Influenza vaccination among infection control teams: A EUCIC survey prior to COVID-19 pandemic

Influenza Vaccination Uptake and Prognostic Factors among Health Professionals in Italy: Results from the Nationwide Surveillance PASSI 2015-2018

(1) Influenza causes a significant health and socio-economic burden every year, and health personnel (HP) are at higher risk of exposure to respiratory pathogens than the general population. (2) The study's purpose was to describe and compare influenza vaccine uptake and its prognostic factors among Medical Doctors (MDs) and Non-Medical Health Personnel (NMHP) vs. Non-HP (NHP). We analyzed 2014-2018 data (n = 105,608) from the Italian Behavioral Risk Factor Surveillance System PASSI that, since 2008, has been collecting health-related information continuously in sampled adults. (3) MDs and NMHP represented, respectively, 1.1% and 4.6% of the sample. Among HP, 22.8% (CI 19.8-26.1%) of MDs and 8.5% (CI 7.5-9.5%) of NMHP reported to have been vaccinated vs. 6.3% (CI 6.1-6.5%) in NHP. This difference is confirmed in the three categories (MDs, NMHP, NHP), even more across age groups: in 18-34 yy, respectively, 9.9%, 4.4%, 3.4% vs. 28.4%, 13.9%, 10.6% in 50-64 yy. PASSI surveillance shows an increasing influenza vaccination uptake over time, especially among MDs (22.2% in 2014 vs. 30.5% in 2018). (4) Despite such an increase, especially among younger HP, influenza vaccination uptake is low. Even more under pandemic scenarios, these figures represent key information to address effective strategies for disease prevention and health promotion.

COVID-19 infection following influenza vaccine injection and its complications among nurses working in educational-medical hospitals of Ardabil in 2020

Objectives

Health care workers are one of the groups at risk of influenza. Currently, influenza vaccination is very important more than ever before. Influenza is evolutionarily similar to SARS-CoV-2, and they have some common epitopes and mechanisms. Thus reducing the severity of COVID-19 disease by influenza vaccination seems possible. Therefore, the aim of this study is to investigate the relationship between influenza vaccination and COVID-19 infection among clinical nurses.

Methodology

The present study is a prospective analysis of nurses working in educational-medical hospitals of Ardabil. In this study, two groups of nurses were considered as case and control groups. The collected data were analyzed using SPSS software and descriptive (mean, standard deviation and frequency) and analytical (Chi-square) tests.

Results

A total of 279 individuals were included in the study according to the research criteria. The maximum duration of the disease was one week in the control group and four weeks in the case group. Chi-square test showed that there was a significant difference in terms of disease duration between the two groups (P = 0.000). Chi-square test showed that there was a statistically significant difference in terms of disease treatment between the two groups (P = 0.000).

Conclusion

Influenza vaccine reduces the incidence of COVID-19 and reduces the need for hospitalization in patients with this disease. However, due to the positive effects of influenza vaccine on COVID-19 and its low cost, it is recommended to inject influenza vaccine more than before.

Healthcare professionals' beliefs regarding influenza vaccination: What has COVID-19 changed?

Background

Influenza poses a potential public health threat among healthcare professionals since an infected healthcare professional can spread the virus to patients at higher risk as well as his/her own family members and colleagues. Annual influenza vaccination is the most effective way to protect HCPs.

Aim

This study was conducted to determine whether demand for and beliefs about influenza vaccination have changed among healthcare professionals in the COVID-19 era and the factors that might have influenced them in the early phase of the pandemic when COVID-19 vaccines were eagerly awaited.

Patients and Methods

This observational descriptive study was conducted between November 16, and December 15, 2020. A total of 317 healthcare professionals completed an online survey. Bivariate analysis and binary logistic regression analysis were performed.

Results

Nineteen (6.0%) healthcare professionals were regularly vaccinated against influenza every year, and 199 (62.8%) had never been vaccinated. During the 2019-2020 season, 30 (9.5%) participants had been vaccinated and the proportion desiring to be vaccinated against influenza during the 2020-2021 season was 49.8% (n = 158). The results revealed that those with chronic diseases, those who believed they had adequate information about influenza vaccination and those who believed healthcare professionals should be vaccinated against influenza regularly every year, respectively, had 3.5 times, 4.7 times, and 11 times higher vaccination rates.

