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Sun G, Zhang L, Qiu Y, Jia Y, Wang Y, Xu H, Zhang A, Hao L, Zhu W, Ye C. Changes of influenza vaccination rate and associated influencing factors after the COVID-19 pandemic in Shanghai, China. Hum Vaccin Immunother 2024; 20:2287294. [PMID: 38299510 PMCID: PMC10841022 DOI: 10.1080/21645515.2023.2287294] [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: 09/27/2023] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
The vaccination rate for seasonal influenza remains low in most regions of China. It is essential to understand the factors that associated with the low influenza vaccination rate in various populations after the COVID-19 pandemic. A cross-sectional survey was conducted with residents in Pudong New Area, Shanghai, China. Respondents' vaccination condition during the 2021-2022 flu season and the reasons for receiving or not receiving influenza vaccine were investigated. Binary logistic regression was conducted to explore potential factors influencing vaccination uptake. 2,476 of 14,001 respondents received an influenza vaccine, with a total coverage of 17.68% (95% CI: 17.05%, 18.32%). Children had the highest vaccination coverage (35.68%; 95% CI: 34.02, 37.33), followed by adults (12.75%; 95% CI: 11.91%, 13.58%) and elderly individuals (11.70%, 95% CI: 10.78%, 12.62%). For children, lower household income was an significant promoting factor. For adults, factors significantly associated with vaccination were household income, sex, and education level. For elderly, factors significantly associated with vaccination were household income, education level, living state, and having underlying diseases. (P < .05)The main reason for vaccine hesitancy among children was worried about side effects (21.49%), for adults and elderly was self-rated good health (adults: 37.14%, elderly people: 30.66%). The overall influenza vaccination coverage rate in Shanghai, especially among elderly individuals, is lower than many developed countries. Appropriate strategies and programs targeting different populations need to be implemented to enhance influenza vaccine coverage.
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Affiliation(s)
- Geyang Sun
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Li Zhang
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Ye Qiu
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yilin Jia
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yuanping Wang
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Hongmei Xu
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Anran Zhang
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Lipeng Hao
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Weiping Zhu
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Chuchu Ye
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
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2
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Yang S, Wang Q, Li T, Long J, Xiong Y, Feng L, Wang Q, Zhao Y, Yang J, Tang W, Zhang H, Qi L. Effectiveness of influenza vaccine among the population in Chongqing, China, 2018-2022: A test negative design-based evaluation. Hum Vaccin Immunother 2024; 20:2376821. [PMID: 39025479 PMCID: PMC11259055 DOI: 10.1080/21645515.2024.2376821] [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: 03/28/2024] [Accepted: 07/03/2024] [Indexed: 07/20/2024] Open
Abstract
Influenza vaccination is the most cost-effective strategy for influenza prevention. Influenza vaccines have been found to be effective against symptomatic and medically attended outpatient influenza illnesses. However, there is currently a lack of data regarding the effectiveness of inactivated influenza vaccines in Chongqing, China. We conducted a prospective observational test-negative design study. Outpatient and emergency cases presenting with influenza-like illnesses (ILI) and available influenza reverse transcription polymerase chain reaction (RT-PCR) were selected and classified as cases (positive influenza RT-PCR) or controls (negative influenza RT-PCR). A total of 7,307 cases of influenza and 7,905 control subjects were included in this study. The overall adjusted influenza vaccine effectiveness (IVE) was 44.4% (95% confidence interval (CI): 32.5-54.2%). In the age groups of less than 6 years old, 6-18 years old, and 19-59 years old, the adjusted IVE were 32.2% (95% CI: 10.0-48.9%), 48.2% (95% CI: 30.6-61.4%), and 72.0% (95% CI: 43.6-86.1%). The adjusted IVE for H1N1, H3N2 and B (Victoria) were 71.1% (95% CI: 55.4-81.3%), 36.1% (95% CI: 14.6-52.2%) and 33.7% (95% CI: 14.6-48.5%). Influenza vaccination was effective in Chongqing from 2018 to 2022. Evaluating IVE in this area is feasible and should be conducted annually in the future.
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Affiliation(s)
- Shuang Yang
- Infectious Disease Prevention and Control, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Qing Wang
- Infectious Disease Prevention and Control, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- 2023 Key Disciplines on Public Health Construction in Chongqing, Chongqing, China
| | - Tingting Li
- Infectious Disease Prevention and Control, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- 2023 Key Disciplines on Public Health Construction in Chongqing, Chongqing, China
| | - Jiang Long
- Infectious Disease Prevention and Control, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- 2023 Key Disciplines on Public Health Construction in Chongqing, Chongqing, China
| | - Yu Xiong
- Infectious Disease Prevention and Control, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- 2023 Key Disciplines on Public Health Construction in Chongqing, Chongqing, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qing Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yong Zhao
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Jule Yang
- Infectious Disease Prevention and Control, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- 2023 Key Disciplines on Public Health Construction in Chongqing, Chongqing, China
| | - Wenge Tang
- Infectious Disease Prevention and Control, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- 2023 Key Disciplines on Public Health Construction in Chongqing, Chongqing, China
| | - Huadong Zhang
- Infectious Disease Prevention and Control, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- 2023 Key Disciplines on Public Health Construction in Chongqing, Chongqing, China
| | - Li Qi
- Infectious Disease Prevention and Control, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- 2023 Key Disciplines on Public Health Construction in Chongqing, Chongqing, China
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3
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Zhou H, Zhao W, Ma R, Zheng Y, Guo Y, Wei L, Wang M. Mixed methods examination of risk perception on vaccination intentions: The perspective of doctor-patient communication. Vaccine 2024; 42:4072-4080. [PMID: 38782664 DOI: 10.1016/j.vaccine.2024.05.019] [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: 08/25/2023] [Revised: 04/17/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024]
Abstract
AIM From the perspective of doctor-patient communication, this research used multiple methods combined natural language processing (NLP), a cross-sectional survey and an online experiment to investigated how risk perception influenced people's vaccination intention. METHODS In Study 1, we used Python to crawl 335,045 comments about COVID-19 vaccine published in a social media platform Sina Weibo (equivalent of Twitter in China) from 31 December 2020 to 31 December 2021. Text analysis and sentiment analysis was used to examine how vaccination intention, as measured by linguistic features from the LIWC dictionary, changed with individuals' perceptions of pandemic risk. In Study 2, we adopted a cross-sectional questionnaire survey to further test the relation of risk perception, vaccination intention, trust in physicians, and perceived medical recommendations in a Chinese sample (n = 386). In Study 3, we conducted an online experiment where we recruited 127 participants with high trust in physicians and 127 participants with low trust, and subsequently randomly allocated them into one of three conditions: control, rational recommendation, or perceptual recommendation. RESULTS Text and sentiment analysis revealed that the use of negative words towards COVID-19 vaccine had a significant decrease at high (vs. low) risk perception level time (Study 1). Trust in physicians mediated the effect of risk perception on vaccination intention and this effect was reinforced for participants with low (vs. high) level of perceived medical recommendation (Study 2), especially for the rational (vs. perceptual) recommendation condition (Study 3). CONCLUSION Risk perception increased vaccination intention through the mediating effect of trust in physicians and the moderating effect of perceived medical recommendations. Rational (vs. perceptual) recommendation is more effective in increasing intention to get vaccinated in people with low trust in physicians.
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Affiliation(s)
- Haichun Zhou
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, 35 Qinghua East Road, Beijing 100083, China.
| | - Wenli Zhao
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, 35 Qinghua East Road, Beijing 100083, China.
| | - Rong Ma
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, 35 Qinghua East Road, Beijing 100083, China
| | - Yishu Zheng
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, 35 Qinghua East Road, Beijing 100083, China.
| | - Yuxuan Guo
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, 35 Qinghua East Road, Beijing 100083, China
| | - Liangyu Wei
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, 35 Qinghua East Road, Beijing 100083, China
| | - Mingyi Wang
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, 35 Qinghua East Road, Beijing 100083, China.
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Eiden AL, Barratt J, Nyaku MK. A review of factors influencing vaccination policies and programs for older adults globally. Hum Vaccin Immunother 2023; 19:2157164. [PMID: 36656057 PMCID: PMC9980618 DOI: 10.1080/21645515.2022.2157164] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Policies and programs to increase vaccine coverage rates among adults 50 years of age or older are limited and vaccine uptake is often suboptimal. Our review evaluated evidence on the effectiveness and success of adult-targeted vaccination interventions and identified literature gaps. Literature was retrieved (2021) from PubMed, Embase, and Google Scholar databases. Outcomes assessed included data on an intervention's effectiveness and impact on vaccine uptake. Interventions were characterized thematically: affordability (n = 9), awareness (n = 25), and vaccination access (n = 6); and included influenza, pneumococcal, tetanus-containing, and herpes zoster vaccines. Interactive interventions directed toward patients, including provider-led educational initiatives and provider recommendations showed more positive associations than less interactive interventions, such as posters and reminder-recall letters. Provider interventions, including awareness campaigns, incentives, affordability efforts, or vaccination site expansion generally showed positive associations. Combining interventions was found to be successful across several studies. Barriers and interventions varied for population subgroups, therefore, tailoring programs is critical.
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Affiliation(s)
- Amanda L Eiden
- Center for Observational and Real-World Evidence, Merck & Co., Inc., Rahway, NJ, USA
| | - Jane Barratt
- International Federation on Ageing, Toronto, ON, Canada
| | - Mawuli K Nyaku
- Center for Observational and Real-World Evidence, Merck & Co., Inc., Rahway, NJ, USA
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Wang Q, Dai P, Jia M, Jiang M, Li J, Yang W, Feng L. Construction of an indicator framework for vaccine inclusion in public health programs: A Delphi-entropy method study. Hum Vaccin Immunother 2023; 19:2272539. [PMID: 37905961 PMCID: PMC10760382 DOI: 10.1080/21645515.2023.2272539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023] Open
Abstract
Governments must decide which vaccine priority to include in their public health programs. Using the modified Delphi and entropy method, we developed an indicator framework for vaccine inclusion at the national, provincial, municipal, and district/county levels, each containing three dimensions. In total, 4 primary indicators, 17 secondary indicators, and 45 tertiary indicators were selected, covering vaccine-preventable diseases, candidate vaccines, and social drivers of the supply and demand sides. From a subjective perspective, there was no significant weighting difference in the primary and secondary indicators at all administrative levels. "Vaccine-preventable diseases" as a primary indicator had the greatest weight in the peer group, of which "Health burden" had the highest weight among the secondary indicators. From the objective perspective, the social drivers on the supply and demand sides of the primary indicators accounted for 65% and higher. Among the secondary indicators, "the characteristics of the candidate vaccine" and "vaccine-related policies on the supply side" held 8% of weights or more at both national and provincial levels. "Demographic characteristics" held the highest weight at the municipal (13.50) and district/county (15.45) level. This study indicates that China needs different considerations when using WHO-recommended vaccines at the national, provincial, municipal, and district/county levels. In addition, this study highlights that behavioral and social drivers are important indicators that need to be considered for decision-making. This framework provides a tool for policymakers to determine the inclusion priority of candidate vaccines.
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Affiliation(s)
- Qing Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Peixi Dai
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengmeng Jia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingyue Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Juan Li
- Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Wang Q, Jin H, Yang L, Jin H, Lin L. Cost-effectiveness of seasonal influenza vaccination of children in China: a modeling analysis. Infect Dis Poverty 2023; 12:92. [PMID: 37821942 PMCID: PMC10566174 DOI: 10.1186/s40249-023-01144-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND China has a high burden of influenza-associated illness among children. We aimed to evaluate the cost-effectiveness of introducing government-funded influenza vaccination to children in China (fully-funded policy) compared with the status quo (self-paid policy). METHODS A decision tree model was developed to calculate the economic and health outcomes, from a societal perspective, using national- and provincial-level data. The incremental cost-effectiveness ratio (ICER) [incremental costs per quality-adjusted life year (QALY) gained] was used to compare the fully-funded policy with the self-paid policy under the willingness-to-pay threshold equivalent to national and provincial GDP per capita. Sensitivity analyses were performed and various scenarios were explored based on real-world conditions, including incorporating indirect effect into the analysis. RESULTS Compared to the self-paid policy, implementation of a fully-funded policy could prevent 1,444,768 [95% uncertainty range (UR): 1,203,446-1,719,761] symptomatic cases, 92,110 (95% UR: 66,953-122,226) influenza-related hospitalizations, and 6494 (95% UR: 4590-8962) influenza-related death per season. The fully-funded policy was cost-effective nationally (7964 USD per QALY gained) and provincially for 13 of 31 provincial-level administrative divisions (PLADs). The probability of a funded vaccination policy being cost-effective was 56.5% nationally, and the probability in 9 of 31 PLADs was above 75%. The result was most sensitive to the symptomatic influenza rate among children under 5 years [ICER ranging from - 25,612 (cost-saving) to 14,532 USD per QALY gained]. The ICER of the fully-funded policy was substantially lower (becoming cost-saving) if the indirect effects of vaccination were considered. CONCLUSIONS Introducing a government-funded influenza policy for children is cost-effective in China nationally and in many PLADs. PLADs with high symptomatic influenza rate and influenza-associated mortality would benefit the most from a government-funded influenza vaccination program.
