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Tiu A, Bansal S. Estimating county-level flu vaccination in the United States. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.10.23289756. [PMID: 37214921 PMCID: PMC10197794 DOI: 10.1101/2023.05.10.23289756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
In the United States, influenza vaccines are an important part of public health efforts to blunt the effects of seasonal influenza epidemics. This in turn emphasizes the importance of understanding the spatial distribution of influenza vaccination coverage. Despite this, high quality data at a fine spatial scale and spanning a multitude of recent flu seasons are not readily available. To address this gap, we develop county-level counts of vaccination across five recent, consecutive flu seasons and fit a series of regression models to these data that account for bias. We find that the spatial distribution of our bias-corrected vaccination coverage estimates is generally consistent from season to season, with the highest coverage in the Northeast and Midwest but is spatially heterogeneous within states. We also observe a negative relationship between a county's vaccination coverage and social vulnerability. Our findings stress the importance of quantifying flu vaccination coverage at a fine spatial scale, as relying on state or region-level estimates misses key heterogeneities.
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Affiliation(s)
- Andrew Tiu
- Department of Biology, Georgetown University, Washington, DC, USA
| | - Shweta Bansal
- Department of Biology, Georgetown University, Washington, DC, USA
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Price AM, Flannery B, Talbot HK, Grijalva CG, Wernli KJ, Phillips CH, Monto AS, Martin ET, Belongia EA, McLean HQ, Gaglani M, Mutnal M, Geffel KM, Nowalk MP, Tartof SY, Florea A, McLean C, Kim SS, Patel MM, Chung JR. Influenza Vaccine Effectiveness Against Influenza A(H3N2)-Related Illness in the United States During the 2021-2022 Influenza Season. Clin Infect Dis 2023; 76:1358-1363. [PMID: 36504336 PMCID: PMC10893961 DOI: 10.1093/cid/ciac941] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/28/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In the United States, influenza activity during the 2021-2022 season was modest and sufficient enough to estimate influenza vaccine effectiveness (VE) for the first time since the beginning of the coronavirus disease 2019 pandemic. We estimated influenza VE against laboratory-confirmed outpatient acute illness caused by predominant A(H3N2) viruses. METHODS Between October 2021 and April 2022, research staff across 7 sites enrolled patients aged ≥6 months seeking outpatient care for acute respiratory illness with cough. Using a test-negative design, we assessed VE against influenza A(H3N2). Due to strong correlation between influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, participants who tested positive for SARS-CoV-2 were excluded from VE estimations. Estimates were adjusted for site, age, month of illness, race/ethnicity, and general health status. RESULTS Among 6260 participants, 468 (7%) tested positive for influenza only, including 440 (94%) for A(H3N2). All 206 sequenced A(H3N2) viruses were characterized as belonging to genetic group 3C.2a1b subclade 2a.2, which has antigenic differences from the 2021-2022 season A(H3N2) vaccine component that belongs to clade 3C.2a1b subclade 2a.1. After excluding 1948 SARS-CoV-2-positive patients, 4312 patients were included in analyses of influenza VE; 2463 (57%) were vaccinated against influenza. Effectiveness against A(H3N2) for all ages was 36% (95% confidence interval, 20%-49%) overall. CONCLUSIONS Influenza vaccination in 2021-2022 provided protection against influenza A(H3N2)-related outpatient visits among young persons.