Conclusion

Although the proportion of healthcare professionals with the intention to be vaccinated for influenza increased with the COVID-19 pandemic, it is still not high enough. Influenza vaccination rates should be promoted by in-service training programs.

Food Literacy Scale: Validation through Exploratory and Confirmatory Factor Analysis in a Sample of Portuguese University Students

Eating behaviors and healthy food choices are associated with food literacy, and they have a huge impact on one's health status. For that reason, to increase food literacy is a way to effectively help individuals make appropriate choices that help maintain health and diminish the incidence of non-communicable diseases. The objective of this work was to test and validate a scale to assess food literacy. The validation was conducted on a sample of 924 Portuguese university students. The scale was composed of 50 items, which were submitted to exploratory and confirmatory factors analysis. The final validated scale corresponded to a second-order model with a global factor called "Food literacy", which retained 26 items distributed by three factors: F1-literacy about the nutritional composition of foods (10 items), F2-literacy about labelling and food choices (7 items), and F3-literacy about healthy eating practices (9 items). The internal consistency of the scale is very high, with an alpha higher than 0.9, and the Pierson correlations between the three factors and the global are also higher than 0.9. In conclusion, the present scale has been validated and can therefore be utilized to measure food literacy.

Monitoring influenza vaccination coverage among healthcare workers during the COVID-19 pandemic: a three-year survey in a large university hospital in North-Western Italy

INTRODUCTION

Healthcare workers (HCWs) are one of the highest priority groups recommended for seasonal influenza vaccination (SIV). Greater awareness of the importance of influenza vaccination was observed among HCWs after the start of the COVID-19 pandemic. The aim of this study was to analyze SIV coverage rates in the 2019-2020, 2020-2021 and 2021-2022 seasons among HCWs employed at the IRCCS Ospedale Policlinico San Martino in Genoa, in order to observe how coverage has changed since the COVID-19 pandemic began.

METHODS

A retrospective, single-center study was conducted among HCWs working at the IRCCS Ospedale Policlinico San Martino in Genoa. The vaccinated population was stratified by gender, age, qualification and area of activity, and the characteristics of vaccinated HCWs were analyzed.

RESULTS

While SIV coverage was below the recommended target in all seasons, a sharp increase was observed in 2020/2021 (12.8%; 40.9% and 23% in 2019/2020, 2020/2021 and 2021/2022, respectively). The mean and median age of vaccinees also increased during the 2020/2021 vaccination campaign (46.7 and 49 years, respectively) in comparison with the 2019/2020 season (43.5 and 45, respectively). In the 2019/2020 and 2021/2022 seasons, a higher proportion of vaccinees were physicians. Vaccinated females outnumbered males, but the coverage rate resulted greater in males than females in all three seasons. While a higher proportion of vaccinated subjects worked in medical areas, the most evident increase over the three years was seen among subjects working in the services area.

CONCLUSIONS

This survey highlights the importance of studying the determinants that influence vaccination adherence and how the COVID-19 pandemic has affected SIV coverage.

Experience of COVID-19 Vaccination among Primary Healthcare Workers in Hong Kong: A Qualitative Study

Studies show that coronavirus disease 2019 (COVID-19) vaccine hesitancy exists among healthcare workers (HCWs). Past personal experiences of vaccination, such as the seasonal influenza vaccination, influence individuals’ intention to receive future vaccinations. This study aimed to explore the experience of COVID-19 vaccination among primary care HCWs in Hong Kong. A qualitative study using semi-structured interviews was conducted. Twenty-eight HCWs (ten doctors, ten nurses, and eight supporting staff) working in nine government-funded primary care clinics in Hong Kong who had completed at least one dose of COVID-19 vaccination were interviewed. Four themes were generated, namely, the cognitive and emotional battle of vaccine hesitancy, catalysts for vaccine acceptance, blasting vaccination myths, and being a positive influence. Providing timely, adequate, and transparent vaccine information and addressing the specific concerns of HCWs about the COVID-19 vaccine could enhance their vaccination uptake in future. Specific vaccine promotion strategies, such as the sharing of vaccination experiences targeted at different subgroups of HCWs, may improve vaccine acceptance through informational social influence.

