnaires in-person. They were surveyed to determine vaccination status and social demographic information. RESULTS The influenza vaccination coverage was 38.7% among elderly people in Beijing in 2012. The most common reason for not being vaccinated was people thinking they did not need to have a flu shot. After controlling for age, gender, income, self-reported health status, and the acceptance of health promotion, the rate in rural areas was 2.566 (95% confidence interval [CI], 1.801-3.655, P<0.010) times greater than that in urban areas. Different mechanisms of health education and health promotion have different influences on vaccination uptake. Those whom received information through television, community boards, or doctors were more likely to get vaccinated compared to those who did not (Odds Ratio [OR]=1.403, P<0.010; OR=1.812, P<0.010; OR=2.647, P<0.010). CONCLUSION The influenza vaccine coverage in Beijing is much lower than that of developed countries with similar policies. The rural-urban disparity in coverage rate (64.1% versus 33.5%), may be explained by differing health provision systems and personal attitudes toward free services due to socioeconomic factors. Methods for increasing vaccination levels include increasing the focus on primary care and health education programs, particularly recommendations from doctors, to the distinct target populations, especially with a focus on expanding these efforts in urban areas.
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Affiliation(s)
- Min Lv
- Beijing Center for Disease Prevention and Control, Beijing 100013, PR China
| | - Renfei Fang
- School of Public Health, Peking University, Beijing 100191, PR China
| | - Jiang Wu
- Beijing Center for Disease Prevention and Control, Beijing 100013, PR China
| | - Xinghuo Pang
- Beijing Center for Disease Prevention and Control, Beijing 100013, PR China
| | - Ying Deng
- Beijing Center for Disease Prevention and Control, Beijing 100013, PR China
| | - Trudy Lei
- School of Public Health of Columbia University, NY 10032, USA
| | - Zheng Xie
- School of Public Health, Peking University, Beijing 100191, PR China.
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Song IG, Lee H, Yi J, Kim MS, Park SM. Influenza Vaccination Coverage and Its Associated Factors among North Korean Defectors Living in the Republic of Korea. J Korean Med Sci 2015; 30:1226-31. [PMID: 26339160 PMCID: PMC4553667 DOI: 10.3346/jkms.2015.30.9.1226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 05/13/2015] [Indexed: 11/20/2022] Open
Abstract
This study aimed to examine influenza vaccination coverage of North Korean defectors (NKD) in the Republic of Korea (Korea) and explore the factors affected the vaccination coverage. Total 378 NKD were analyzed. Four Korean control subjects were randomly matched by age and gender from the Korea National Health and Nutrition Examination Survey V (n = 1,500). The adjusted vaccination coverage revealed no statistical difference between the defectors group and indigenous group (29.1% vs. 29.5%, P = 0.915). In the aged under 50 group, the vaccination coverage of NKD was higher than that of Korean natives (37.8% vs. 25.8%, P = 0.016). However in the aged 50 yr and over group, the vaccination coverage of North Korean defectors was lower than that of the natives (28.0% vs. 37.6%, P = 0.189). Even the gap was wider in the aged 65 yr and over group (36.4% vs. 77.8%, P = 0.007). Gender and medical check-up experience within 2 yr showed association with the vaccination coverage of NKD. Influenza vaccination coverage of aged defectors' group (aged 50 yr and over) was lower than indigenous people though overall vaccination coverage was similar. Further efforts to increase influenza vaccination coverage of this group are needed.