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Affiliation(s)
- Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, China
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7TH, UK
| | - Huajie Jin
- King's Health Economics, Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, SE5 8AF, UK
| | - Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, China
- Centre for Digital Public Health in Emergencies, Institute for Risk and Disaster Reduction, University College London, London, WC1E 6BT, UK
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, China.
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China.
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7TH, UK
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong, Hong Kong Special Administrative Region, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China
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7
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Yang L, Zhen S, Li L, Wang Q, Yang G, Cui T, Shi N, Xiu S, Zhu L, Xu X, Wang L, Jin H, Ji L. Assessing vaccine literacy and exploring its association with vaccine hesitancy: A validation of the vaccine literacy scale in China. J Affect Disord 2023; 330:275-282. [PMID: 36907456 DOI: 10.1016/j.jad.2023.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 02/27/2023] [Accepted: 03/07/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Assessment of vaccine literacy is essential for understanding people's ability to access various vaccine information to meet health demands. Few studies have examined the role of vaccine literacy in vaccine hesitancy, which is a psychological state. This study aimed to validate the applicability of the HLVa-IT (Vaccine Health Literacy of Adults in Italian) scale in Chinese settings and to explore the association between vaccine literacy and vaccine hesitancy. METHODS From May to June 2022, we conducted an online cross-sectional survey in mainland China. Potential factor domains were obtained by the exploratory factor analysis. Cronbach's alpha coefficient, composite reliability values, and square root values of average variances extracted were calculated to determine the internal consistency and discriminant validity. The association between vaccine literacy, vaccine acceptance, with vaccine hesitancy was assessed using logistic regression analysis. RESULTS Totally, 12,586 participants completed the survey. Two potential dimensions, the functional and the interactive/critical, were identified. Cronbach's alpha coefficient and composite reliability values were >0.90. The square root values of average variances extracted exceeded the related correlations. The functional dimension (adjusted odds ratio (aOR): 0579; 95 % Confidence Interval (CI); 0.529, 0.635), interactive (aOR: 0.654; 95%CI: 0.531, 0.806)/critical (aOR: 0.709; 95%CI: 0.575, 0.873) dimension were significantly and negatively associated with vaccine hesitancy. Similar results were also found in different vaccines acceptance subgroups. LIMITATIONS This report is limited by the convenience sampling method. CONCLUSIONS The modified HLVa-IT is suitable for use in Chinese settings. Vaccine literacy was negatively associated with vaccine hesitancy.
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Affiliation(s)
- Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Shiqi Zhen
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Lan Li
- Institute of Disaster Risk Reduction, University College London, London, United Kingdom
| | - Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Guoping Yang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Tingting Cui
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Naiyang Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China
| | - Shixin Xiu
- Department of Immunization Planning, Wuxi Center for Disease Control and Prevention, Wuxi, PR China
| | - Lin Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Xuepeng Xu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Liping Wang
- Yancheng Center for Disease Control and Prevention, Yancheng, PR China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, PR China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, PR China.
| | - Lili Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
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Ji M, Huang Z, Ren J, Wagner AL. Vaccine hesitancy and receipt of mandatory and optional pediatric vaccines in Shanghai, China. Hum Vaccin Immunother 2022; 18:2043025. [PMID: 35321621 PMCID: PMC9196833 DOI: 10.1080/21645515.2022.2043025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/11/2022] [Indexed: 11/04/2022] Open
Abstract
Given increased global concern about vaccine hesitancy, this study estimates coverage of mandatory vs non-mandatory vaccines in children, and assesses whether vaccine hesitancy among young parents relates to their child's eventual vaccination status in Shanghai, China. In a cohort study within Shanghai, China, we ascertained vaccine hesitancy among parents of young infants, and later abstracted their child's electronic immunization records. We measure full coverage of vaccines on the mandatory, and publicly funded Expanded Program on Immunization (EPI). Non-EPI vaccines included pneumococcal conjugate vaccine, Haemophilus influenzae type b vaccine, and rotavirus vaccine. Vaccine hesitancy was linked to vaccine uptake through mixed effects logistic regression models. Among 972 children, full coverage of all EPI vaccines by 15 months was 95%, compared to dose 1 coverage of pneumococcal conjugate vaccine at 13%, Haemophilus influenzae type b vaccine at 68%, and rotavirus vaccine at 52%. Vaccine hesitancy was not significantly linked with full coverage of all EPI vaccines (OR: 1.55, 95% CI: .89, 2.72), but coverage in the vaccine hesitant was lower for pneumococcal conjugate vaccine dose 1 (OR: .70, 95% CI: .53, .91), and rotavirus vaccine dose 1 (OR: .69, 95% CI: .56, .86). Disparities by education level were not significant for EPI vaccines, but were for dose 1 of pneumococcal conjugate vaccine rotavirus vaccine. Overall, vaccine hesitancy was related to lower uptake of non-EPI, but not EPI vaccines. Shanghai has a robust system for insurance equitable access to EPI vaccines, but if vaccine hesitancy grows, it could reduce coverage of non-EPI vaccines.
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Affiliation(s)
- Mengdi Ji
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Zhuoying Huang
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, Shanghai, China
| | - Jia Ren
- Department of Immunization Program, Shanghai Municipal Centers for Disease Control & Prevention, Shanghai, China
| | - Abram L. Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Fang H, Chen C, Fang Y, He X, Hou Z, Jiang M, Jiang Y, Li S, Liu Y, Sui B, Sun Q, Wu J, Xu T, Yang J, Yin Z, Ying X, Yuan B, Zheng H, Zheng Y. A guideline for economic evaluations of vaccines and immunization programs in China. Hum Vaccin Immunother 2022; 18:2132802. [PMID: 36287462 PMCID: PMC9746533 DOI: 10.1080/21645515.2022.2132802] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
This study aimed to develop a consensus framework for economic evaluations of vaccines as a national guideline in China. Some unique and important aspects were particularly emphasized. Nineteen Chinese experts in the field of health economics and immunization decision-making were nominated to select and discuss relevant aspects of vaccine economic evaluations in China. A workshop attended by external experts was held to summarize unique and important aspects and formulate consensus recommendations. There were ten unique and/or important aspects identified for economic evaluations of vaccines in China, including study perspectives, comparator strategies, analysis types, model choices, costing approaches, utility measures, discounting, uncertainty, equity, and evaluation purposes. Background information and expert recommendations were provided for each aspect. Economic evaluations of vaccines should play an important role in China's immunization policy-making. This guideline can help improve the quality of economic evaluations as a good practice consensus.
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Affiliation(s)
- Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China,Institute for Global Health and Development, Peking University, Beijing, China,CONTACT Hai Fang China Center for Health Development Studies, Peking University, Beijing, China
| | - Chen Chen
- School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi Province, China
| | - Xiaoning He
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Zhiyuan Hou
- School of Public Health, Fudan University, Shanghai, China
| | - Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, Shaanxi Province, China
| | - Yawen Jiang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong Province, China
| | - Shunping Li
- School of Public Health, Shandong University, Jinan, Shandong Province, China
| | - Yang Liu
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK,Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Binyan Sui
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Qiang Sun
- School of Public Health, Shandong University, Jinan, Shandong Province, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Tingting Xu
- School of Public Health, Capital Medical University, Beijing, China
| | - Juan Yang
- School of Public Health, Fudan University, Shanghai, China
| | - Zundong Yin
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaohua Ying
- School of Public Health, Fudan University, Shanghai, China
| | - Beibei Yuan
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Hui Zheng
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yaming Zheng
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
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10
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Eiden AL, Barratt J, Nyaku MK. Drivers of and barriers to routine adult vaccination: A systematic literature review. Hum Vaccin Immunother 2022; 18:2127290. [PMID: 36197070 DOI: 10.1080/21645515.2022.2127290] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We performed a systematic literature review in PubMed and Embase (2016-2021) to investigate the drivers of and barriers to routine vaccination in adults aged 50 and older globally. A thematic assessment identified three categories across 61 publications: sociodemographic, health-related, and attitudinal. The most common sociodemographic determinants (factors identified in studies; n = 47) associated with vaccination uptake were economic status, age, education, and household composition, which had mixed effects on vaccine uptake. For health-related determinants (n = 27), individuals with comorbidities and health care consumption were the most common factors, both increased vaccine uptake. The most common attitudinal factors (n = 42) were self-efficacy, provider or other's recommendations, and vaccine-preventable disease awareness; across studies, all attitude factors had a positive effect, unlike the sociodemographic and health status categories. Findings suggest that patient and provider awareness and education campaigns are effective ways to increase uptake of routine vaccinations in older adults.
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Affiliation(s)
- Amanda L Eiden
- Center for Observational and Real-World Evidence, Merck & Co., Inc, Rahway, NJ, USA
| | - Jane Barratt
- International Federation on Ageing, Toronto, Ontario, Canada
| | - Mawuli K Nyaku
- Center for Observational and Real-World Evidence, Merck & Co., Inc, Rahway, NJ, USA
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11
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Jin S, Jiang C, Xia T, Gu Z, Yu H, Li J, Zheng Y, Pan H, Qiao J, Cai R, Wu H, Wang C. Age-dependent and sex-dependent differences in mortality from influenza-associated cardiovascular diseases among older adults in Shanghai, China: a population-based study. BMJ Open 2022; 12:e061068. [PMID: 36123078 PMCID: PMC9486318 DOI: 10.1136/bmjopen-2022-061068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Influenza epidemics lead to substantial morbidity and mortality among older adults. This study aimed to analyse and assess the age-specific and sex-specific differences in mortality rates for cardiovascular disease (CVD) associated with influenza in older adults. DESIGN We obtained weekly data on mortality from CVD in adults≥60 years, categorised into five age groups. We used a quasi-Poisson model and adjusted for long-term and seasonal trends and absolute humidity as confounding factors. The male-to-female ratio (M/F ratio) was an indicator for assessing sex differences. SETTING Shanghai, China. PARTICIPANT We analysed 440 107 CVD deaths in adults aged ≥60 years, including 44 913 cases positive for influenza and 1 927 487 outpatient visits for influenza-like illness from 2010 to 2019. MAIN OUTCOME MEASURES Age-specific and sex-specific excess CVD mortality rates in older adults for various combinations of CVDs and influenza viruses. RESULTS Variations were observed in the excess mortality from CVD, ischaemic heart disease (IHD) and stroke depending on the influenza types/subtypes in different age and sex categories. The ≥85 years group had the highest excess mortality rates per 100 000 persons for CVD, IHD and stroke, while influenza A (H3N2) virus accounted for the highest mortality from CVD, IHD and stroke in people aged ≥65 years. Older men had a significantly lower influenza-associated IHD mortality rate than women, with an M/F ratio of 0.77 (p<0.05). CONCLUSIONS Excess mortality rates for CVDs associated with influenza increased with age in older adults. The risk for influenza-associated IHD mortality was significantly higher in older women than men. Our findings will help implement targeted health strategies, including the promotion of influenza vaccination and early therapeutic intervention for the older population with CVD, to curb the influenza burden effectively.
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Affiliation(s)
- Shan Jin
- Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Chenyan Jiang
- Institute of Communicable Diseases Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Tian Xia
- Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Zhen Gu
- Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Huiting Yu
- Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jing Li
- Renal Division, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Clinical Research Academy, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Yaxu Zheng
- Institute of Communicable Diseases Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Hao Pan
- Institute of Communicable Diseases Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jiaying Qiao
- Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Renzhi Cai
- Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Huanyu Wu
- Institute of Communicable Diseases Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Chunfang Wang
- Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
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12
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Gogou E, Hatzoglou C, Zarogiannis SG, Siachpazidou D, Gerogianni I, Kotsiou OS, Varsamas C, Gourgoulianis KI. Are younger COPD patients adequately vaccinated for influenza and pneumococcus? Respir Med 2022; 203:106988. [PMID: 36162248 DOI: 10.1016/j.rmed.2022.106988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/31/2022] [Accepted: 09/09/2022] [Indexed: 11/15/2022]
Abstract
Influenza and pneumococcal pneumonia are major causes of increased morbidity and mortality among elderly and COPD patients. Vaccines against influenza and pneumococcus are recommended for COPD patients according to GOLD 2020 guidelines to prevent serious illnesses. Despite their high morbidity and mortality burden, the vaccination coverage rates remain far below the WHO's recommended targets. In Greece, there are insufficient data on influenza and pneumococcal immunization rates among younger COPD patients. This study investigated whether COPD patients under the age of 65 are adequately vaccinated against influenza and pneumococcus and the factors that influence vaccination rates. 1100 individuals at 22 Primary Health Centers in Central Greece participated in a two-year spirometry monitoring program. Face-to-face interviews were used to collect information regarding demographics, smoking status, comorbidities, respiratory illnesses in the previous two years, and influenza and pneumococcal vaccination coverage from all COPD patients. 117 patients aged 40-65 years old were diagnosed with COPD and 80.3% were males. Only 40.2% of them had received influenza and 32.5% pneumococcus vaccinations. Age, advanced stage of COPD, years on COPD diagnosis, respiratory infection within the previous two years, comorbidity, and smoking cessation are all positively connected with influenza and pneumococcus vaccine coverage in younger COPD patients. Gender, education level, and marital status did not affect influenza and pneumococcus vaccination rates. These vaccination rates among younger COPD patients demonstrate the need for increased awareness and knowledge about the advantages of immunizations in lowering morbidity and mortality.
