Predictors of IV behaviors during and after the 2009 influenza pandemic in France

Shifting the Demand for Vaccines: A Review of Strategies

Vaccines prevent millions of deaths, and yet millions of people die each year from vaccine-preventable diseases. The primary reason for these deaths is that a significant fraction of the population chooses not to vaccinate. Why don't people vaccinate, and what can be done to increase vaccination rates besides providing free and easy access to vaccines? This review presents a conceptual framework, motivated by economic theory, of which factors shift the demand for vaccines. Next, it critically examines the literature on these demand shifters and interventions that target these demand shifters. The review concludes with offering directions for future research and lessons for public health decision-making. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

The role of health determinants in the influenza vaccination uptake among older adults (65+): a scope review

Background

Although the burden of influenza infection is the highest in older adults, vaccination coverage remains low, despite this age group being more vulnerable than others.

Aims

Given the current pandemic of SARS-CoV-2, it was the aim of this scope review to update knowledge on factors affecting seasonal influenza vaccine uptake among older adults to strengthen prevention approaches in the context of an overall burden of infectious diseases.

Methods

We searched bibliographic databases from 2012 to 2019. All studies reviewed one or more social determinant of health listed by WHO, or factors affecting the decision-making process whether to accept influenza vaccine or not.

Results

Overall, 44 studies were included, 41 determinants were extracted and summarized into six categories. Older age and constitutional factors including multiple chronic diseases as well as preventive lifestyle and frequent routine healthcare utilization positively affected vaccination uptake (VU). Living and working conditions are also researched determinants of influenza vaccine uptake. A small number of studies explored the role of social inclusion and system-based interventions.

Discussion and conclusions

This scope review provides a comprehensive overview on factors affecting seasonal influenza vaccination uptake among older citizens. The review also clearly shows gaps for evidence on system-based level or political strategies to improve vaccination uptake.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40520-021-01793-3.

Developing and Maintaining Public Trust During and Post-COVID-19: Can We Apply a Model Developed for Responding to Food Scares?

Trust in public health officials and the information they provide is essential for the public uptake of preventative strategies to reduce the transmission of COVID-19. This paper discusses how a model for developing and maintaining trust in public health officials during food safety incidents and scandals might be applied to pandemic management. The model identifies ten strategies to be considered, including: transparency; development of protocols and procedures; credibility; proactivity; putting the public first; collaborating with stakeholders; consistency; education of stakeholders and the public; building your reputation; and keeping your promises. While pandemic management differs insofar as the responsibility lies with the public rather than identifiable regulatory bodies, and governments must weigh competing risks in creating policy, we conclude that many of the strategies identified in our trust model can be successfully applied to the maintenance of trust in public health officials prior to, during, and after pandemics.

Seasonal influenza vaccination in older people: A systematic review and meta-analysis of the determining factors

Background/Objectives

Despite influenza vaccination programs in various jurisdictions, seasonal influenza vaccine (SIV) uptake remains suboptimal among older people (≥65years old), an important subpopulation for influenza vaccination. We sought to summarize determinants of SIV uptake (any vaccine receipt) and vaccination adherence (receipt of vaccine in two or more seasons in sequence) among older people.

Methods

We searched for population-based studies conducted in community-dwelling older people (irrespective of their health status) from 2000–2019. Two reviewers independently selected publications for inclusion. One reviewer extracted data from the included studies; a second checked the extracted data for errors. Disagreements were resolved by discussion and consensus, or a third reviewer. We were interested in the determinants of SIV uptake and vaccination adherence. Where appropriate, we pooled adjusted results using the inverse variance, random-effects method and reported the odds ratios (OR) and their 95% confidence intervals (CI).

Results

Out of 11,570 citations screened, we included 34 cross-sectional studies. The following were associated with increased SIV uptake: being older (OR 1.52, 95%CI 1.38–1.67 [21 studies]), white (1.30, 1.14–1.49 [10 studies]), married (1.23, 1.17–1.28 [9 studies]), non-smoker (1.28, 1.11–1.47 [7 studies]), of a higher social class (1.20, 1.06–1.36 [2 studies]), having a higher education (1.12, 1.04–1.21 [14 studies]), having a higher household income (1.11, 1.05–1.18 [8 studies]), having a chronic illness (1.53, 1.44–1.63 [16 studies]), having poor self-assessed health (1.23, 1.02–1.40 [9 studies]), having a family doctor (2.94, 1.79–4.76 [2 studies]), and having health insurance (1.58, 1.13–2.21 [6 studies]). The influence of these factors varied across geographical regions. Being older (1.26, 1.11–1.44 [2 studies]) was also associated with increased vaccination adherence.

Conclusions

Several factors may determine SIV uptake and vaccination adherence among older people. More studies are needed to provide a stronger evidence base for planning more effective influenza vaccination programs.

Barriers of Influenza Vaccination Intention and Behavior - A Systematic Review of Influenza Vaccine Hesitancy, 2005 - 2016

BACKGROUND

Influenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake.

OBJECTIVE

This review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area.

METHODS

Thirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination.

RESULTS

Most studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups.

CONCLUSION

Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.

A Meta-Analysis of the Association between Gender and Protective Behaviors in Response to Respiratory Epidemics and Pandemics

Respiratory infectious disease epidemics and pandemics are recurring events that levy a high cost on individuals and society. The health-protective behavioral response of the public plays an important role in limiting respiratory infectious disease spread. Health-protective behaviors take several forms. Behaviors can be categorized as pharmaceutical (e.g., vaccination uptake, antiviral use) or non-pharmaceutical (e.g., hand washing, face mask use, avoidance of public transport). Due to the limitations of pharmaceutical interventions during respiratory epidemics and pandemics, public health campaigns aimed at limiting disease spread often emphasize both non-pharmaceutical and pharmaceutical behavioral interventions. Understanding the determinants of the public’s behavioral response is crucial for devising public health campaigns, providing information to parametrize mathematical models, and ultimately limiting disease spread. While other reviews have qualitatively analyzed the body of work on demographic determinants of health-protective behavior, this meta-analysis quantitatively combines the results from 85 publications to determine the global relationship between gender and health-protective behavioral response. The results show that women in the general population are about 50% more likely than men to adopt/practice non-pharmaceutical behaviors. Conversely, men in the general population are marginally (about 12%) more likely than women to adopt/practice pharmaceutical behaviors. It is possible that factors other than pharmaceutical/non-pharmaceutical status not included in this analysis act as moderators of this relationship. These results suggest an inherent difference in how men and women respond to epidemic and pandemic respiratory infectious diseases. This information can be used to target specific groups when developing non-pharmaceutical public health campaigns and to parameterize epidemic models incorporating demographic information.