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Affiliation(s)
- In Gyu Song
- Department of Pediatrics, Hana Medical Center, Settlement Support Center for North Korean Refugees, Anseong, Korea
- Center for Medicine and Korean Reunification, Seoul National University College of Medicine, Seoul, Korea
| | - Haewon Lee
- Center for Medicine and Korean Reunification, Seoul National University College of Medicine, Seoul, Korea
| | - Jinseon Yi
- Center for Medicine and Korean Reunification, Seoul National University College of Medicine, Seoul, Korea
| | - Min Sun Kim
- Public Health Medical Service, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
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Taheri Tanjani P, Babanejad M, Najafi F. Influenza vaccination uptake and its socioeconomic determinants in the older adult Iranian population: A national study. Am J Infect Control 2015; 43:e1-5. [PMID: 25798776 DOI: 10.1016/j.ajic.2015.02.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 02/01/2015] [Accepted: 02/02/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The relationship between socioeconomic status and influenza vaccine uptake has a different pattern in different societies. The objective of this study was to assess the socioeconomic factors influencing influenza vaccination uptake in the older adult Iranian population. METHODS In this cross-sectional study, 1,350 Iranian adults aged ≥60 years were selected using a multistage sampling method. Self-report questionnaires were administered to collect information on the status of influenza vaccine uptake within the last year. RESULTS Overall, 10.4% of the older adult Iranian population had received influenza vaccinations within the last year. Several determinants were associated with influenza vaccination uptake, such as current occupation, education level, ethnicity, source of income, financial support from relatives, satisfaction with income, type of health insurance, and having complementary health insurance for outpatient services. Other factors, such as age, sex, marital status, residential area, and having health insurance, had no influence on the probability of vaccine uptake. After adjusting for desired variables, we found that having an occupation (odds ratio [OR] = 2.08; 95% confidence interval [CI], 1.08-4.02) and having complementary health insurance for outpatient services (OR = 1.65; 95% CI, 1.06-2.56) remained associated with higher influenza vaccine uptake. CONCLUSIONS The influenza vaccination rate in older adult Iranians was found to be low. Occupation and having complementary health insurance were associated with influenza vaccination uptake among Iranian older adults. Considering the mentioned variables in future studies is advised.
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Sato APS, Antunes JLF, Moura RF, de Andrade FB, Duarte YAO, Lebrão ML. Factors associated to vaccination against influenza among elderly in a large Brazilian metropolis. PLoS One 2015; 10:e0123840. [PMID: 25874953 PMCID: PMC4395161 DOI: 10.1371/journal.pone.0123840] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 02/25/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND This study aimed to estimate coverage and identify factors associated to vaccination against influenza in the elderly population. METHODS The study design was cross-sectional and population based. Data was collected in 2010 by the Health, Well-Being and Aging Study. Sample consisted of 1,341 community-dwelling elderly, in São Paulo, Brazil. Association between vaccination and covariates was evaluated by means of prevalence ratios estimated by Poisson regression models. RESULTS Self-reported vaccination coverage was 74.2% (95% confidence interval: 71.3-76.9). Remaining physically active and having had recent interaction with health services, mainly with public units of healthcare, were the main incentives to increase vaccination coverage among the elderly; whereas lower age, living alone and absent interaction with health services were the main constraints to influenza vaccination at the community level. These covariates had already been reported to influence influenza vaccination of elders in previous years. CONCLUSION Previous knowledge already available on the main constraints to influenza vaccination has not allowed to remove them. Influenza campaigns should be strengthened to increase vaccination coverage, especially in the group more reticent to vaccination. Instructing healthcare providers to recommend vaccine uptake is an important piece of this puzzle.