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Affiliation(s)
- Evdoxia Gogou
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
| | - Chryssi Hatzoglou
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece
| | - Sotirios G Zarogiannis
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece
| | - Dimitra Siachpazidou
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
| | - Irini Gerogianni
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
| | - Ourania S Kotsiou
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
| | - Charalampos Varsamas
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
| | - Konstantinos I Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
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13
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Pang Y, Liu X, Liu G, Lv M, Lu M, Wu J, Huang Y. Effectiveness of influenza vaccination on in-hospital death and recurrent hospitalization in older adults with cardiovascular diseases. Int J Infect Dis 2022; 122:162-168. [PMID: 35654282 DOI: 10.1016/j.ijid.2022.05.059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 05/21/2022] [Accepted: 05/26/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES There is limited evidence on the effectiveness of influenza vaccination on hospitalization outcomes by cardiovascular disease (CVD) subtypes or comorbidities. METHODS This study involved 713,488 records of hospitalization of adults ≥60 years with CVD from the Beijing Urban Employee Basic Medical Insurance database. Logistic regression with generalized estimating equations was conducted to estimate the effectiveness of influenza vaccination on in-hospital death and recurrent hospitalization, adjusting for unmeasured confounders. RESULTS The coverage of influenza vaccination was only 13.3% among older adults hospitalized for CVD. Influenza vaccination was associated with 15% (odds ratios 0.85 [0.74, 0.99]) lower risk of in-hospital death among patients with CVD, with stronger associations in patients with stroke. Influenza vaccination was associated with 6% (0.94 [0.88, 0.99]) and 28% (0.72 [0.56, 0.93]) lower risks of recurrent hospitalization for ischemic heart disease (IHD) and respiratory disease in patients with IHD, but there were no clear associations in patients with stroke. For in-hospital death, the protective association of influenza vaccination was stronger in patients with fewer comorbidities and was similar to that of joint vaccinations of influenza and pneumococcal vaccinations. CONCLUSION The protective association of influenza vaccination on CVD hospitalization outcomes serves as the evidence base to increase the uptake of influenza vaccination among older adults in China.
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Affiliation(s)
- Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Xiaofan Liu
- Department of Biostatistics, Yale School of Public Health, New Haven, CT
| | - Guangqi Liu
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Min Lv
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Ming Lu
- Department of Biomedical Informatics, School of Basic Medicine, Peking University, Beijing, 100191, China
| | - Jiang Wu
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yangmu Huang
- Department of Global Health, School of Public Health, Peking University, Beijing, China.
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14
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Shao W, Chen X, Zheng C, Wang G, Zhang B, Zhang W. Pneumococcal vaccination coverage and willingness in mainland China. Trop Med Int Health 2022; 27:864-872. [PMID: 35942809 DOI: 10.1111/tmi.13809] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To estimate the coverage and willingness of pneumococcal vaccination and further explore the influencing factors of vaccination willingness among people in mainland China. METHODS Literature searches were conducted independently by two researchers in English- and Chinese-language databases from database inception to October 6, 2021. A random-effects meta-analysis model was used to derive summary vaccination coverage and willingness. Predefined subgroup analysis and meta-regression were performed to explore the sources of heterogeneity. RESULTS 97 studies were included in this meta-analysis. The summary vaccination coverage in 76 included studies was 21.7% (95% CI: 17.2 - 26.5%). Subgroup analysis shows that the summary coverage was 29.0% (95% CI, 20.4 - 39.1%) among permanent residents and 20.7% (95% CI, 12.4 - 35.9%) among floating residents. The eastern and central regions presented higher coverage than the western region. Notable differences were observed between the various study populations. 27 studies provided an estimation of vaccination willingness, with a summary willingness of 51.2% (95% CI, 40.4 - 61.9%). In subgroup analysis the summary willingness was 57.9 % (95% CI, 48.3 - 67.2%) in urban areas and 52.3 % (95% CI, 40.8 - 63.8%) in rural areas. Parents with children and people with a history of pneumonia were more willing to be vaccinated than the elderly. Recommendations by family members and physicians, previous pneumococcal and influenza vaccination, perceived vaccination effectiveness and severity of disease and a history of pneumonia contributed to vaccination willingness. CONCLUSIONS Compared to global estimates and to other countries, pneumococcal vaccination coverage and willingness are at a lower level in mainland China. Recommendations for vaccination by family members and doctors, a history of vaccination and the perception of pneumonia and vaccination are associated with greater willingness to be vaccinated. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Weihao Shao
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaorui Chen
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Caifang Zheng
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Gaili Wang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Bowen Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Weidong Zhang
- Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou, China
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15
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Chen H, Huang Z, Chang S, Hu M, Lu Q, Zhang Y, Wang H, Xiao Y, Wang H, Ge Y, Zou Y, Cui F, Han S, Zhang M, Wang S, Zhu X, Zhang B, Li Z, Ren J, Chen X, Ma R, Zhang L, Guo X, Luo L, Sun X, Yang X. Immunogenicity and safety of an inactivated SARS-CoV-2 vaccine (Sinopharm BBIBP-CorV) coadministered with quadrivalent split-virion inactivated influenza vaccine and 23-valent pneumococcal polysaccharide vaccine in China: A multicentre, non-inferiority, open-label, randomised, controlled, phase 4 trial. Vaccine 2022; 40:5322-5332. [PMID: 35931636 PMCID: PMC9334936 DOI: 10.1016/j.vaccine.2022.07.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/07/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022]
Abstract
Background The safety and immunogenicity of the coadministration of an inactivated SARS-CoV-2 vaccine (Sinopharm BBIBP-CorV), quadrivalent split-virion inactivated influenza vaccine (IIV4), and 23-valent pneumococcal polysaccharide vaccine (PPV23) in adults in China is unknown. Methods In this open-label, non-inferiority, randomised controlled trial, participants aged ≥ 18 years were recruited from the community. Individuals were eligible if they had no history of SARS-CoV-2 vaccine or any pneumonia vaccine and had not received an influenza vaccine during the 2020–21 influenza season. Eligible participants were randomly assigned (1:1:1), using block randomization stratified, to either: SARS-CoV-2 vaccine and IIV4 followed by SARS-CoV-2 vaccine and PPV23 (SARS-CoV-2 + IIV4/PPV23 group); two doses of SARS-CoV-2 vaccine (SARS-CoV-2 vaccine group); or IIV4 followed by PPV23 (IIV4/PPV23 group). Vaccines were administered 28 days apart, with blood samples taken on day 0 and day 28 before vaccination, and on day 56. Results Between March 10 and March 15, 2021, 1152 participants were recruited and randomly assigned to three groups (384 per group). 1132 participants were included in the per-protocol population (375 in the SARS-CoV-2 + IIV4/PPV23 group, 380 in the SARS-CoV-2 vaccine group, and 377 in the IIV4/PPV23 group). The seroconversion rate (100 % vs 100 %) and GMT (159.13 vs 173.20; GMT ratio of 0.92 [95 % CI 0.83 to 1.02]) of SARS-CoV-2 neutralising antibodies in the SARS-CoV-2 + IIV4/PPV23 group was not inferior to those in the SARS-CoV-2 vaccine group. The SARS-CoV-2 + IIV4/PPV23 group was not inferior to the IIV4/PPV23 group in terms of seroconversion rates and GMT of influenza virus antibodies for all strains except for the seroconversion rate for the B/Yamagata strain. The SARS-CoV-2 + IIV4/PPV23 group was not inferior to the IIV4/PPV23 group regarding seroconversion rates and GMC of Streptococcus pneumoniae IgG antibodies specific to all serotypes. All vaccines were well tolerated. Conclusions The coadministration of the inactivated SARS-CoV-2 vaccine and IIV4/PPV23 is safe with satisfactory immunogenicity. This study is registered with ClinicalTrials.gov, NCT04790851.
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16
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Ali HA, Hartner AM, Echeverria-Londono S, Roth J, Li X, Abbas K, Portnoy A, Vynnycky E, Woodruff K, Ferguson NM, Toor J, Gaythorpe KA. Vaccine equity in low and middle income countries: a systematic review and meta-analysis. Int J Equity Health 2022; 21:82. [PMID: 35701823 PMCID: PMC9194352 DOI: 10.1186/s12939-022-01678-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/17/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Evidence to date has shown that inequality in health, and vaccination coverage in particular, can have ramifications to wider society. However, whilst individual studies have sought to characterise these heterogeneities in immunisation coverage at national level, few have taken a broad and quantitative view of the contributing factors to heterogeneity in immunisation coverage and impact, i.e. the number of cases, deaths, and disability-adjusted life years averted. This systematic review aims to highlight these geographic, demographic, and sociodemographic characteristics through a qualitative and quantitative approach, vital to prioritise and optimise vaccination policies. METHODS A systematic review of two databases (PubMed and Web of Science) was undertaken using search terms and keywords to identify studies examining factors on immunisation inequality and heterogeneity in vaccination coverage. Inclusion criteria were applied independently by two researchers. Studies including data on key characteristics of interest were further analysed through a meta-analysis to produce a pooled estimate of the risk ratio using a random effects model for that characteristic. RESULTS One hundred and eight studies were included in this review. We found that inequalities in wealth, education, and geographic access can affect vaccine impact and vaccination dropout. We estimated those living in rural areas were not significantly different in terms of full vaccination status compared to urban areas but noted considerable heterogeneity between countries. We found that females were 3% (95%CI[1%, 5%]) less likely to be fully vaccinated than males. Additionally, we estimated that children whose mothers had no formal education were 28% (95%CI[18%,47%]) less likely to be fully vaccinated than those whose mother had primary level, or above, education. Finally, we found that individuals in the poorest wealth quintile were 27% (95%CI [16%,37%]) less likely to be fully vaccinated than those in the richest. CONCLUSIONS We found a nuanced picture of inequality in vaccination coverage and access with wealth disparity dominating, and likely driving, other disparities. This review highlights the complex landscape of inequity and further need to design vaccination strategies targeting missed subgroups to improve and recover vaccination coverage following the COVID-19 pandemic. TRIAL REGISTRATION Prospero, CRD42021261927.
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Affiliation(s)
| | | | | | - Jeremy Roth
- Imperial College London, Praed Street, London, UK
| | - Xiang Li
- Imperial College London, Praed Street, London, UK
| | - Kaja Abbas
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Allison Portnoy
- Center for Health Decision Science, Harvard T H Chan School of Public Health, Cambridge, USA
| | | | - Kim Woodruff
- Imperial College London, Praed Street, London, UK
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17
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Jiang M, Yao X, Li P, Fang Y, Feng L, Hayat K, Shi X, Gong Y, Peng J, Atif N. Impact of video-led educational intervention on uptake of influenza vaccine among the elderly in western China: a community-based randomized controlled trial. BMC Public Health 2022; 22:1128. [PMID: 35668438 PMCID: PMC9169441 DOI: 10.1186/s12889-022-13536-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 05/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Influenza vaccination coverage rate among the elderly is low in China. We aimed to evaluate the impact of video-led educational intervention on influenza vaccine uptake among the Chinese elderly. METHODS A randomized controlled trial was conducted in 8 communities of Xi'an, a representative city in western China. Elderly aged over 60 years were randomized to the control group and intervention group (12-minute video education on influenza and its vaccination). Participants' knowledge, attitudes, and practices (KAP) of influenza was assessed by using a questionnaire survey before and after the intervention. The primary outcomes were participants' willingness to get influenza vaccinated and their actual uptake rates in the 2020-21 flu season. Secondary outcomes were the variations of pre- and post-intervention KAP scores. Intention-to-treat analysis was performed to analyze the data, and sensitivity analyses were conducted to examine the robustness of the results. RESULTS A total of 350 people were enrolled, with 175 individuals for each group. Participants in the intervention group were more willing to receive influenza vaccination than those in the control group (64.6% vs. 51.4%, p<0.05). The influenza vaccination uptake rate occurred in 10.3% of participants in the intervention group and 3.4% in the control group (odds ratio, 3.23; 95% CI 1.25-8.32, p<0.001). The post-intervention KAP scores in the intervention group were significantly higher compared to those in the control group (p<0.001). CONCLUSION Video-led education was an effective and feasible approach to improve old people's willingness and uptake of influenza vaccination in western China.