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Affiliation(s)
- Ashley M Price
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brendan Flannery
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - H Keipp Talbot
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Carlos G Grijalva
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Karen J Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - C Hallie Phillips
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Arnold S Monto
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Emily T Martin
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | | | | | - Manjusha Gaglani
- Department of Pediatrics, Baylor Scott & White Health, USA
- Department of Medical Education, Texas A&M University College of Medicine, Temple, Texas, USA
| | - Manohar Mutnal
- Department of Pediatrics, Baylor Scott & White Health, USA
- Department of Medical Education, Texas A&M University College of Medicine, Temple, Texas, USA
| | - Krissy Moehling Geffel
- Department of Family Medicine, University of Pittsburgh Schools of the Health Sciences and University of Pittsburgh Medical Center, Pittsburgh, Pannsylvania, USA
| | - Mary Patricia Nowalk
- Department of Family Medicine, University of Pittsburgh Schools of the Health Sciences and University of Pittsburgh Medical Center, Pittsburgh, Pannsylvania, USA
| | - Sara Y Tartof
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Ana Florea
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Callie McLean
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sara S Kim
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Manish M Patel
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jessie R Chung
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Hood N, Flannery B, Gaglani M, Beeram M, Wernli K, Jackson ML, Martin ET, Monto AS, Zimmerman R, Raviotta J, Belongia EA, McLean HQ, Kim S, Patel MM, Chung JR. Influenza Vaccine Effectiveness Among Children: 2011-2020. Pediatrics 2023; 151:e2022059922. [PMID: 36960655 PMCID: PMC10071433 DOI: 10.1542/peds.2022-059922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Infants and children are at increased risk of severe influenza virus infection and its complications. Influenza vaccine effectiveness (VE) varies by age, influenza season, and influenza virus type/subtype. This study's objective was to examine the effectiveness of inactivated influenza vaccine against outpatient influenza illness in the pediatric population over 9 influenza seasons after the 2009 A(H1N1) pandemic. METHODS During the 2011-2012 through the 2019-2020 influenza seasons at outpatient clinics at 5 sites of the US Influenza Vaccine Effectiveness Network, children aged 6 months to 17 years with an acute respiratory illness were tested for influenza using real-time, reverse-transcriptase polymerase chain reaction. Vaccine effectiveness was estimated using a test-negative design. RESULTS Among 24 148 enrolled children, 28% overall tested positive for influenza, 3017 tested positive for influenza A(H3N2), 1459 for influenza A(H1N1)pdm09, and 2178 for influenza B. Among all enrollees, 39% overall were vaccinated, with 29% of influenza cases and 43% of influenza-negative controls vaccinated. Across all influenza seasons, the pooled VE for any influenza was 46% (95% confidence interval, 43-50). Overall and by type/subtype, VE against influenza illness was highest among children in the 6- to 59-month age group compared with older pediatric age groups. VE was lowest for influenza A(H3N2) virus infection. CONCLUSIONS Analysis of multiple seasons suggested substantial benefit against outpatient illness. Investigation of host-specific or virus-related mechanisms that may result in differences by age and virus type/subtype may help further efforts to promote increased vaccination coverage and other influenza-related preventative measures.
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Affiliation(s)
- Nicole Hood
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brendan Flannery
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Manjusha Gaglani
- Texas A&M University Health Science Center College of Medicine, Temple, Texas
- Baylor Scott & White Health Research Institute, Temple, Texas
| | - Madhava Beeram
- Texas A&M University Health Science Center College of Medicine, Temple, Texas
- Baylor Scott & White Health Research Institute, Temple, Texas
| | - Karen Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Michael L. Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Emily T. Martin
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Arnold S. Monto
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Richard Zimmerman
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jonathan Raviotta
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | - Sara Kim
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Manish M. Patel
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jessie R. Chung
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia
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Chung JR, Kim SS, Flannery B, Smith ME, Dunnigan K, Raiyani C, Murthy K, Gaglani M, Jackson ML, Jackson LA, Bear T, Moehling Geffel K, Nowalk MP, Zimmerman RK, Martin ET, Lamerato L, McLean HQ, King JP, Belongia EA, Thompson MG, Patel M. Vaccine-associated attenuation of subjective severity among outpatients with influenza. Vaccine 2022; 40:4322-4327. [PMID: 35710506 PMCID: PMC9638984 DOI: 10.1016/j.vaccine.2022.06.019] [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: 04/05/2022] [Revised: 05/24/2022] [Accepted: 06/05/2022] [Indexed: 11/18/2022]
Abstract
Influenza vaccines can mitigate illness severity, including reduced risk of ICU admission and death, in people with breakthrough infection. Less is known about vaccine attenuation of mild/moderate influenza illness. We compared subjective severity scores in vaccinated and unvaccinated persons with medically attended illness and laboratory-confirmed influenza. Participants were prospectively recruited when presenting for care at five US sites over nine seasons. Participants aged ≥ 16 years completed the EQ-5D-5L visual analog scale (VAS) at enrollment. After controlling for potential confounders in a multivariable model, including age and general health status, VAS scores were significantly higher among 2,830 vaccinated participants compared with 3,459 unvaccinated participants, indicating vaccinated participants felt better at the time of presentation for care. No differences in VAS scores were observed by the type of vaccine received among persons aged ≥ 65 years. Our findings suggest vaccine-associated attenuation of milder influenza illness is possible.