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Affiliation(s)
- Ana Paula Sayuri Sato
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Roudom Ferreira Moura
- Center for Epidemiological Surveillance “Professor Alexandre Vranjac” of the São Paulo State, São Paulo, Brazil
| | - Fabíola Bof de Andrade
- Center for Studies in Public Health and Aging, Rene Rachou Research Institute, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | | | - Maria Lúcia Lebrão
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
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Mc Hugh SM, Browne J, O'Neill C, Kearney PM. The influence of partial public reimbursement on vaccination uptake in the older population: a cross-sectional study. BMC Public Health 2015; 15:83. [PMID: 25652743 PMCID: PMC4328256 DOI: 10.1186/s12889-015-1356-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 01/05/2015] [Indexed: 11/30/2022] Open
Abstract
Background Flu vaccination is recommended annually for high risk groups. However, in Ireland, free access to vaccination is not universal for those in high risk groups; the vaccine and consultation are only free for those with a medical card, a means tested scheme. Few private health insurance policies cover the cost of attendance for vaccination in general practice. The aim was to examine the influence of this reimbursement policy on vaccination coverage among older adults. Methods Cross-sectional wave 1 data from The Irish Longitudinal Study on Ageing (TILDA) were analysed (2009–2011). TILDA is a nationally representative prospective cohort study of adults aged ≥50, sampled using multistage stratified clustered sampling. Self-reported entitlement to healthcare was categorised as 1) medical card only 2) private health insurance only, 3) both and 4) neither. The outcome was responses to ‘have you ever had a flu shot’. Multivariate logistic regression was used, adjusting for age and need. Results 68.6% of those defined as clinically high-risk received the flu vaccination in the past (95% CI = 67-71%). Those with a medical card were almost twice as likely to have been vaccinated, controlling for age and chronic illness (OR = 1.9, 95% CI = 1.5-2.5, p = <0.001). Conclusions Having a medical card increased the likelihood of being vaccinated, independent of age and need. The mismatch between vaccination guidelines and reimbursement policy is creating unequal access to recommended services among high risk groups. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1356-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sheena M Mc Hugh
- Department of Epidemiology & Public Health, Western Gateway Complex, University College Cork, Western Rd, Cork, Ireland.
| | - John Browne
- Department of Epidemiology & Public Health, Western Gateway Complex, University College Cork, Western Rd, Cork, Ireland.
| | - Ciaran O'Neill
- School of Business and Economics, National University of Ireland, Galway, Ireland.
| | - Patricia M Kearney
- Department of Epidemiology & Public Health, Western Gateway Complex, University College Cork, Western Rd, Cork, Ireland.
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Factors affecting the uptake of vaccination by the elderly in Western society. Prev Med 2014; 69:224-34. [PMID: 25456809 DOI: 10.1016/j.ypmed.2014.10.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/09/2014] [Accepted: 10/13/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To present the results of a literature review on factors related to vaccine uptake by elderly persons. METHODS A systematic literature search was performed using Medline, Embase, and SciSearch to collect all publications available on factors related to vaccine uptake from 1966 until October 2012 for West European and North American societies. In total, 1001 articles were identified and 60 were included in the review. RESULTS We identified six main themes that influence the willingness to be vaccinated: 1) attitudes and beliefs regarding vaccination in general including positive and negative attitudes and beliefs; 2) perceived risk and severity including knowledge, perceived susceptibility and severity and personal experience; 3) vaccine characteristics including side-effects, effectiveness, content of the vaccine and knowledge; 4) advice and information including influence of the healthcare worker and relatives and the information source and format; 5) general health-related behavior including previous vaccinations, visiting GP or senior center and other preventive behaviors; and 6) accessibility and affordability including logistics, combinations of vaccines and costs. CONCLUSION The most important factors related to vaccine uptake are people's attitudes and beliefs regarding vaccination (especially their negative attitudes), recommendations of healthcare workers, side effects and effectiveness of the vaccine, and perceived susceptibility.