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Affiliation(s)
- Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China. .,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China. .,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China. .,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China.
| | - Xuelin Yao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
| | - Pengchao Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
| | - Liuxin Feng
- Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
| | - Xinke Shi
- Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Yilin Gong
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
| | - Jin Peng
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
| | - Naveel Atif
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
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18
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Wu L, Guo X, Liu J, Ma X, Huang Z, Sun X. Evaluation of influenza vaccination coverage in Shanghai city during the 2016/17 to 2020/21 influenza seasons. Hum Vaccin Immunother 2022; 18:2075211. [PMID: 35621293 PMCID: PMC9481150 DOI: 10.1080/21645515.2022.2075211] [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] [Indexed: 11/10/2022] Open
Abstract
Influenza is a common infectious disease resulting in substantial morbidity and mortality globally. The most effective strategy for preventing influenza is annual vaccination; however, the coverage rate of the influenza vaccine in Shanghai has not been well explored or reported. Therefore, this study aimed to determine coverage with the influenza vaccine and access trends in Shanghai city; data from Shanghai immunization information system was analyzed to estimate vaccination coverage during 2016–2017 through 2020–2021 influenza seasons. Vaccination coverage by age groups, immigration status, and districts was accessed. The influenza vaccination coverage (at least one dose) for 2016/2017 to 2020/2021 influenza seasons was 10.8‰ (95‰ CI: 10.7–10.8), 12.3‰ (95‰ CI: 12.3–12.4), 10.1‰ (95‰ CI: 10.0–10.1), 20.1‰ (95‰ CI: 20.0–20.2) and 50.8‰ (95‰ CI: 50.7–50.8) respectively. Although we found significantly higher vaccination coverage in females, children from 6 months to 17 years, and residents, it is still low in all subgroups of the population in Shanghai. Therefore, taking effective steps to promote influenza vaccination in Shanghai is recommended.
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Affiliation(s)
- Linlin Wu
- Department of Immunization Program, Shanghai Municipal Centers for Disease Prevention and Control, Shanghai, China
| | - Xiang Guo
- Department of Immunization Program, Shanghai Municipal Centers for Disease Prevention and Control, Shanghai, China
| | - Jiechen Liu
- Department of Immunization Program, Shanghai Municipal Centers for Disease Prevention and Control, Shanghai, China
| | - Xiaoying Ma
- Department of Immunization Program, Shanghai Municipal Centers for Disease Prevention and Control, Shanghai, China
| | - Zhuoying Huang
- Department of Immunization Program, Shanghai Municipal Centers for Disease Prevention and Control, Shanghai, China
| | - Xiaodong Sun
- Department of Immunization Program, Shanghai Municipal Centers for Disease Prevention and Control, Shanghai, China
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19
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Lai X, Wahl B, Yu W, Xu T, Zhang H, Garcia C, Qin Y, Guo Y, Yin Z, Knoll MD, Fang H. National, regional, and provincial disease burden attributed to Streptococcus pneumoniae and Haemophilus influenzae type b in children in China: Modelled estimates for 2010-17. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 22:100430. [PMID: 35308577 PMCID: PMC8928075 DOI: 10.1016/j.lanwpc.2022.100430] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Vaccination against Streptococcus pneumoniae (pneumococcus) and Haemophilus influenzae type b (Hib) is not included in China's national immunization programme. To inform China's immunization polices, we estimated annual national, regional, and provincial childhood mortality and morbidity attributable to pneumococcus and Hib in 2010-17. Methods We estimated proportions of pneumonia and meningitis deaths and cases attributable to pneumococcus and Hib using evidence from vaccine clinical trials and surveillance studies of bacterial meningitis and pathogen-specific case fatality ratios (CFR). Then we applied the proportions to model provincial-level pneumonia cases and deaths, meningitis deaths and meningitis CFR in children aged 1-59 months, accounting for vaccine coverage. Non-pneumonia, non-meningitis (NPNM) invasive disease cases were derived by applying NPNM meningitis ratios to meningitis estimates. Findings In 2010-17, annual pneumococcal deaths fell by 49% from 15 600 (uncertainty range: 10 800-17 300) to 8 000 (5 500-8 900), and Hib deaths fell by 56% from 6 500 (4 500-8 800) to 2 900 (2 000-3 900). Severe pneumococcal and Hib cases decreased by 16% to 218 200 (161 500-252 200) in 2017 and 29% to 49 900 (29 000-99 100). Estimated 2017 national three-dose coverage in private market was 1·3% for PCV and 33·4% for Hib vaccine among children aged 1-59 months. Provinces in the west region had the highest disease burden. Interpretation Childhood mortality and morbidity attributable to pneumococcal and Hib has decreased in China, but still substantially varied by region and province. Higher vaccine coverage could further reduce disease burden. Funding Bill & Melinda Gates Foundation.
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Affiliation(s)
- Xiaozhen Lai
- China Center for Health Development Studies, Peking University, Beijing, China
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Brian Wahl
- Johns Hopkins India, Lucknow, India
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Wenzhou Yu
- National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tingting Xu
- Department of Health Policy and Management, School of Public Health, Capital Medical University, Beijing, China
| | - Haijun Zhang
- China Center for Health Development Studies, Peking University, Beijing, China
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Cristina Garcia
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Ying Qin
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Zundong Yin
- National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maria Deloria Knoll
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China
- Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Research Center for Vaccine Economics, Peking University, Beijing, China
- Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
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20
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Pharmacists’ Seasonal Influenza Vaccine Recommendations. PHARMACY 2022; 10:pharmacy10030051. [PMID: 35645330 PMCID: PMC9149822 DOI: 10.3390/pharmacy10030051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/06/2022] [Accepted: 04/14/2022] [Indexed: 11/28/2022] Open
Abstract
Seasonal influenza vaccination rates among European countries remain low despite the World Health Organization’s recommendations to vaccinate high-risk groups. Healthcare worker recommendations are strong predictors of increased vaccination uptake in the population. Therefore, this study aimed to analyze seasonal influenza vaccination recommendation behavior among pharmacists towards high-risk groups including patients, coworkers, and pharmacists’ family members during the COVID-19 pandemic. This cross-sectional, questionnaire-based research was conducted in Switzerland during the flu season and sent to all members of the Swiss Pharmacist Association. In December 2020, 569 community pharmacists completed the online survey. The influenza vaccination recommendation rates for high-risk patients were 93.6% for the elderly, 70.7% for pregnant women, 65.2% for immunocompromised people, and 60.3% for patients with chronic diseases. Pharmacists tend to recommend influenza immunization to patients more than to family members and colleagues. Holding a certification to administer immunization and personal influenza vaccine history were the main predictors for recommending influenza vaccination to patients, family members, and colleagues. Our results indicated that influenza vaccination recommendation rates in our whole sample of pharmacists, were higher for vaccinated and immunizing pharmacists. Ensuring high vaccinations rates and high ratio of immunizing pharmacists may be important in promoting seasonal influenza vaccination in the general population.
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21
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Wei J, Zhao M, Meng F, Chen J, Xu Y. Influence of Internet Celebrity Medical Experts on COVID-19 Vaccination Intention of Young Adults: An Empirical Study From China. Front Public Health 2022; 10:887913. [PMID: 35517646 PMCID: PMC9062698 DOI: 10.3389/fpubh.2022.887913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
With the continuous expansion of COVID-19, many medical experts with the characteristics of “Internet Celebrities” are increasingly influencing people's vaccination behavior, which is crucial for overall social welfare. To explore the influence of Internet celebrity medical experts on people's vaccination against COVID-19, this study constructed a conceptual model of COVID-19 vaccination intention based on the professionalism, morality, interaction dimension, and information content of Internet celebrity medical experts, to generate perceived value by establishing a trusting relationship between them and the influenced people. The empirical analysis shows that interactivity and information content are important factors determining the influence of Internet celebrity medical experts. In the context of high demands for COVID-19 vaccines, it is more effective to influence vaccination intention through strong demand than through generating trust. The empirical analysis shows that Internet celebrity medical experts have a significant role in COVID-19 vaccination, and interactivity and information content are two important factors determining the influence. Through the connection of information-demand, Internet celebrity medical experts can greatly influence the perceived value, by coaction with trust to influence the final intention. Therefore, the COVID-19 vaccination persuasion information released by Internet celebrity medical experts should be elaborately organized and demonstrated, especially from the demand aspect, and government could put more resources to support the information to spread.
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Affiliation(s)
- Jianliang Wei
- School of Management Science and Engineering (MSE), Zhejiang Gongshang University, Hangzhou, China
| | - Minjun Zhao
- School of MSE, Zhejiang Gongshang University, Hangzhou, China
| | - Fei Meng
- Zhejiang Police College, Hangzhou, China
| | - Jingjing Chen
- Zhijiang College, Zhejiang University of Technology, Hangzhou, China
- Jingjing Chen
| | - Yingying Xu
- School of Economics and Management, University of Science and Technology Beijing, Beijing, China
- *Correspondence: Yingying Xu
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22
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Barriers and facilitators to uptake and promotion of influenza vaccination among health care workers in the community in Beijing, China: A qualitative study. Vaccine 2022; 40:2202-2208. [DOI: 10.1016/j.vaccine.2022.02.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 01/02/2023]
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23
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Diamond C, Gong H, Sun FY, Liu Y, Quilty BJ, Jit M, Yang J, Yu H, Edmunds WJ, Baguelin M. Regional-based within-year seasonal variations in influenza-related health outcomes across mainland China: a systematic review and spatio-temporal analysis. BMC Med 2022; 20:58. [PMID: 35139857 PMCID: PMC8830135 DOI: 10.1186/s12916-022-02269-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/19/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND China experiences large variations in influenza seasonal activity. We aim to update and improve the current understanding of regional-based within-year variations of influenza activity across mainland China to provide evidence for the planning and optimisation of healthcare strategies. METHODS We conducted a systematic review and spatio-temporal meta-analysis to assess regional-based within-year variations of ILI outpatient consultation rates, influenza test positivity rates amongst both ILI outpatients and SARI inpatients, and influenza-associated excess mortality rates. We searched English and Chinese databases for articles reporting time-series data on the four influenza-related outcomes at the sub-national and sub-annual level. After synthesising the data, we reported on the mean monthly rate, epidemic onset, duration, peak and intensity. RESULTS We included 247 (7.7%) eligible studies in the analysis. We found within-year influenza patterns to vary across mainland China in relation to latitude and geographic location. High-latitude provinces were characterised by having short and intense annual winter epidemics, whilst most mid-latitude and low-latitude provinces experience semi-annual epidemics or year-round activity. Subtype activity varied across the country, with A/H1N1pdm09 and influenza B occurring predominantly in the winter, whereas A/H3N2 activity exhibited a latitudinal divide with high-latitude regions experiencing a winter peak, whilst mid and low-latitude regions experienced a summer epidemic. Epidemic onsets and peaks also varied, occurring first in the north and later in the southeast. We found positive associations between all influenza health outcomes. In addition, seasonal patterns at the prefecture and county-level broadly resembled their wider province. CONCLUSIONS This is the first systematic review to simultaneously examine the seasonal variation of multiple influenza-related health outcomes at multiple spatial scales across mainland China. The seasonality information provided here has important implications for the planning and optimisation of immunisation programmes and healthcare provision, supporting the need for regional-based approaches to address variations in local epidemiology.
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Affiliation(s)
- Charlie Diamond
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Hui Gong
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Fiona Yueqian Sun
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Yang Liu
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Billy J Quilty
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark Jit
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Juan Yang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - W John Edmunds
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Marc Baguelin
- Department of Infectious Disease Epidemiology, Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.,MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
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24
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Song Z, Liu X, Xiang P, Lin Y, Dai L, Guo Y, Liao J, Chen Y, Liang Y, Sun Y. The Current Status of Vaccine Uptake and the Impact of COVID-19 on Intention to Vaccination in Patients with COPD in Beijing. Int J Chron Obstruct Pulmon Dis 2021; 16:3337-3346. [PMID: 34949917 PMCID: PMC8688833 DOI: 10.2147/copd.s340730] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background SARS-CoV-2 tends to cause more severe disease in patients with COPD once they are infected. We aimed to investigate the rates of influenza, pneumococcal and COVID-19 vaccination uptake in patients with COPD and to determine whether the COVID-19 pandemic and widespread vaccination against COVID-19 had any impact on the intention to accept influenza vaccines in these patients. Methods We conducted a multi-center and cross-sectional survey in seven tertiary hospitals in Beijing and consecutively recruited outpatients with COPD from June 1st to July 30th, 2021. The survey included patient’s clinical characteristics, uptake of influenza, pneumococcal and COVID-19 vaccination, vaccine knowledge, attitude towards vaccines, and the change of intention to receive influenza vaccination after COVID-19 epidemic and COVID-19 vaccination in Beijing. Results A total of 264 patients were enrolled. The rate of COVID-19 vaccination during the study period was 39.0%. The rates of influenza vaccination in the past season and pneumococcal vaccination in the past year were 22.7% and 5.7%, respectively. Of the patients who had not received COVID-19 vaccination (n = 161), only 16.2% reported that COVID-19 vaccination was recommended by clinicians, while 23.5% had no knowledge regarding COVID-19 vaccination. About 51.1% of the patients reported that their intention to receive influenza vaccination was influenced by the COVID-19 pandemic. COVID-19 vaccination was independently associated with a positive change in intention to receive influenza vaccination. Conclusion The coverage rate of COVID-19 vaccination among patients with COPD in Beijing was 39.0%, and that of influenza and pneumococcal vaccination was very low. The COVID-19 pandemic and the COVID-19 vaccination campaign showed a significant, positive impact on patients with COPD in terms of influenza vaccination. Improving awareness of the effectiveness and safety of vaccines among both healthcare professionals and patients could increase vaccination coverage in patients with COPD.