COVID-19 vaccination hesitancy in Italian healthcare workers: a systematic review and meta-analysis

INTRODUCTION

As for other vaccines, vaccination hesitancy may be a determining factor in the success (or otherwise) of the COVID-19 immunization campaign in healthcare workers (HCWs).

AREAS COVERED

To estimate the proportion of HCWs in Italy who expressed COVID-19 vaccine hesitancy, we conducted a systematic review of the relevant literature and a meta-analysis. Determinants of vaccine compliance and options suggested by these studies to address vaccine hesitancy among HCWs were also analyzed. Seventeen studies were included in the meta-analysis and systematic review, selected from scientific articles available in the MEDLINE/PubMed, Google Scholar and Scopus databases between January 1, 2020 and January 25, 2022. The vaccine hesitancy rate among HCWs was 13.1% (95%CI: 6.9-20.9%). The vaccine hesitancy rate among HCWs investigated before and during the vaccination campaign was 18.2% (95%CI=12.8-24.2%) and 8.9% (95%CI=3.4-16.6%), respectively. That main reasons for vaccine hesitation were lack of information about vaccination, opinion that the vaccine is unsafe, and fear of adverse events.

EXPERT OPINION

Despite strategies to achieve a greater willingness to immunize in this category, mandatory vaccination appears to be one of the most important measures that can guarantee the protection of HCWs and the patients they care for.

Seasonal Influenza Vaccination at a German University Hospital: Distinguishing Barriers Between Occupational Groups

The annual influenza vaccination has been officially recommended for medical staff in Germany since 1988. Nevertheless, the vaccination rate among medical staff is still low. The present study deals with the influenza vaccination rate of staff at a German University hospital over time as well as with the reasons that led to a positive vaccination decision and the barriers to acceptance of vaccination. For this purpose, the staff members received questionnaires in which they were asked about influenza vaccination and the reasons for or against vaccination. In addition, the questionnaire contains information on gender, age group, occupational group and presence of a chronic co-morbidity. Logistic regression analysis was used to investigate which of these predictors most strongly influenced the vaccination decision. It was shown that the reasons for or against vaccination differ significantly between the occupational groups and that the occupational group affiliation has the greatest influence on the vaccination decision in the comparison of the investigated predictors. In order to achieve a positive influence on vaccination acceptance, future measures should focus on increasing confidence in vaccination and on increasing the perception of risk from influenza illness. The findings may contribute to future targeted strategies to increase vaccination rates and suggest occupational group-specific interventions.

Optional Vaccines in Children—Knowledge, Attitudes, and Practices in Romanian Parents

Vaccination is one of the most useful medical interventions for controlling certain infectious diseases. The aim of current research is to identify some of the drivers of vaccine hesitancy or acceptance in a rather skeptical European population by addressing parental perception on optional vaccination (OV) perception. Novel tools, delivered by social media, were used in our research attempt. A validated questionnaire was distributed online among parents. Parental knowledge, attitudes and perceptions of OV were analyzed. The majority of parent respondents (55.1%) showed very good knowledge about vaccination and vaccine-preventable diseases, and 76.0% stated that they had given at least one optional vaccine to at least one of their children. The most common optional vaccine administered was the rotavirus vaccine. The level of knowledge appeared to be related to compliance with OV. Concurrently, the rate of vaccine acceptance in the NIP (National Immunization Program) was not correlated with the level of parental knowledge. In total, a high percentage of parents (77.6%) believed that OV can bring an additional health safety benefit to their children. This study shows the need to involve the medical community in a steady dialogue with parents about OV. Raising awareness by presenting clear and understandable information could be a game-changing intervention in mitigating the public health impact of OV-preventable diseases.