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Vinograd I, Baslo R, Eliakim-Raz N, Farbman L, Taha A, Sakhnini A, Lador A, Stemmer S, Gafter-Gvili A, Fraser D, Leibovici L, Paul M. Factors associated with influenza vaccination among adult cancer patients: a case–control study. Clin Microbiol Infect 2014; 20:899-905. [DOI: 10.1111/1469-0691.12625] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 03/12/2014] [Accepted: 03/13/2014] [Indexed: 01/25/2023]
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Thomas RE, Lorenzetti DL. Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database Syst Rev 2014; 2014:CD005188. [PMID: 24999919 PMCID: PMC6464876 DOI: 10.1002/14651858.cd005188.pub3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The effectiveness of interventions to increase the uptake of influenza vaccination in people aged 60 and older is uncertain. OBJECTIVES To assess access, provider, system and societal interventions to increase the uptake of influenza vaccination in people aged 60 years and older in the community. SEARCH METHODS We searched CENTRAL (2014, Issue 5), MEDLINE (January 1950 to May week 3 2014), EMBASE (1980 to June 2014), AgeLine (1978 to 4 June 2014), ERIC (1965 to June 2014) and CINAHL (1982 to June 2014). SELECTION CRITERIA Randomised controlled trials (RCTs) of interventions to increase influenza vaccination uptake in people aged 60 and older. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study quality and extracted influenza vaccine uptake data. MAIN RESULTS This update identified 13 new RCTs; the review now includes a total of 57 RCTs with 896,531 participants. The trials included community-dwelling seniors in high-income countries. Heterogeneity limited meta-analysis. The percentage of trials with low risk of bias for each domain was as follows: randomisation (33%); allocation concealment (11%); blinding (44%); missing data (49%) and selective reporting (100%). Increasing community demand (32 trials, 10 strategies)The interventions with a statistically significant result were: three trials (n = 64,200) of letter plus leaflet/postcard compared to letter (odds ratio (OR) 1.11, 95% confidence interval (CI) 1.07 to 1.15); two trials (n = 614) of nurses/pharmacists educating plus vaccinating patients (OR 3.29, 95% CI 1.91 to 5.66); single trials of a phone call from a senior (n = 193) (OR 3.33, 95% CI 1.79 to 6.22), a telephone invitation versus clinic drop-in (n = 243) (OR 2.72, 95% CI 1.55 to 4.76), a free groceries lottery (n = 291) (OR 1.04, 95% CI 0.62 to 1.76) and nurses educating and vaccinating patients (n = 485) (OR 152.95, 95% CI 9.39 to 2490.67).We did not pool the following trials due to considerable heterogeneity: postcard/letter/pamphlets (16 trials, n = 592,165); tailored communications (16 trials, n = 388,164); customised letter/phone-call (four trials, n = 82,465) and client-based appraisals (three trials, n = 4016), although several trials showed the interventions were effective. Enhancing vaccination access (10 trials, six strategies)The interventions with a statistically significant result were: two trials (n = 2112) of home visits compared to clinic invitation (OR 1.30, 95% CI 1.05 to 1.61); two trials (n = 2251) of free vaccine (OR 2.36, 95% CI 1.98 to 2.82) and one trial (n = 321) of patient group visits (OR 24.85, 95% CI 1.45 to 425.32). One trial (n = 350) of a home visit plus vaccine encouragement compared to a home visit plus safety advice was non-significant.We did not pool the following trials due to considerable heterogeneity: nurse home visits (two trials, n = 2069) and free vaccine compared to no intervention (two trials, n = 2250). Provider- or system-based interventions (17 trials, 11 strategies)The interventions with a statistically significant result were: two trials (n = 2815) of paying physicians (OR 2.22, 95% CI 1.77 to 2.77); one trial (n = 316) of reminding physicians about all their patients (OR 2.47, 95% CI 1.53 to 3.99); one trial (n = 8376) of posters plus postcards (OR 2.03, 95% CI 1.86 to 2.22); one trial (n = 1360) of chart review/feedback (OR 3.43, 95% CI 2.37 to 4.97) and one trial (n = 27,580) of educational outreach/feedback (OR 0.77, 95% CI 0.72 to 0.81).Trials of posters plus postcards versus posters (n = 5753), academic detailing (n = 1400) and increasing staff vaccination rates (n = 26,432) were non-significant.We did not pool the following trials due to considerable heterogeneity: reminding physicians (four trials, n = 202,264) and practice facilitators (three trials, n = 2183), although several trials showed the interventions were effective. Interventions at the societal level We identified no RCTs of interventions at the societal level. AUTHORS' CONCLUSIONS There are interventions that are effective for increasing community demand for vaccination, enhancing access and improving provider/system response. Heterogeneity limited pooling of trials.