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Affiliation(s)
- Zhu Song
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Xiaofang Liu
- Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People's Republic of China
| | - Pingchao Xiang
- Department of Respiratory and Critical Care Medicine, Peking University Shougang Hospital, Beijing, 100144, People's Republic of China
| | - Yingxiang Lin
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, People's Republic of China
| | - Li Dai
- Department of Respiratory and Critical Care Medicine, Beijing Jishuitan Hospital, Beijing, 100035, People's Republic of China
| | - Yanfei Guo
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China
| | - Jiping Liao
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, 100034, People's Republic of China
| | - Yahong Chen
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Ying Liang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Yongchang Sun
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, People's Republic of China
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25
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Pang Y, Yu M, Lv M, Lu M, Wu J, Xie Z, Huang Y. Repeated influenza vaccination and hospitalization outcomes among older patients with cardiovascular or respiratory diseases. Hum Vaccin Immunother 2021; 17:5522-5528. [PMID: 35133241 PMCID: PMC8903947 DOI: 10.1080/21645515.2021.2007012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Influenza vaccination in a single season protects against hospitalization outcomes among older adults hospitalized for cardiovascular or respiratory diseases, but the effectiveness of repeated influenza vaccination is less clear. Four hospitalization outcomes (in-hospital death, re-admission, length of stay, and direct medical costs) were extracted from the Beijing Urban Employee Basic Medical Insurance database in 2015-2016 for adults aged ≥60 years hospitalized for cardiovascular or respiratory diseases. Vaccination status during three influenza seasons (2013/2014-2015/2016) was ascertained through linkages to the Beijing Elderly Influenza Vaccination database. The summer months (June-August) were used as a reference period to control unmeasured confounders during the influenza season. There were 99,135 periods of observation in the analysis, with 8.3% participants receiving influenza vaccination in all three seasons. After adjusting for confounders, influenza vaccination in all three seasons was associated with a lower risk of re-admission among patients with cardiovascular diseases (odds ratio 0.71 [95% CI 0.53-0.96]) and a lower risk of death among patients with respiratory diseases (0.68 [0.46-0.98]) compared with those unvaccinated in any season. Among patients with cardiovascular diseases, influenza vaccination in all three seasons was also associated with a non-significant lower risk of death (0.66 [0.44-1.03]) in addition to shorter hospital stays and lower direct medical costs. When stratified by history of vaccination, the effectiveness of current season vaccination was similar among patients with cardiovascular or respiratory diseases (p-value for heterogeneity all >0.05). Repeated influenza vaccination protected against hospitalization outcomes among older adults with cardiovascular or respiratory diseases.
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Affiliation(s)
- Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Mengke Yu
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Min Lv
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Ming Lu
- Department of Biomedical Informatics, School of Basic Medicine, Peking University, Beijing, China
| | - Jiang Wu
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Zheng Xie
- Department of Global Health, School of Public Health, Peking University, Beijing, China,CONTACT Min Lv Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, 16 Hepinglizhong Road, Beijing 100013, China
| | - Yangmu Huang
- Department of Global Health, School of Public Health, Peking University, Beijing, China,Yangmu Huang School of Public Health, Peking University, 38 Xueyuan Road, Beijing100191, China
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26
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Voglino G, Barbara A, Dallagiacoma G, Santangelo OE, Provenzano S, Gianfredi V. Do Degree Programs Affect Health Profession Students' Attitudes and Opinions Toward Vaccinations? An Italian Multicenter Study. Saf Health Work 2021; 13:59-65. [PMID: 35936207 PMCID: PMC9346936 DOI: 10.1016/j.shaw.2021.10.005] [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: 10/14/2019] [Revised: 06/21/2021] [Accepted: 10/12/2021] [Indexed: 12/01/2022] Open
Abstract
Background Healthcare workers' attitudes toward vaccination have been widely described in the literature, but a restricted amount of studies assessed healthcare students' knowledge, attitudes, and opinions on this issue. This study aimed to estimate the influence of a degree course on knowledge and immunization behavior among healthcare students and to compare medical students with students from other health profession degree programs to identify possible differences. Methods A multicenter, cross-sectional study was performed in 2018 in 14 Italian Universities (3,131 students were interviewed). A validated questionnaire was used to assess knowledge, attitudes, and opinions toward vaccinations, with a specific focus on influenza vaccine and attitudes toward mandatory vaccination policies. Statistical software STATA® 14 was used. Results Significant differences were recorded between medical students and other healthcare students. The intention to get vaccinated against influenza during the next season and having been vaccinated in the previous season was higher in the medical group (p < 0.001). In the group of students of other health professions, we registered a lower probability of identifying themselves as a high-risk group for contracting infectious diseases as a consequence of their profession and health status (aOR 0.49; CI95%: 0.40–0.60) and an increased likelihood of defining their level of knowledge on vaccine-preventable diseases and related vaccinations as “insufficient/sufficient/fair” (aOR 1.31; CI95%: 1.11–1.56). Conclusions Results show several differences between medical students and students of other health professions when it comes to vaccination knowledge, attitudes, and perceptions, as well as a general low tendency to be vaccinated against influenza.
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Affiliation(s)
| | - Andrea Barbara
- Section of Hygiene – Institute of Public Health, Università Cattolica Del Sacro Cuore, Roma, Italy
- Corresponding author. Section of Hygiene – Institute of Public Health, Università Cattolica del Sacro Cuore, Largo F. Vito, 1 00168 Roma, Italy.
| | - Giulia Dallagiacoma
- Post-Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Omar Enzo Santangelo
- Department of Health Promotion, Maternal-Infant, Internal Medicine and Specialization of Excellence “G. D'Alessandro”, University of Palermo, Palermo, Italy
| | - Sandro Provenzano
- Department of Health Promotion, Maternal-Infant, Internal Medicine and Specialization of Excellence “G. D'Alessandro”, University of Palermo, Palermo, Italy
| | - Vincenza Gianfredi
- Post-Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Perugia, Perugia, Italy
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27
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Hu Y, Liang H, Chen F, Shen L, Pan X, Wang Y, Chen Y, Lv H. Evaluating the vaccination coverage: validity of household-hold vaccination booklet and caregiver's recall. Hum Vaccin Immunother 2021; 17:3034-3041. [PMID: 33825657 DOI: 10.1080/21645515.2021.1906151] [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: 10/21/2022] Open
Abstract
BACKGROUND We compared results from household data sources to medical record sources by using data from a vaccination coverage survey. METHODS Vaccination coverage (VC) was calculated based on parental recall, household vaccination booklet, and Zhejiang provincial immunization information system (ZJIIS). We evaluated the accuracy of VC based on household sources (vaccination booklet and recall) assuming the medical record was accurate. Concordance, sensitivity, specificity, positive predictive value, and negative predictive value were estimated as well as the Kappa statistic was also used to evaluate the agreement between data sources. RESULTS Among the 1,800 children identified in the household survey, all were registered in ZJIIS. VC estimated using the vaccination booklet alone was substantially lower than that based on medical records (net bias 3.4-16.7% in different age groups). VC based on parental recall ranged from 2.5% below (among children aged 1 year) to 16.7% points above (among children aged 6 years) than those based on medical records. Concordance was lowest for card estimates (32.5-45.5%). Sensitivity was <60% for all household sources, except for recall source. Specificity was lowest for recall estimates (14.5-42.6%). Positive predictive value was >75%, while negative predictive value was <50%, for all household sources. Kappa statistics generally indicated poor agreement between household and medical record sources. CONCLUSIONS Household-retained vaccination booklets and parental recall were insufficient sources for evaluating the VC. Our findings emphasized the importance of taking interventions to make the vaccination booklet more consistent with the records from medical resource.
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Affiliation(s)
- Yu Hu
- Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Hu Liang
- Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Fuxing Chen
- Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Linzhi Shen
- Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Xuejiao Pan
- Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Ying Wang
- Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Yaping Chen
- Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Huakun Lv
- Institute of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
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28
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Timeliness, completeness, and timeliness-and-completeness of serial routine vaccinations among rural children in Southwest China: A multi-stage stratified cluster sampling survey. Vaccine 2021; 39:3236-3249. [PMID: 33966907 DOI: 10.1016/j.vaccine.2021.04.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/31/2021] [Accepted: 04/23/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Vaccination coverage is widely used as metric of vaccination programme performance. However, VPDs outbreaks were reported in areas with high vaccination coverage. Timeliness and completeness have been considered more important assessment indicators of routine vaccination than overall vaccination coverage, but little is known in rural China. This study aimed to assess the timeliness and completeness of serial routine vaccinations among children in rural Southwest China. METHODS A multi-stage stratified cluster survey was conducted among 1062 children aged 18-48 months in rural Guangxi. Vaccination status was obtained from child's vaccination certificate. We calculated timely vaccination coverage, complete vaccination coverage, timely-and-complete vaccination coverage and 95% CI for routine vaccination through weighted estimation analysis. Weighted Kaplan-Meier analyses were applied to estimate the median delay periods for each dose of serial routine vaccines, including one-dose BCG, three-dose HepB, three-dose OPV, four-dose DTP, two-dose MCV, two-dose JEV and two-dose MPV-A. Complete coverage, and timely-and-complete coverage for combined 5-vaccine series were calculated. RESULTS For each dose of routine vaccines, overall vaccination coverages were over 90%, but timely vaccination coverage ranged from the lowest of 44.4% for JEV1 to the highest of 92.5% for MPV-A1. For multi-dose routine vaccines, complete vaccination coverages varied from the lowest of 92.9% for MCV to the highest of 100% for HepB, and timely-and-complete vaccination coverages were lower than 80%, ranging from the lowest of 30% for JEV to the highest of 77.2% for MPV-A. For combined 5-vaccine series, complete coverage was 77%, while timely-and-complete coverage was 12.1%. MPV-A1 had the longest median delay of 176 days, but BCG and HepB1 had the shortest of 1 day. CONCLUSIONS The overall coverages of serial routine vaccinations were high, but the timeliness and completeness were poor. Relevant agencies of vaccination service should address timeliness-and-completeness into the assessment indicators of routine vaccination service quality.
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29
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Jiang M, Li P, Yao X, Hayat K, Gong Y, Zhu S, Peng J, Shi X, Pu Z, Huang Y, Fang Y. Preference of influenza vaccination among the elderly population in Shaanxi province, China. Hum Vaccin Immunother 2021; 17:3119-3125. [PMID: 33950797 DOI: 10.1080/21645515.2021.1913029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The influenza vaccination uptake rate is low in China. In the current study, we aimed to explore the preferences of influenza vaccination among the Chinese elderly. A discrete choice experiment design was performed to assess their preferences toward five influenza vaccination attributes, including vaccine effectiveness, duration of protection, severe adverse effects, vaccination cost, and vaccination recommendation source. A total of 144 participants aged over 60 years from three cities of Shaanxi province in China were surveyed. A mixed logit model was employed to analyze the data. The elderly population were found to prefer influenza vaccination with a longer duration of protection, followed by lower severe adverse effects, higher vaccine effectiveness, and recommended by healthcare providers. The vaccination cost was the least important attribute. The most considerable marginal willingness to pay for vaccination (CNY220.90) and the highest vaccination choice probability (83.70%) occurred when the duration of protection extended from 3 to 12 months. The present study's findings would inform decision-makers on implementing appropriate interventions for the increase of influenza vaccination coverage among the elderly in China.
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Affiliation(s)
- Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Pengchao Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Xuelin Yao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China.,Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Yilin Gong
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Shan Zhu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Jin Peng
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Xinke Shi
- Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Zhaojing Pu
- Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yifan Huang
- Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
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Yan S, Wang Y, Zhu W, Zhang L, Gu H, Liu D, Zhu A, Xu H, Hao L, Ye C. Barriers to influenza vaccination among different populations in Shanghai. Hum Vaccin Immunother 2021; 17:1403-1411. [PMID: 33270473 PMCID: PMC8078689 DOI: 10.1080/21645515.2020.1826250] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/16/2020] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Seasonal influenza vaccination coverage remains low in most areas of China. Its influencing factors and barriers in various populations receiving influenza vaccinations need to be well understood to promote vaccination. METHODS A cross-sectional survey was conducted with residents in 48 communities. Vaccination status in the 2018-2019 influenza season and reasons for or against vaccination were surveyed. The potential factors influencing vaccination uptake were determined using bivariate logistic regression. RESULTS In total, 1301 of the 11053 respondents received an influenza vaccine during the 2018-2019 season with a coverage rate of 11.8% (95% CI, 11.2-12.4). The vaccine coverage was highest among children (26.6%, 95%CI: 24.8-28.5), followed by adults (8.2%, 95%CI: 7.4-9.0) and elderly people (7.3%, 95%CI: 6.5-8.1) (p < .001). Those with chronic underlying conditions all had higher vaccine coverage than did those without for different groups (p < .001). Among the three groups, the most common reason for being unvaccinated was worrying about the side effects (45.0%), believing they were healthy and did not need to get vaccinated (42.2%), and lack of influenza vaccine awareness (48.3%). Low education level and lack of awareness were identified as predictors of low coverage rate. CONCLUSION Influenza vaccination coverage is low among different populations in Shanghai. Our study highlights the need for appropriate influenza vaccination strategies and programmes targeting different populations.