Forecasting the COVID-19 vaccine uptake rate: an infodemiological study in the US

A year following the initial COVID-19 outbreak in China, many countries have approved emergency vaccines. Public-health practitioners and policymakers must understand the predicted populational willingness for vaccines and implement relevant stimulation measures. This study developed a framework for predicting vaccination uptake rate based on traditional clinical data - involving an autoregressive model with autoregressive integrated moving average (ARIMA) - and innovative web search queries - involving a linear regression with ordinary least squares/least absolute shrinkage and selection operator, and machine-learning with boost and random forest. For accuracy, we implemented a stacking regression for the clinical data and web search queries. The stacked regression of ARIMA (1,0,8) for clinical data and boost with support vector machine for web data formed the best model for forecasting vaccination speed in the US. The stacked regression provided a more accurate forecast. These results can help governments and policymakers predict vaccine demand and finance relevant programs.

COVID-19 Vaccine Booster Hesitancy (VBH) of Healthcare Workers in Czechia: National Cross-Sectional Study

The emerging SARS-CoV-2 variants and waning vaccine-elicited immunity are two public health challenges that occurred simultaneously and synergistically during the summer of 2021 and led to a surging demand for COVID-19 vaccine booster dose (BD) rollout. This study aimed to evaluate the COVID-19 vaccine booster hesitancy (VBH) among Czech healthcare workers to explore the potential determinants of VBH. A national cross-sectional survey-based study was carried out between 3 and 11 November 2021, using an online self-administered questionnaire (SAQ) that explored the participants' demographic characteristics, COVID-19 infection and vaccine anamneses, willingness to receive COVID-19 vaccine BD, and the psychosocial drivers of VBH. A total of 3454 HCW properly responded to the online SAQ, of which 80.9% were females, 30.3% were medical professionals, and 50.5% were ≤47 years old. Most of the participants were already inoculated against SARS-CoV-2 (95.2%), and BTN162b2 was the most commonly administered vaccine (90.7%). As the study sample was planned to represent the target population, it revealed a high level of BD acceptance (71.3%) among Czech HCW, while 12.2% were still hesitant and 16.6% were against the currently available BD. These results are consistent with other recent results from central Europe. Medical professional, male, and older participants were more likely to accept BD rather than allied health professional, female, and younger participants. The BDs' perceived effectiveness against severe illness, symptomatic infection, and community transmission was a significant and strong predictor for BD acceptance, while the effectiveness against the circulating variants was not that important for our target population. The BDs' perceived safety and ethical dilemmas of vaccine justice should be addressed sufficiently while communicating with HCW and other population groups. The altruistic reasons for BD acceptance, i.e., family protection, patient protection, and community health protection, underpin the recommendation of postponing the COVID-19 vaccine mandating in favour of stressing these altruistic concerns amid public health messaging.

Determinants of seasonal influenza vaccination hesitancy among healthcare personnel: An integrative review

AIMS AND OBJECTIVES

To explore the determinants of and behaviour change models for seasonal influenza vaccination compliance among healthcare personnel.

BACKGROUND

COVID-19 vaccine hesitancy among healthcare personnel may be better understood by exploring determinants of seasonal influenza vaccine hesitancy.

DESIGN

Integrative literature review.

METHODS

A systematic search was conducted in accordance with PRISMA guidelines. Six thousand and forty-eight articles were screened. Seventy-eight met inclusion criteria. Due to the heterogeneity of included articles, a narrative synthesis was conducted utilising a conceptual matrix to identify thematic categories.

RESULTS

Six thematic categories were identified as influencing HCP SIV compliance: 'perceived vulnerability', 'trust', 'past behaviour', 'professional duty', 'access and convenience' and 'knowledge and experience'. The Health Belief Model (HBM) was the most commonly utilised health behaviour change model within the seasonal influenza vaccination context. Few studies have examined seasonal influenza vaccine acceptance and uptake within the Australian HCP context, particularly involving community care and aged care.

CONCLUSIONS

Factors that appear to relate to influenza vaccination compliance among HCP can be grouped according to several thematic categories, and they also appear influential in COVID-19 vaccine uptake. In particular, an emerging focus on 'trust' or the more emotive considerations of decision-making around health-protective behaviours requires further exploration in the context of a pandemic. Efforts to influence these domains to increase compliance, however, are likely to be impeded by a lack of a well-developed and tested behaviour change model.