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Affiliation(s)
- Roger E Thomas
- University of CalgaryDepartment of Family Medicine, Faculty of MedicineUCMC#1707‐1632 14th AvenueCalgaryCanadaT2M 1N7
| | - Diane L Lorenzetti
- Faculty of Medicine, University of CalgaryDepartment of Community Health Sciences3rd Floor TRW3280 Hospital Drive NWCalgaryCanadaT2N 4Z6
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Schneeberg A, Bettinger JA, McNeil S, Ward BJ, Dionne M, Cooper C, Coleman B, Loeb M, Rubinstein E, McElhaney J, Scheifele DW, Halperin SA. Knowledge, attitudes, beliefs and behaviours of older adults about pneumococcal immunization, a Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network (PCIRN) investigation. BMC Public Health 2014; 14:442. [PMID: 24884433 PMCID: PMC4046143 DOI: 10.1186/1471-2458-14-442] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 05/02/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fewer Canadian seniors are vaccinated against pneumococcal disease than receive the influenza vaccine annually. Improved understanding of factors influencing pneumococcal vaccination among older adults is needed to improve vaccine uptake. METHODS A self-administered survey measuring knowledge, attitudes, beliefs and behaviours about pneumococcal vaccination was administered to a cohort of seniors participating in a clinical trial of seasonal influenza vaccines at eight centers across Canada. Eligible participants were ambulatory adults 65 years of age or older, in good health or with stable health conditions, previously given influenza vaccine. The primary outcome was self-reported receipt of pneumococcal vaccination. Multi-variable logistic regression was used to determine factors significantly associated with pneumococcal vaccine receipt. RESULTS A total of 863 participants completed questionnaires (response rate 92%); 58% indicated they had received the pneumococcal vaccine. Being offered the vaccine by a health care provider had the strongest relationship with vaccine receipt (AOR 23.4 (95% CI 13.4-40.7)). Other variables that remained significantly associated with vaccine receipt in the multivariable model included having heard of the vaccine (AOR 10.1(95% CI 4.7-21.7)), and strongly agreeing that it is important for adults > 65 to be vaccinated against pneumococcus (AOR 3.3 (95% CI 1.2-9.2)). Participants who were < 70 years of age were less likely to be vaccinated. CONCLUSIONS These results indicate healthcare recommendation significantly influenced vaccine uptake in this population of older adults. Measures to encourage healthcare providers to offer the vaccine may help increase coverage.