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Affiliation(s)
- Sijin Yan
- Division of Infectious Disease Prevention and Disinfection Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yuanping Wang
- Division of Infectious Disease Prevention and Disinfection Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Weiping Zhu
- Division of Infectious Disease Prevention and Disinfection Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Li Zhang
- Division of Infectious Disease Prevention and Disinfection Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Huozheng Gu
- Division of Infectious Disease Prevention and Disinfection Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Dan Liu
- Division of Infectious Disease Prevention and Disinfection Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Aiqin Zhu
- Division of Infectious Disease Prevention and Disinfection Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Hongmei Xu
- Division of Infectious Disease Prevention and Disinfection Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Lipeng Hao
- Division of Infectious Disease Prevention and Disinfection Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Chuchu Ye
- Division of Infectious Disease Prevention and Disinfection Management, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
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Lee JE, Shin DW, Shin J, Cho IY, Lee J, Hwang J, Cho B, Song YM. A cross-sectional study of factors associated with influenza vaccination in Korean cancer survivors. Eur J Cancer Care (Engl) 2021; 30:e13443. [PMID: 33764597 DOI: 10.1111/ecc.13443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 07/20/2020] [Accepted: 10/14/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate factors associated with influenza vaccination in cancer survivors. METHODS Study subjects were 1,945 Korean adult cancer survivors. Through medical record review and self-administered questionnaires, social and medical information was collected. Influenza vaccination was defined as ever having received a flu vaccine between one year before cancer diagnosis and the survey date. Multiple logistic regression analysis was used to evaluate factors associated with influenza vaccination. RESULTS Overall, 60.8% of study subjects had received an influenza vaccination. Younger survivors had a significantly lower vaccination rate than did the elderly survivors (80.22% vs. 54.73%). In younger survivors, longer time elapsed since cancer diagnosis, lifestyle modification counselling during cancer treatment, adequate physical exercise (≥150 min/week) and complementary medication use were positively associated with vaccination, whereas extra-pulmonary cancers, multimodality (≥3) cancer treatment and higher educational achievement were inversely associated. In elderly survivors, fewer factors had a positive (adequate physical exercise) or inverse (multimodality cancer treatment and current smoking) association with influenza vaccination. CONCLUSION Influenza vaccination rate was suboptimal, especially among younger cancer survivors. Targeted strategies are necessary to improve influenza vaccination in cancer survivors with consideration of individual characteristics such as age, lifestyle, cancer treatment modality, cancer type and education level.
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Affiliation(s)
- Ji Eun Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Korea
| | - Dong Wook Shin
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinyoung Shin
- Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - In Young Cho
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jungkwon Lee
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JiHye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - BeLong Cho
- Department of Family Medicine, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Korea
| | - Yun-Mi Song
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Hu Y, Chen Y, Wang Y, Liang H, Lv H. The trends of socioeconomic inequities in full vaccination coverage among children aged 12-23 months from 2000 to 2017: evidence for mitigating disparities in vaccination service in Zhejiang province. Hum Vaccin Immunother 2021; 17:810-817. [PMID: 32730179 DOI: 10.1080/21645515.2020.1790907] [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: 10/23/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the trends and changes in inequities in the completeness of the primary vaccination (CPV) scheduled before the first year of age among children aged 12-23 months, from 2000 to 2017. Methods: Data were extracted from five rounds of the provincial vaccination coverage survey (PVCS) in 2000, 2004, 2008, 2014 and 2017, respectively. The household income per month was used as an index of socioeconomic status for the inequity analysis. The concentration index (CI) was used to quantify the degree of inequity, and the decomposition approach was applied to quantify the contributions from independent factors to inequity in the CPV. Results: The CPV was significantly improved from 2000 to 2017, with 67.0% for the 2000 PVCS and 86.0% for the 2017 PCVS. The CI value decreased from 0.29839 for the 2000 round to 0.03601 for the 2017 round. The decomposition analysis indicated that independent variables such as birth order, ethnic group, mother's education, maternal employment status, residence, immigration status and the percentage of the total health spending allocated to public health could explain the inequity in the CPV in varying degrees. Conclusions: A sharp reduction in socioeconomic inequity in the CPV was observed from 2000 to 2017. Policy recommendations to reduce the inequality in the CPV should focus on children with the risk factors found in this study, for better outcome in full vaccination and long-lasting herd immunity.
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Affiliation(s)
- Yu Hu
- Department of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Yaping Chen
- Department of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Ying Wang
- Department of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Hu Liang
- Department of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Huakun Lv
- Department of Immunization and Prevention, Zhejiang Center for Disease Control and Prevention, Hangzhou, China
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Wang J, Lyu Y, Zhang H, Jing R, Lai X, Feng H, Knoll MD, Fang H. Willingness to pay and financing preferences for COVID-19 vaccination in China. Vaccine 2021; 39:1968-1976. [PMID: 33714653 PMCID: PMC7914003 DOI: 10.1016/j.vaccine.2021.02.060] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 01/19/2023]
Abstract
Background The COVID-19 pandemic has caused significant diseases and economic burdens in the world. Vaccines are often considered as a cost-effective way to prevent and control infectious diseases, and the research and development of COVID-19 vaccines have been progressing unprecedently. It is needed to understand individuals’ willingness to pay (WTP) among general population, which provides information about social demand, access and financing for future COVID-19 vaccination. Objective To investigate individuals’ WTP and financing mechanism preference for COVID-19 vaccination during the pandemic period in China. Methods During March 1–18, 2020, we conducted a network stratified random sampling survey with 2058 respondents in China. The survey questionnaires included out-of-pocket WTP, financing mechanism preference as well as basic characteristics of the respondents; risk perception and impact of the COVID-19 pandemic; attitude for future COVID-19 vaccination. Multivariable Tobit regression was used to determine impact factors for respondents’ out-of-pocket WTP. Results The individuals’ mean WTP for full COVID-19 vaccination was CNY 254 (USD 36.8) with median of CNY 100 (USD 14.5). Most respondents believed that governments (90.9%) and health insurance (78.0%) needed to pay for some or full portions of COVID-19 vaccination, although 84.3% stated that individuals needed to pay. Annual family income, employee size in the workplace, and whether considering the COVID-19 pandemic in China in a declining trend affected respondents’ WTP significantly. Conclusion The findings demonstrated the individuals’ WTP for COVID-19 vaccination in China and their preferences for financing sources from individuals, governments and health insurance. And to suggest an effective and optimal financing strategy, the public health perspective with equal access to COVID-19 vaccination should be prioritized to ensure a high vaccination rate.
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Affiliation(s)
- Jiahao Wang
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Yun Lyu
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Haijun Zhang
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Rize Jing
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Xiaozhen Lai
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Huangyufei Feng
- School of Public Health, Peking University, Beijing 100083, China; China Center for Health Development Studies, Peking University, Beijing 100083, China.
| | - Maria Deloria Knoll
- International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing 100083, China; Peking University Health Science Center-Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Beijing 100083, China; Key Laboratory of Reproductive Health National Health Commission of the People's Republic of China, Beijing 100083, China.
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Li J, Chen Y, Wang X, Yu H. Influenza-associated disease burden in mainland China: a systematic review and meta-analysis. Sci Rep 2021; 11:2886. [PMID: 33536462 PMCID: PMC7859194 DOI: 10.1038/s41598-021-82161-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/18/2021] [Indexed: 11/22/2022] Open
Abstract
Influenza causes substantial morbidity and mortality. Many original studies have been carried out to estimate disease burden of influenza in mainland China, while the full disease burden has not yet been systematically reviewed. We did a systematic review and meta-analysis to assess the burden of influenza-associated mortality, hospitalization, and outpatient visit in mainland China. We searched 3 English and 4 Chinese databases with studies published from 2005 to 2019. Studies reporting population-based rates of mortality, hospitalization, or outpatient visit attributed to seasonal influenza were included in the analysis. Fixed-effects or random-effects model was used to calculate pooled estimates of influenza-associated mortality depending on the degree of heterogeneity. Meta-regression was applied to explore the sources of heterogeneity. Publication bias was assessed by funnel plots and Egger’s test. We identified 30 studies eligible for inclusion with 17, 8, 5 studies reporting mortality, hospitalization, and outpatient visit associated with influenza, respectively. The pooled influenza-associated all-cause mortality rates were 14.33 and 122.79 per 100,000 persons for all ages and ≥ 65 years age groups, respectively. Studies were highly heterogeneous in aspects of age group, cause of death, statistical model, geographic location, and study period, and these factors could explain 60.14% of the heterogeneity in influenza-associated mortality. No significant publication bias existed in estimates of influenza-associated all-cause mortality. Children aged < 5 years were observed with the highest rates of influenza-associated hospitalizations and ILI outpatient visits. People aged ≥ 65 years and < 5 years contribute mostly to mortality and morbidity burden due to influenza, which calls for targeted vaccination policy for older adults and younger children in mainland China.
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Affiliation(s)
- Jing Li
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Xuhui District, Shanghai, 200231, China
| | - Yinzi Chen
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Xuhui District, Shanghai, 200231, China
| | - Xiling Wang
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Xuhui District, Shanghai, 200231, China. .,Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.
| | - Hongjie Yu
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Xuhui District, Shanghai, 200231, China
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Tao YY, Li JX, Hu YM, Hu YS, Zeng G, Zhu FC. Quadrivalent influenza vaccine (Sinovac Biotech) for seasonal influenza prophylaxis. Expert Rev Vaccines 2021; 20:1-11. [PMID: 33434084 DOI: 10.1080/14760584.2021.1875823] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Quadrivalent Influenza Vaccine (Sinovac Biotech) is a quadrivalent split-virion-inactivated influenza vaccine approved in China in June 2020 for individuals ≥3 years of age. It contains 15 µg hemagglutinin per strain including A/H1N1, A/H3N2, B/Victoria, and B/Yamagata, which could potentially improve protection against influenza B viruses. AREAS COVERED In this review, we summarize the development of quadrivalent influenza vaccines in China and foreign countries, and assess the immunogenicity and safety from the phase I and III clinical trials of Quadrivalent Influenza Vaccine in individuals ≥3 years of age. We also discuss the potential application of Quadrivalent Influenza Vaccine in young children 6-35 months of age according to the results of the phase III trial. EXPERT COMMENTARY The immunogenicity and safety profiles of Quadrivalent Influenza Vaccine containing two A and two B strains were comparable to the trivalent vaccines for the shared strains. The addition of a second B strain to the trivalent vaccine could induce superior immune responses for the alternate B strain. Since the two B strains co-circulated worldwide, the introduction of quadrivalent influenza vaccines has been expected to be a cost-effective strategy.
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Affiliation(s)
- Yan-Yang Tao
- School of Public Health, Southeast University; Nanjing, China
| | - Jing-Xin Li
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yue-Mei Hu
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yuan-Sheng Hu
- Clinical Research Department, Sinovac Biotech Co., LTD., Beijing, China
| | - Gang Zeng
- Clinical Research Department, Sinovac Biotech Co., LTD., Beijing, China
| | - Feng-Cai Zhu
- School of Public Health, Southeast University; Nanjing, China.,NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
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Impacts of expanding provider choice for free flu vaccination among the elderly in Korea. Health Policy 2020; 124:1115-1120. [PMID: 32843226 DOI: 10.1016/j.healthpol.2020.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/03/2020] [Accepted: 07/28/2020] [Indexed: 11/21/2022]
Abstract
The Korean government, to increase the vaccination rates, implemented the policy expanding provider choice for free seasonal influenza vaccine for the elderly through contracting the provision of immunization to the private sector in 2015. Using the annual nationally representative individual between 2014-2017, this study explores the impacts of the policy change by using a difference-in-differences approach. Results show that influenza vaccine uptake at private clinics increases by 12 percentage points after the policy change. However, this effect is offset by a reduction in uptake at public health centers by 13 percentage points. As a result, we find no evidence that the policy increases overall vaccination coverage among the elderly. These results indicate that policymakers need to explore the reasons for vaccine hesitancy before delivering interventions.
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Song YM, Shin J, Ko H, Yoo JE, Cho IY, Shin DW, Cho B, Lee JE, Hwang J, Lee J. Factors associated with pneumococcal vaccination uptake by cancer survivors. J Cancer Surviv 2020; 15:234-243. [PMID: 32779103 DOI: 10.1007/s11764-020-00927-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 08/04/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to evaluate factors associated with pneumococcal vaccination uptake (PVU) of cancer survivors. METHODS A total of 2032 Korean adult cancer survivors diagnosed between June of 1975 and February of 2018 have participated. Information on PVU status and selected variables were collected through self-administered questionnaires and medical record review. Factors associated PVU were investigated using multiple logistic regression analysis. RESULTS PVU rate markedly differed by age strata and cancer sites: 73.9% for elderly (≥ 65 years) survivors and 34.6% for younger (< 65 years) survivors and 73.4% for lung cancer survivors and 42.1% for non-lung cancer survivors. Regular physical exercise was associated with higher PVU in both age groups: Odds ratio (OR) and 95% confidence interval (CI) were 1.52 (1.20, 1.94) for younger and 1.78 (1.09, 2.90) for elderly survivors. Complementary medication use was positively associated with PVU with borderline significance in both age groups. However, the association of PVU with other factors differed between the two age groups. In younger survivors, a positive association with PVU was evident for longer time lapse after cancer diagnosis, chronic disease, and living with spouse/or partner, while cancer stage, educational achievement, and alcohol use were inversely associated PVU. On the other hand, multi-modality (≥ 3) cancer treatment was inversely associated with PVU only in elderly survivors. CONCLUSIONS PVU of Korean cancer survivors was suboptimal in younger survivors and non-lung cancer survivors. Factors associated with PVU differed between younger and elderly survivors, and more diverse factors were identified for younger survivors. IMPLICATIONS FOR CANCER SURVIVORS In order to promote adherence to PVU in cancer survivors, careful consideration of high-risk factors for non-immunization within cancer survivorship context would be necessary together with free-of-charge vaccination policy.