RELEVANCE TO CLINICAL PRACTICE

Healthcare personnel (HCP) face high levels of occupational exposure to seasonal influenza every year. An emerging focus on 'trust' and the more emotive considerations of decision-making around health-protective behaviours requires further exploration in the context of a pandemic.

Early COVID-19 Vaccination of Romanian Medical and Social Personnel

Background: In December 2020, the first doses of COVID-19 vaccines arrived in Romania and were made available to medical and social staff. Vaccine hesitancy appeared as a barrier to effectively ending the pandemic. The opinions of medical and social staff influence the opinion of the general population. This study assesess the attitudes, knowledge, and opinion of medical and social personnel toward COVID-19 vaccines and vaccination and the influencing factors. Methods: 1025 persons participated in an online cross-sectional study from March until July 2021. Results: Out of 1021 eligible responders, 719 (70.42%) had been vaccinated: 227 with one dose (22.23%) and 492 with two doses (48.18%). There were 302 responders who were not vaccinated at all. Out of them, 188 refused vaccinations. The participants showed a good understanding and knowledge of SARScoV-2 transmission and treatment. Geographic area, medical profession, and medical experience influenced COVID-19 vaccination (p < 0.001). There were no associations between willingness to vaccinate and vaccine/virus knowledge. Most of the responders who were vaccinated or wanted to be vaccinated indicated an mRNA vaccine as their first choice. The variables that were significantly associated with reporting COVID-19 vaccine acceptance after logistic regression were: living in an urban area (Ora = 1.58, 95% CI: 0.98–2.56), being female (Ora = 1.59; 95% CI:1.03–2.44), and being a medical doctor (Ora = 3.40; 95% CI: 1.84–6.26). Conclusions: These findings show that vaccine hesitancy persists in medical and social personnel in Romania, and, hence, it may be reflected in the hesitancy of the general population toward vaccination.

Determinants of COVID-19 vaccine preference: A survey study in Japan

Objective

Vaccination is a critical measure for containing the COVID-19 pandemic. We survey the determinants that affect the preference for COVID-19 vaccines in Japan, a vaccine hesitant nation.

Setting and design

We conducted a randomized conjoint analysis survey of the preference for vaccines on the Internet by recruiting a nonprobability sample of 15,000 Japanese adults. The survey assigned 5 choice tasks to the respondents. In each task, the respondents evaluated 2 hypothetical COVID-19 vaccines and were asked which they would choose. The vaccine attributes included efficacy, major and minor adverse side effects, country of vaccine development and clinical trial, and vaccine type.

Treatment

The choice task asked the participants to select a vaccine from 2 hypothetical vaccines as an optional vaccine or select a vaccine as mandated one with a probability of 0.5 for each.

Results

Compared to China-developed vaccines, domestically developed or US-developed vaccines raised the choice probability by 37.3 and 27.4 percentage points, respectively. A domestic clinical trial increased the choice probability by 14.8, an increase in efficacy from 50% to 90% increased that by 18.0, and a decrease in the risk of severe adverse side effects from 1 per 10 thousand to 1 per 1 million increased that by 16.9 percentage points, respectively. The vaccine type was irrelevant. Making vaccination compulsory increased the choice probability of China- and Russia-developed vaccines by 0.6 and 0.4, high-risk vaccines by 0.5, and a modestly effective (70%) vaccine by 0.4 percentage points, respectively. General vaccination hesitancy, political positions, demographic characteristics, education, and income were irrelevant.

Conclusions

A domestically developed vaccine with a domestic clinical trial could substantially increase the preference for the vaccine. Making vaccination compulsory could modestly reduce the penalty for a vaccine with adverse side effects, geopolitical, and efficacy concerns, possibly through mitigating free-riding concerns to achieve herd immunity.

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We implement a randomized conjoint experiment on preference of COVID-19 vaccines.

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We asked 15,000 Japanese adults which to prefer between two hypothetical vaccines.

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As a treatment, we randomly assigned voluntary and compulsory vaccination scenarios.

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Domestic development and clinical trial were substantially preferred.

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Compulsory vaccination modestly raised preference for riskier vaccines.