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Affiliation(s)
- Jessie R Chung
- U.S. Centers for Disease Control and Prevention, Influenza Division, Atlanta, GA, United States.
| | - Sara S Kim
- U.S. Centers for Disease Control and Prevention, Influenza Division, Atlanta, GA, United States
| | - Brendan Flannery
- U.S. Centers for Disease Control and Prevention, Influenza Division, Atlanta, GA, United States
| | | | | | | | | | - Manjusha Gaglani
- Baylor Scott & White Health, Temple, TX, United States; Texas A&M University College of Medicine, Temple, TX, United States
| | - Michael L Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Lisa A Jackson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Todd Bear
- University of Pittsburgh, United States
| | | | | | | | - Emily T Martin
- University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Lois Lamerato
- Henry Ford Health System, Detroit, MI, United States
| | - Huong Q McLean
- Marshfield Clinic Research Institute, Marshfield, WI, United States
| | - Jennifer P King
- Marshfield Clinic Research Institute, Marshfield, WI, United States
| | | | - Mark G Thompson
- U.S. Centers for Disease Control and Prevention, Influenza Division, Atlanta, GA, United States
| | - Manish Patel
- U.S. Centers for Disease Control and Prevention, Influenza Division, Atlanta, GA, United States
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Du M, Tao L, Liu J. Association between risk perception and influenza vaccine hesitancy for children among reproductive women in China during the COVID-19 pandemic: a national online survey. BMC Public Health 2022; 22:385. [PMID: 35197035 PMCID: PMC8865491 DOI: 10.1186/s12889-022-12782-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background In China, the national prevalence of parental influenza vaccine hesitancy (IVH) during the pandemic of coronavirus disease 2019 (COVID-19), and the association between risk perception and parental IVH are still unclear. We aimed to explore the association between risk perception and IVH for children among reproductive women in China, a poorly studied area. Methods From December 14, 2020, to January 31, 2021, we conducted a national anonymous online survey on IVH for children among reproductive women in China. We assessed risk perception including perceived susceptibility, severity, barriers, and benefits using the Health Belief Model and then classified each variable into three groups based on tertiles. Logistic regression models were used to calculate the adjusted odds ratio (aOR) of risk perception related to vaccine hesitancy after controlling for sociodemographic characteristics, health status, and knowledge of influenza, among other factors. Additionally, subgroup analysis was performed. Results Among 3,011 reproductive women, 9.13% reported IVH. In multivariable models, vaccine hesitancy was associated with low perceived susceptibility (aOR = 2.55, 95% CI: 1.79–3.65), higher perceived barriers (moderate: aOR = 1.47, 95% CI: 1.04–2.08; high: aOR = 2.20, 95% CI: 1.47–3.30), and low perceived benefit (moderate: aOR = 1.40, 95% CI: 1.03–1.92; low: aOR = 2.10, 95% CI: 1.43–3.07). Subgroup analysis showed that vaccine hesitancy was more likely to occur among women with high perceived barriers aged < 30 years compared with those older than 30 years (P for difference = 0.041) and among women with moderate perceived benefit who had never conceived compared with those had a history of pregnancy (P for difference = 0.048). Conclusions Nearly one in 10 reproductive women was hesitant about influenza vaccination for their children during the COVID-19 pandemic. To mitigate vaccine hesitancy, our findings highlight a need for tailored public health measures to increase perceived disease susceptibility and vaccine benefit and decrease perceived barriers. Furthermore, the effect of high perceived barriers and moderate perceived benefit on vaccine hesitancy was higher among younger women and women who had never conceived. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12782-0.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, No.49 Huayuan North Road, Haidian District, Beijing, 100083, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China. .,Institute for Global Health and Development, Peking University, No.5 Yiheyuan Road, Haidian District, Beijing, 100871, China. .,National Health Commission Key Laboratory of Reproductive Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China.