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Affiliation(s)
- Yun-Mi Song
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Jinyoung Shin
- Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - Hyeonyoung Ko
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jung Eun Yoo
- Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, South Korea
| | - In Young Cho
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dong Wook Shin
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - BeLong Cho
- Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, South Korea
| | - Ji Eun Lee
- Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, South Korea
| | - JiHye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jungkwon Lee
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
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Pang Y, Wang Q, Lv M, Yu M, Lu M, Huang Y, Wu J, Xie Z. Influenza Vaccination and Hospitalization Outcomes Among Older Patients With Cardiovascular or Respiratory Diseases. J Infect Dis 2020; 223:1196-1204. [PMID: 32779725 DOI: 10.1093/infdis/jiaa493] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/31/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Influenza vaccination has been suggested to protect against death and recurrent events among patients with cardiovascular disease or chronic obstructive respiratory disease, but there is limited evidence in older adults, who have higher risks of influenza-associated hospitalization and mortality. METHODS Patients aged ≥60 years hospitalized for cardiovascular or respiratory diseases from the Beijing Urban Employee Basic Medical Insurance database during 3 influenza seasons (2013-2014 through 2015-2016) were pooled to estimate the effects of influenza vaccination on hospitalization outcomes. Vaccination status was ascertained through cross-referencing the Beijing Elderly Influenza Vaccination database. The summer months (June-August) were used as a reference period to adjust for unmeasured confounders during influenza seasons. RESULTS After adjustment for both measured and unmeasured confounders, influenza vaccination was associated with lower risks of in-hospital deaths among patients hospitalized for cardiovascular (odds ratio [95% confidence interval], 0.85 [.68-1.06]) or respiratory diseases (0.66 [.54-.82]). Influenza vaccination was associated with a lower risk of readmission among patients with cardiovascular (odds ratio [95% confidence interval], 0.81 [.69-.95]) but not respiratory diseases (1.12 [.92-1.35]). Influenza vaccination was also associated with lower direct medical costs, but not with length of stay. CONCLUSIONS Influenza vaccination protected against hospitalization outcomes among older adults with cardiovascular or respiratory diseases.
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Affiliation(s)
- Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Qi Wang
- Hospital Service Management Office, Peking University Third Hospital, Beijing, China.,Department of Global Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Min Lv
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Mengke Yu
- Department of Global Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Ming Lu
- Department of Biomedical Informatics, School of Basic Medicine, Peking University Health Science Center, Beijing, China
| | - Yangmu Huang
- Department of Global Health, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jiang Wu
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Zheng Xie
- Department of Global Health, School of Public Health, Peking University Health Science Center, Beijing, China
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Incidence of Guillain-Barré Syndrome is not Associated with Influenza Vaccination in the Elderly. Vaccines (Basel) 2020; 8:vaccines8030431. [PMID: 32752037 PMCID: PMC7563234 DOI: 10.3390/vaccines8030431] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 12/24/2022] Open
Abstract
We aimed to analyze the incidence of Guillain-Barré syndrome (GBS) and its association with influenza vaccination (IV) in the elderly population. This study included 2470 patients hospitalized with GBS (G61.0) between 2014 and 2016 based on the Korean National Health Insurance Service (NHIS) claims data. We reviewed every medical claim in the 42 days preceding GBS diagnosis looking for precedent causes of GBS. To assess the relationship between IV and the development of GBS, data from the NHIS and the National Vaccination Registry were combined and analyzed. Using a self-controlled case series (SCCS) approach, we calculated the incidence rate ratio by setting the risk period as 42 days following vaccination. The annual background incidence of GBS was estimated at 4.15 per 100,000 persons. More than half of the patients with newly developed GBS had a previous infection or surgery. The incidence of GBS within 42 days of IV was estimated at 0.32 per 100,000 vaccinated persons. SCCS analysis showed that the risk of GBS was not significantly higher. While GBS can potentially develop from various infections, no association was found between GBS and IV. These results will contribute to developing an evidence-based vaccine policy that includes a clear causality assessment of adverse events.
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Portero de la Cruz S, Cebrino J. Trends, Coverage and Influencing Determinants of Influenza Vaccination in the Elderly: A Population-Based National Survey in Spain (2006-2017). Vaccines (Basel) 2020; 8:vaccines8020327. [PMID: 32575497 PMCID: PMC7350209 DOI: 10.3390/vaccines8020327] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/11/2020] [Accepted: 06/17/2020] [Indexed: 12/19/2022] Open
Abstract
Influenza is a significant public health problem and the elderly are at a greater risk of contracting the disease. The vaccination coverage of the elderly is below the Spanish target of 65% for each influenza season. The aims of this study were to report the coverage of influenza vaccination in Spain among the population aged ≥65 years and high-risk groups for suffering chronic diseases, to analyze the time trends from 2006 to 2017 and to identify the factors which affect vaccination coverage. A nationwide cross-sectional study was conducted including 20,753 non-institutionalized individuals aged ≥65 years who had participated in the Spanish National Health Surveys in 2006, 2011/2012, and 2017. Sociodemographic, health-related variables, and influenza vaccination data were used. A logistic regression analysis was performed to determine the variables associated with influenza vaccination. Influenza vaccination coverage was 60%. By chronic condition, older people with high cholesterol levels and cancer had the lowest vaccination coverage (62.41% and 60.73%, respectively). This coverage declined from 2006 to 2017 in both groups. Higher influenza vaccination was associated with males, Spanish nationality, normal social support perceived, polypharmacy, worse perceived health, participation in other preventive measures, and increasing age and the number of chronic diseases.
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Affiliation(s)
- Silvia Portero de la Cruz
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba, Avda. Menéndez Pidal, S/N, 14071 Córdoba, Spain
- Correspondence: ; Tel.: +34-957-218-093
| | - Jesús Cebrino
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Seville, Avda. Doctor Fedriani, S/N, 41009 Seville, Spain;
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Qi L, Li Q, Ding XB, Gao Y, Ling H, Liu T, Xiong Y, Su K, Tang WG, Feng LZ, Liu QY. Mortality burden from seasonal influenza in Chongqing, China, 2012-2018. Hum Vaccin Immunother 2020; 16:1668-1674. [PMID: 32343618 PMCID: PMC7482776 DOI: 10.1080/21645515.2019.1693721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose To estimate influenza-associated excess mortality rates (EMRs) in Chongqing from 2012 to 2018. Methods We obtained weekly mortality data for all-cause and four underlying causes of death (circulatory and respiratory disease (CRD), pneumonia and influenza (P&I), chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IDH)), and influenza surveillance data, from 2012 to 2018. A negative-binomial regression model was used to estimate influenza-associated EMRs in two age groups (<65 years and ≥65 years). Results It was estimated that an annual average of 10025 influenza-associated deaths occurred in Chongqing, corresponding to 5.2% of all deaths. The average EMR for all-cause death associated with influenza was 33.5 (95% confidence interval (CI): 31.5–35.6) per 100 000 persons, and in separate cause-specific models we attributed 24.7 (95% CI: 23.3–26.0), 0.8 (95% CI: 0.7–0.8), 8.5 (95% CI: 8.1–9.0) and 5.0 (95% CI: 4.7–5.3) per 100 000 persons EMRs to CRD, P&I, COPD and IDH, respectively. The estimated EMR for influenza B virus was 20.6 (95% CI: 20.3–21.0), which was significantly higher than the rates of 5.3 (95% CI: 4.5–6.1) and 7.5 (95% CI: 6.7–8.3) for A(H3N2) and A(H1N1) pdm09 virus, respectively. The estimated EMR was 152.3 (95% CI: 136.1–168.4) for people aged ≥65 years, which was significantly higher than the rate for those aged <65 years (6.8, 95% CI: 6.3–7.2). Conclusions Influenza was associated with substantial EMRs in Chongqing, especially among elderly people. Influenza B virus caused a relatively higher excess mortality impact compared with A(H1N1)pdm09 and A(H3N2). It is advisable to optimize future seasonal influenza vaccine reimbursement policy in Chongqing to curb disease burden.
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Affiliation(s)
- Li Qi
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing, China.,Infectious Disease Control and Prevention Department, Chongqing Municipal Center for Disease Control and Prevention , Chongqing, China
| | - Qin Li
- Infectious Disease Control and Prevention Department, Chongqing Municipal Center for Disease Control and Prevention , Chongqing, China
| | - Xian-Bin Ding
- Infectious Disease Control and Prevention Department, Chongqing Municipal Center for Disease Control and Prevention , Chongqing, China
| | - Yuan Gao
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing, China
| | - Hua Ling
- Infectious Disease Control and Prevention Department, Chongqing Municipal Center for Disease Control and Prevention , Chongqing, China
| | - Tian Liu
- Infectious Disease Control and Prevention Department, Jingzhou Center for Disease Control and Prevention , Jingzhou City, Hubei Province, China
| | - Yu Xiong
- Infectious Disease Control and Prevention Department, Chongqing Municipal Center for Disease Control and Prevention , Chongqing, China
| | - Kun Su
- Infectious Disease Control and Prevention Department, Chongqing Municipal Center for Disease Control and Prevention , Chongqing, China
| | - Wen-Ge Tang
- Infectious Disease Control and Prevention Department, Chongqing Municipal Center for Disease Control and Prevention , Chongqing, China
| | - Lu-Zhao Feng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention , Beijing, China
| | - Qi-Yong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing, China
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Yang J, Atkins KE, Feng L, Baguelin M, Wu P, Yan H, Lau EHY, Wu JT, Liu Y, Cowling BJ, Jit M, Yu H. Cost-effectiveness of introducing national seasonal influenza vaccination for adults aged 60 years and above in mainland China: a modelling analysis. BMC Med 2020; 18:90. [PMID: 32284056 PMCID: PMC7155276 DOI: 10.1186/s12916-020-01545-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China has an aging population with an increasing number of adults aged ≥ 60 years. Influenza causes a heavy disease burden in older adults, but can be alleviated by vaccination. We assessed the cost-effectiveness of a potential government-funded seasonal influenza vaccination program in older adults in China. METHODS We characterized the health and economic impact of a fully funded influenza vaccination program for older adults using China-specific influenza disease burden, and related cost data, etc. Using a decision tree model, we calculated the incremental costs per quality-adjusted life year (QALY) gained of vaccination from the societal perspective, at a willingness-to-pay threshold equivalent to GDP per capita (US$8840). Moreover, we estimated the threshold vaccination costs, under which the fully funded vaccination program is cost-effective using GDP per capita as the willingness-to-pay threshold. RESULTS Compared to current self-paid vaccination, a fully funded vaccination program is expected to prevent 19,812 (95% uncertainty interval, 7150-35,783) influenza-like-illness outpatient consultations per year, 9418 (3386-17,068) severe acute respiratory infection hospitalizations per year, and 8800 (5300-11,667) respiratory excess deaths due to influenza per year, and gain 70,212 (42,106-93,635) QALYs per year. Nationally, the incremental costs per QALY gained of the vaccination program is US$4832 (3460-8307), with a 98% probability of being cost-effective. The threshold vaccination cost is US$10.19 (6.08-13.65). However, variations exist between geographical regions, with Northeast and Central China having lower probabilities of cost-effectiveness. CONCLUSIONS Our results support the implementation of a government fully funded older adult vaccination program in China. The regional analysis provides results across settings that may be relevant to other countries with similar disease burden and economic status, especially for low- and middle-income countries where such analysis is limited.