Disproportionate COVID-19 vaccine acceptance rate among healthcare professionals on the eve of nationwide vaccine distribution in Bangladesh

BACKGROUND

: Acceptance of the COVID-19 vaccine by the target groups would play a crucial role in stemming the pandemic. Healthcare professionals (HCPs) are the priority group for vaccination due to them having the highest risk of exposure to infection. This survey aimed to assess their acceptance of COVID-19 vaccines in Bangladesh.

RESEARCH DESIGN AND METHODS

A cross-sectional survey using an online questionnaire was conducted between January 3 to 25, 2021, among HCPs (n=834) in Bangladesh. The main outcome measures were vaccine acceptance by HCPs if one was available.

RESULTS

Less than 50% of HCPs would receive the vaccine against COVID-19 if available and 54% were willing to take the vaccine at some stage in the future. Female participants (OR:1.64;95%CI:1.172-2.297), respondents between 18-34 years old (OR:2.42; 95% CI:1.314-4.463), HCPs in the public sector (OR:2.09; 95% CI:1.521-2.878), and those who did not receive a flu vaccine in the previous year (OR:3.1; 95% CI:1.552-6.001) were more likely to delay vaccination.

CONCLUSIONS

The study revealed that, if available, less than half of the HCPs would accept a COVID-19 vaccine in Bangladesh. To ensure the broader success of the vaccination drive, tailored strategies and vaccine promotion campaigns targeting HCPs and the general population are needed.

Attitudes and Acceptance of COVID-19 Vaccination Among Nurses and Midwives in Cyprus: A Cross-Sectional Survey

Healthcare workers are at the frontline of the COVID-19 pandemic and have been identified as a priority target group for COVID-19 vaccines. This study aimed to determine the COVID-19 vaccination intention among nurses and midwives in Cyprus and reveal the influential factors that affected their decision. An Internet-based cross-sectional survey was conducted between December 8 and 28, 2020. Data collection was accomplished using a self-administered questionnaire with questions about socio-demographic characteristics, questions assessing general vaccination-related intentions and behaviors, and the intention to accept COVID-19 vaccination. A sample of 437 responders answered the survey, with 93% being nurses and 7% midwives. A small proportion of the participants would accept a vaccine against COVID-19, while 70% could be qualified as "vaccine hesitant." The main reasons for not receiving the COVID-19 vaccine were concerns about the vaccine's expedited development and fear of side effects. More females, individuals with a larger median age, and a higher number of years of working experience, intended to accept the COVID-19 vaccination, compared with those not intended to accept and undecided groups (p < 0.01). Having a seasonal flu vaccination in the last 5 years, receiving the vaccines recommended for health professionals, and working in the private sector were associated with a higher probability of COVID-19 vaccination acceptance. A considerable rate of nurses and midwives in Cyprus reported unwillingness to receive a COVID-19 vaccine due to vaccine-related concerns. Our findings highlight the need for forthcoming vaccination campaigns and programs to tackle coronavirus vaccine hesitancy barriers to achieve the desirable vaccination coverage.

Factors Affecting Attitudes towards COVID-19 Vaccination: An Online Survey in Slovenia

While the problem of vaccine hesitancy is not new, it has become more pronounced with the new COVID-19 vaccines and represents an obstacle to resolving the crisis. Even people who would usually trust vaccines and experts now prefer to wait for more information. A cross-sectional online survey was conducted in Slovenia in December 2020 to find out the attitudes of the population regarding COVID-19 vaccination and the factors that affect these attitudes. Based on 12,042 fully completed questionnaires, we find that higher intention to get vaccinated is associated with men, older respondents, physicians and medical students, respondents who got the influenza vaccination, those who knew someone who had gotten hospitalised or died from COVID-19 and those who have more trust in experts, institutions and vaccines. Nurses and technicians were less likely to get vaccinated. In answers to an open question, sceptics were split into those doubting the quality due to the rapid development of the vaccine and those that reported personal experiences with side effects of prior vaccinations. Although the Slovenian population is diverse in its attitudes towards vaccination, the results are comparable to those found in other countries. However, there are potential limitations to the generalizability of the findings that should be addressed in future studies.