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Olson SM, Newhams MM, Halasa NB, Feldstein LR, Novak T, Weiss SL, Coates BM, Schuster JE, Schwarz AJ, Maddux AB, Hall MW, Nofziger RA, Flori HR, Gertz SJ, Kong M, Sanders RC, Irby K, Hume JR, Cullimore ML, Shein SL, Thomas NJ, Stewart LS, Barnes JR, Patel MM, Randolph AG. Vaccine Effectiveness Against Life-Threatening Influenza Illness in US Children. Clin Infect Dis 2022; 75:230-238. [PMID: 35024795 DOI: 10.1093/cid/ciab931] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Predominance of 2 antigenically drifted influenza viruses during the 2019-2020 season offered an opportunity to assess vaccine effectiveness against life-threatening pediatric influenza disease from vaccine-mismatched viruses in the United States. METHODS We enrolled children aged <18 years admitted to the intensive care unit with acute respiratory infection across 17 hospitals. Respiratory specimens were tested using reverse-transcription polymerase chain reaction for influenza viruses and sequenced. Using a test-negative design, we estimated vaccine effectiveness comparing odds of vaccination in test-positive case patients vs test-negative controls, stratifying by age, virus type, and severity. Life-threating influenza included death or invasive mechanical ventilation, vasopressors, cardiopulmonary resuscitation, dialysis, or extracorporeal membrane oxygenation. RESULTS We enrolled 159 critically ill influenza case-patients (70% ≤8 years; 51% A/H1N1pdm09 and 25% B-Victoria viruses) and 132 controls (69% were aged ≤8 years). Among 56 sequenced A/H1N1pdm09 viruses, 29 (52%) were vaccine-mismatched (A/H1N1pdm09/5A+156K) and 23 (41%) were vaccine-matched (A/H1N1pdm09/5A+187A,189E). Among sequenced B-lineage viruses, majority (30 of 31) were vaccine-mismatched. Effectiveness against critical influenza was 63% (95% confidence interval [CI], 38% to 78%) and similar by age. Effectiveness was 75% (95% CI, 49% to 88%) against life-threatening influenza vs 57% (95% CI, 24% to 76%) against non-life-threating influenza. Effectiveness was 78% (95% CI, 41% to 92%) against matched A(H1N1)pdm09 viruses, 47% (95% CI, -21% to 77%) against mismatched A(H1N1)pdm09 viruses, and 75% (95% CI, 37% to 90%) against mismatched B-Victoria viruses. CONCLUSIONS During a season when vaccine-mismatched influenza viruses predominated, vaccination was associated with a reduced risk of critical and life-threatening influenza illness in children.