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Affiliation(s)
- Juan Yang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Katherine E Atkins
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Luzhao Feng
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Marc Baguelin
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Peng Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Han Yan
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Eric H Y Lau
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Joseph T Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yang Liu
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Mark Jit
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Modelling and Economics Unit, Public Health England, London, UK
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
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Wang Y, Cheng M, Wang S, Wu F, Yan Q, Yang Q, Li Y, Guo X, Fu C, Shi Y, Wagner AL, Boulton ML. Vaccination coverage with the pneumococcal and influenza vaccine among persons with chronic diseases in Shanghai, China, 2017. BMC Public Health 2020; 20:359. [PMID: 32188428 PMCID: PMC7081528 DOI: 10.1186/s12889-020-8388-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 02/21/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Adults with chronic conditions such as heart disease, diabetes, or lung disease are more likely to develop complications from a number of vaccine-preventable diseases, including influenza and pneumonia. In this study, we use the data from a chronic disease management information system in Shanghai to estimate vaccination coverage and characterize predictors of seasonal influenza and 23-valent pneumococcal polysaccharide vaccine (PPSV23) vaccination among people with chronic disease in Shanghai. METHODS The Shanghai Centers for Disease Control and Prevention have information systems related to chronic disease management, hospital records, and immunizations. Data from individuals with hypertension, diabetes and chronic obstructive pulmonary disease (COPD) were abstracted during July 2017. The main outcome was coverage of pneumococcal and influenza vaccination. Vaccination coverage was calculated across demographic groups. Significance in bivariate associations was assessed through Pearson's chi-square tests, and in multivariable models through logistic regression models with a forward stepwise method to select variables. RESULTS In the sample of 2,531,227 individuals ≥15 years, 22.8% were vaccinated for pneumonia from January 2013 to July 2017, and the vaccination coverage of influenza in the 2016/17 influenza season was 0.4%. Vaccination coverage was highest in those 70-79 and lowest in those younger than 60. Compared to urban areas, uptake in rural areas was higher for pneumonia vaccination (OR: 2.43, 95% CI: 2.41, 2.45), but lower for influenza vaccination (OR: 0.55, 95% CI: 0.51, 0.59). Having a greater number of chronic diseases was associated with higher likelihood of pneumonia vaccination (3 vs 1: OR: 1.68, 95% CI: 1.64, 1.71), but this relationship was not statistically significant for influenza vaccination. CONCLUSIONS We found low levels with of pneumococcal vaccination, and extremely low uptake of influenza vaccination among individuals with high risk conditions in Shanghai who should be priority groups targeted for vaccination. Interventions could be designed to target groups with low uptake - like younger adults, and individuals who have not yet retired.
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Affiliation(s)
- Yuheng Wang
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control & Prevention, 1380 West Zhongshan Road, Shanghai, 200336 China
| | - Minna Cheng
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control & Prevention, 1380 West Zhongshan Road, Shanghai, 200336 China
| | - Siyuan Wang
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control & Prevention, 1380 West Zhongshan Road, Shanghai, 200336 China
| | - Fei Wu
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control & Prevention, 1380 West Zhongshan Road, Shanghai, 200336 China
| | - Qinghua Yan
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control & Prevention, 1380 West Zhongshan Road, Shanghai, 200336 China
| | - Qinping Yang
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control & Prevention, 1380 West Zhongshan Road, Shanghai, 200336 China
| | - Yanyun Li
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control & Prevention, 1380 West Zhongshan Road, Shanghai, 200336 China
| | - Xiang Guo
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control & Prevention, 1380 West Zhongshan Road, Shanghai, 200336 China
| | - Chen Fu
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control & Prevention, 1380 West Zhongshan Road, Shanghai, 200336 China
| | - Yan Shi
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control & Prevention, 1380 West Zhongshan Road, Shanghai, 200336 China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Road, Shanghai, 200031 China
| | - Abram L. Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, 48109 MI USA
| | - Matthew L. Boulton
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, 48109 MI USA
- Department of Internal Medicine, Division of Infectious Disease, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, 48109 MI USA
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Hu Y, Wang Y, Chen Y, Liang H. Analyzing the Urban-Rural Vaccination Coverage Disparity through a Fair Decomposition in Zhejiang Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224575. [PMID: 31752311 PMCID: PMC6887931 DOI: 10.3390/ijerph16224575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/16/2019] [Accepted: 11/17/2019] [Indexed: 12/30/2022]
Abstract
Objectives: Exploring determinants underlying disparities in full vaccination coverage (FVC) can contribute to improved immunization interventions. FVC and its risk factors in Zhejiang province have been studied, yet the determinants explaining the rural-urban disparity in FVC have not been studied. This study aimed to disentangle the factors explaining rural-urban disparities in FVC of vaccine doses scheduled during the first year of life in Zhejiang province. Methods: We used data from a vaccination coverage survey among children aged 24-35 months conducted in 2016. The outcome measure was full vaccination status, and the grouping variable was the area of residence. Descriptive statistics were used to analyze the FVC and rural-urban residence across the exposure variables. The Fairlie decomposition technique was used to decompose factors contributing to explaining the FVC disparity. Results: There were 847 children included in this study, of which 49.6% lived in a rural area. FVC was 94% in rural areas and 85% in urban areas. A disparity of 9% to the advantage of the rural areas and the exposure variables explained 81.1% of the disparity. Maternal factors explained 49.7% of the explained disparity with education, occupation, and ethnicity being the significant contributors to the explained disparity. Children's birth order and immigration status contributed somewhat to the explained inequality. Conclusion: There was a significant disparity in FVC in Zhejiang province, a disadvantage to the urban areas. Policy recommendations or health interventions to reduce the inequality should be focused on eliminating poverty and women's illiteracy, targeted at migrant children or children from minority ethnicities.
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Yu J, Ren X, Ye C, Tian K, Feng L, Song Y, Cowling BJ, Li Z. Influenza Vaccination Coverage among Registered Nurses in China during 2017-2018: An Internet Panel Survey. Vaccines (Basel) 2019; 7:E134. [PMID: 31569475 PMCID: PMC6963313 DOI: 10.3390/vaccines7040134] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 12/15/2022] Open
Abstract
Influenza vaccination is recommended for nurses in China but is not mandatory or offered free of charge. The main objective of this study was to determine influenza vaccination coverage and the principal factors influencing influenza vaccination among nurses in China. During 22 March-1 April 2018, we conducted an opt-in internet panel survey among registered nurses in China. Respondents were recruited from an internet-based training platform for nurses. Among 22,888 nurses invited to participate, 4706 responded, and 4153 were valid respondents. Overall, 257 (6%) nurses reported receiving the seasonal influenza vaccine during the 2017/2018 season. Vaccination coverage was highest among nurses working in Beijing (10%, p < 0.001) and nurses working in primary care (12%, p = 0.023). The top three reasons for not being vaccinated were lack of time (28%), not knowing where and when to get vaccinated (14%), and lack of confidence in the vaccine's effectiveness (12%). Overall, 41% of nurses reported experiencing at least one episode of influenza-like illness (ILI) during the 2017/2018 season; 87% of nurses kept working while sick, and 25% of nurses reported ever recommending influenza vaccination to patients. Compared with nurses who did not receive influenza vaccination in the 2017/2018 season, nurses who received influenza vaccination were more likely to recommend influenza vaccination to patients (67% vs. 22%, p < 0.001). Influenza vaccination coverage among nurses was low, and only a small proportion recommended influenza vaccine to patients. Our findings highlight the need for a multipronged strategy to increase influenza vaccination among nurses in China.
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Affiliation(s)
- Jianxing Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Xiang Ren
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Chuchu Ye
- Research Base of Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Pudong New Area Center for Disease Control and Prevention, Shanghai 200136, China.
| | - Keqing Tian
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Luzhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Ying Song
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China.
| | - Zhongjie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
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Huo X, Zhu FC. Influenza surveillance in China: a big jump, but further to go. LANCET PUBLIC HEALTH 2019; 4:e436-e437. [DOI: 10.1016/s2468-2667(19)30158-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 01/22/2023]
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Feng W, Cui J, Li H. Determinants of Willingness of Patients with Type 2 Diabetes Mellitus to Receive the Seasonal Influenza Vaccine in Southeast China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122203. [PMID: 31234404 PMCID: PMC6617503 DOI: 10.3390/ijerph16122203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 11/16/2022]
Abstract
Willingness of patients with Type 2 diabetes mellitus (T2DM) to receive the seasonal influenza vaccine is low in China. A cross-sectional study on a representative sample of T2DM patients was conducted in Ningbo, a city in southeast China, to assess T2DM patients' willingness to be vaccinated against influenza and identify the influence factors of this willingness. Data regarding the participant's history of influenza, the knowledge, willingness and uptake of the influenza vaccine, demographic characteristics, reasons for willingness or unwillingness to be vaccinated was collected. Only 19.55% of a total of 1749 participants reported a willingness to be vaccinated. Factors positively associated with willingness to be vaccinated were perceived susceptibility to influenza (OR = 1.9, 95% CI: 1.5-2.5), awareness of the vaccine (OR = 1.7, 95% CI: 1.3-2.3) and previous history of influenza vaccination (OR = 4.4, 95% CI: 3.0-6.4). Patients with T2DM who were farmers (OR = 0.6, 95% CI: 0.4-0.8) and those managed by contracted family doctors (OR = 0.8, 95% CI: 0.6-1.0) expressed less willingness to be vaccinated. Targeted interventions such as enhancing health education and strengthening medical staff training should be conducted to increase T2DM patients' willingness to be vaccinated and enhance influenza vaccine uptake among this population.
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Affiliation(s)
- Wei Feng
- Department of Chronic Diseases and Community Health, Fenghua District Center for Disease Control and Prevention, Ningbo 315000, Zhejiang, China.
| | - Jun Cui
- Department of Chronic Disease Prevention, Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315000, Zhejiang, China.
| | - Hui Li
- Department of Chronic Disease Prevention, Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315000, Zhejiang, China.
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Li Z, Yu J, Ren X, Ye C, Tian K, Feng L, Song Y, Cowling BJ. Influenza Vaccination Coverage among Registered Nurses in China during 2017-2018: an Internet Panel Survey (Preprint). JMIR Public Health Surveill 2019. [DOI: 10.2196/14893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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49
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Zeng Y, Yuan Z, Yin J, Han Y, Chu CI, Fang Y. Factors affecting parental intention to vaccinate kindergarten children against influenza: A cross-sectional survey in China. Vaccine 2019; 37:1449-1456. [DOI: 10.1016/j.vaccine.2019.01.071] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/27/2018] [Accepted: 01/23/2019] [Indexed: 01/10/2023]
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50
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Zhang D, Zhang Y, Wang Q, Lock J, Pan Y, Cui S, Yang P, Hu Y. The effectiveness of influenza vaccination in preventing hospitalizations in elderly in Beijing, 2016-18. Vaccine 2019; 37:1853-1858. [PMID: 30827734 DOI: 10.1016/j.vaccine.2019.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/30/2019] [Accepted: 02/01/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Influenza vaccinations play an important role in preventing influenza related hospitalizations. The objective of this study was to estimate the effectiveness of vaccination in protecting Beijing residents aged ≥60 years from influenza related hospitalizations during the 2016/17 and 2017/18 influenza seasons. METHODS Patients who met the definition of severe acute respiratory infection (SARI) and were hospitalized in the nine sentinel hospitals in Beijing during the 2016/17 and 2017/18 influenza seasons were identified as the study population. The vaccination status of patients was obtained from a vaccination registry. Real-time reversetranscription polymerasechainreaction (RT-PCR) experiments were conducted to test pharyngeal or lower respiratory tract samples collected from SARI patients for influenza A and B viruses. Vaccine effectiveness (VE) was examined using a test-negative design that compare the odds of vaccination among influenza positives and negatives, adjusting for calendar week of illness onset, age, and underlying medical conditions. RESULTS We identified 50,364 patients in the study, in which there were 145 influenza cases and 528 influenza-negative controls aged ≥60 years in 2016/17 season and 149 cases and 358 controls aged ≥60 years in 2017/18 season. The most commonly identified subtype among participants was influenza A(H3N2) in 2016/17 and 2017/18 season (78.5% and 70.6%). Among the adults aged ≥60 years, the adjusted VE of vaccination against any influenza virus for serious acute respiratory infection (SARI) patients was 32.8% (95% confidence interval [CI]: -22.0 to 63.0%) in 2016/17 season. While the adjusted VE in 2017/18 season were 4.6% (95% CI: -72.4 to 47.2%) against any types of influenza, 29.2% (95% CI: -92.9 to 74%) against influenza A(H1N1)pdm09, -37.7% (95% CI: -293.8; 51.9%) against influenza A(H3N2) viruses, and 3.6% (95% CI: -113.8 to 56.5%) against influenza B. CONCLUSION The influenza vaccine provided moderate protection in 2016/17 season and mild protection in 2017/18 season for influenza related inpatients of adults aged ≥60 years in Beijing.
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Affiliation(s)
- Daitao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China; Institute of Infectious Diseases and Endemic Diseases Control, Beijing Municipal Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, No.16 Hepingli Middle Street, 100013 Beijing, China
| | - Yi Zhang
- Institute of Infectious Diseases and Endemic Diseases Control, Beijing Municipal Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, No.16 Hepingli Middle Street, 100013 Beijing, China
| | - Quanyi Wang
- Institute of Infectious Diseases and Endemic Diseases Control, Beijing Municipal Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, No.16 Hepingli Middle Street, 100013 Beijing, China
| | - Jerome Lock
- Department of Health Ethics and Society, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Yang Pan
- Institute of Infectious Diseases and Endemic Diseases Control, Beijing Municipal Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, No.16 Hepingli Middle Street, 100013 Beijing, China
| | - Shujuan Cui
- Institute of Infectious Diseases and Endemic Diseases Control, Beijing Municipal Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, No.16 Hepingli Middle Street, 100013 Beijing, China
| | - Peng Yang
- Institute of Infectious Diseases and Endemic Diseases Control, Beijing Municipal Center for Disease Prevention and Control & Beijing Research Center for Preventive Medicine, No.16 Hepingli Middle Street, 100013 Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China.
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