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Affiliation(s)
- Amy Schneeberg
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Vaccine Evaluation Center, British Columbia Children’s Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Julie A Bettinger
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Vaccine Evaluation Center, British Columbia Children’s Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Shelly McNeil
- Canadian Center for Vaccinology, Dalhousie University, Capital Health and IWK Health Centre Halifax, Halifax, Nova Scotia, Canada
| | - Brian J Ward
- Vaccine Study Centre, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Marc Dionne
- Research Center, Centre Hospitalier Universitaire, Quebec City, Quebec, Canada
| | - Curtis Cooper
- The Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada
| | - Brenda Coleman
- University of Toronto and Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Mark Loeb
- McMaster University, Hamilton, Ontario, Canada
| | - Ethan Rubinstein
- University of Manitoba, Department of Medicine, Winnipeg, Manitoba, Canada
| | - Janet McElhaney
- University of British Columbia, VITALiTY Research Center, Vancouver, British Columbia, Canada
| | - David W Scheifele
- Vaccine Evaluation Center, British Columbia Children’s Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, Dalhousie University, Capital Health and IWK Health Centre Halifax, Halifax, Nova Scotia, Canada
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Dubé E, Gagnon D, Kiely M, Defay F, Guay M, Boulianne N, Sauvageau C, Landry M, Turmel B, Markowski F, Hudon N. Seasonal influenza vaccination uptake in Quebec, Canada, 2 years after the influenza A(H1N1) pandemic. Am J Infect Control 2014; 42:e55-9. [PMID: 24773805 DOI: 10.1016/j.ajic.2014.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 01/06/2014] [Accepted: 01/06/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND A decrease in seasonal influenza vaccine uptake was observed after the influenza A(H1N1) pandemic in 2009. The goal of our study was to assess seasonal influenza vaccine uptake in 2011-2012, 2 years after the influenza A(H1N1) pandemic mass immunization campaign and to identify the main reasons for having or not having received the vaccine. METHODS A telephone survey using random-digit dialing methodology was conducted. Case-weights were assigned to adjust for disproportionate sampling and for nonresponse bias. Descriptive statistics were generated for all variables. RESULTS Seasonal influenza vaccine uptake was 57% among adults aged ≥60 years, 35% among adults with chronic medical conditions, and 44% among health care workers. The main reasons given for having been vaccinated were to be protected from influenza and a high perceived susceptibility to influenza, whereas low perceived susceptibility to influenza and low perceived severity of influenza were the main reasons for not having been vaccinated. CONCLUSIONS An increase in seasonal influenza vaccine uptake was observed 2 years after the influenza A(H1N1) pandemic. However, vaccine coverage is still below the target level of 80%. More efforts are needed to develop effective strategies to increase seasonal influenza vaccine uptake.
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Wheelock A, Miraldo M, Parand A, Vincent C, Sevdalis N. Journey to vaccination: a protocol for a multinational qualitative study. BMJ Open 2014; 4:e004279. [PMID: 24486678 PMCID: PMC3913205 DOI: 10.1136/bmjopen-2013-004279] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 12/19/2013] [Accepted: 01/10/2014] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION In the past two decades, childhood vaccination coverage has increased dramatically, averting an estimated 2-3 million deaths per year. Adult vaccination coverage, however, remains inconsistently recorded and substandard. Although structural barriers are known to limit coverage, social and psychological factors can also affect vaccine uptake. Previous qualitative studies have explored beliefs, attitudes and preferences associated with seasonal influenza (flu) vaccination uptake, yet little research has investigated how participants' context and experiences influence their vaccination decision-making process over time. This paper aims to provide a detailed account of a mixed methods approach designed to understand the wider constellation of social and psychological factors likely to influence adult vaccination decisions, as well as the context in which these decisions take place, in the USA, the UK, France, India, China and Brazil. METHODS AND ANALYSIS We employ a combination of qualitative interviewing approaches to reach a comprehensive understanding of the factors influencing vaccination decisions, specifically seasonal flu and tetanus. To elicit these factors, we developed the journey to vaccination, a new qualitative approach anchored on the heuristics and biases tradition and the customer journey mapping approach. A purposive sampling strategy is used to select participants who represent a range of key sociodemographic characteristics. Thematic analysis will be used to analyse the data. Typical journeys to vaccination will be proposed. ETHICS AND DISSEMINATION Vaccination uptake is significantly influenced by social and psychological factors, some of which are under-reported and poorly understood. This research will provide a deeper understanding of the barriers and drivers to adult vaccination. Our findings will be published in relevant peer-reviewed journals and presented at academic conferences. They will also be presented as practical recommendations at policy and industry meetings and healthcare professionals' forums. This research was approved by relevant local ethics committees.
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Affiliation(s)
- Ana Wheelock
- Faculty of Medicine, Imperial College London, London, UK
| | | | - Anam Parand
- Faculty of Medicine, Imperial College London, London, UK
| | - Charles Vincent
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Nick Sevdalis
- Faculty of Medicine, Imperial College London, London, UK
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