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Affiliation(s)
- Samantha M Olson
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Margaret M Newhams
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Natasha B Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Leora R Feldstein
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Tanya Novak
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Anesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - Scott L Weiss
- Division of Critical Care, Department of Anesthesiology and Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Bria M Coates
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Jennifer E Schuster
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Adam J Schwarz
- Department of Pediatrics, Children's Hospital of Orange County, Orange, California, USA
| | - Aline B Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Mark W Hall
- Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Ryan A Nofziger
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron, Ohio, USA
| | - Heidi R Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor, Michigan, USA
| | - Shira J Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, New Jersey, USA
| | - Michele Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ronald C Sanders
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - Janet R Hume
- Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Melissa L Cullimore
- Division of Pediatric Critical Care, Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Steven L Shein
- Division of Pediatric Critical Care Medicine, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Neal J Thomas
- Department of Pediatrics, Penn State Hershey Children's Hospital, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Laura S Stewart
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - John R Barnes
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Manish M Patel
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Adrienne G Randolph
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Anesthesia, Harvard Medical School, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Della Polla G, Licata F, Angelillo S, Pelullo CP, Bianco A, Angelillo IF. Characteristics of Healthcare Workers Vaccinated against Influenza in the Era of COVID-19. Vaccines (Basel) 2021; 9:vaccines9070695. [PMID: 34202867 PMCID: PMC8310005 DOI: 10.3390/vaccines9070695] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/20/2021] [Accepted: 06/20/2021] [Indexed: 12/13/2022] Open
Abstract
Understanding the potential impact of COVID-19 on receiving influenza vaccination among healthcare workers (HCWs) is of utmost importance. The purposes of the present cross-sectional study were to describe the characteristics and to explore the predictors of receiving influenza vaccination among a large cohort of Italian HCWs in hospital settings. Information was collected through an anonymous questionnaire from December 2020 through January 2021. General and practice characteristics, perceived risk of seasonal influenza, attitudes towards efficacy and safety of influenza vaccination, and reasons behind the decision to be vaccinated against influenza were explored. Fewer than half (46.2%) of HCWs agreed that influenza is a serious illness and perceived the risk of getting infected with influenza, and concerns about the safety of the vaccination were significant positive predictors. Fewer than half of the respondents were not concerned at all about the efficacy (48.6%) and safety (49.8%) of influenza vaccination, and 51.9% reported that they have not received a seasonal influenza vaccine during the previous season. The most mentioned reason for receiving the influenza vaccine in the current season was that influenza and COVID-19 share some similar symptoms. Study results will aid policymakers in developing vaccination education programs, promotion of trust to address negative misconceptions, and to achieve future high coverage among this high-risk group.
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Affiliation(s)
- Giorgia Della Polla
- Health Direction, Teaching Hospital, University of Campania “Luigi Vanvitelli”, Via Santa Maria di Costantinopoli 104, 80138 Naples, Italy;
| | - Francesca Licata
- Department of Health Sciences, University of Catanzaro ‘‘Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (F.L.); (S.A.); (A.B.)
| | - Silvia Angelillo
- Department of Health Sciences, University of Catanzaro ‘‘Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (F.L.); (S.A.); (A.B.)
| | - Concetta Paola Pelullo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni 5, 80138 Naples, Italy;
| | - Aida Bianco
- Department of Health Sciences, University of Catanzaro ‘‘Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (F.L.); (S.A.); (A.B.)
| | - Italo Francesco Angelillo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni 5, 80138 Naples, Italy;
- Correspondence: ; Tel.: +39-081-566-7717
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Sample size considerations for mid-season estimates from a large influenza vaccine effectiveness network in the United States. Vaccine 2021; 39:3324-3328. [PMID: 33994240 DOI: 10.1016/j.vaccine.2021.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Mid-season influenza vaccine effectiveness (VE) estimates are a useful tool to help guide annual influenza vaccine strain selection, vaccine policy, and public health messaging. We propose using a sample size-driven approach with data-driven inputs for publication of mid-season influenza VE. METHODS We used pooled inputs for VE by (sub)type and average vaccine coverage by age groups using data from eight seasons of the US Influenza VE Network to calculate sample sizes needed to estimate mid-season VE. RESULTS We estimate that 135 influenza-positive cases would be needed to detect an overall VE of 40% with 55% vaccine coverage among test-negative controls. Larger sample sizes would be required to produce reliable estimates specifically against influenza A/H3N2 and for older age groups. CONCLUSION Using an existing network, most of the recent influenza seasons in the US would facilitate valid mid-season VE estimates using the proposed sample sizes for broad age groupings.
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