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Rana B, Jimenez HR, Khan ZM, Narayanan N. Association between Socioeconomic Status and Vaccination Hesitancy, Reluctancy and Confidence among Asian-Americans Living in the State of New Jersey. J Community Health 2024; 49:829-834. [PMID: 39014152 PMCID: PMC11345316 DOI: 10.1007/s10900-024-01381-2] [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] [Accepted: 06/28/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUD Socioeconomic status (SES) plays a vital role in determining vaccination uptake and attitudes. Vaccine hesitancy varies among different communities, yet knowledge of vaccine attitudes among Asian-Americans is limited. OBJECTIVE This study aims to investigate the relationship between SES and vaccine attitudes among Asian-Americans in the State of New Jersey (NJ). METHODS Asian-Americans aged ≥ 18 years living in NJ were included (N = 157). SES was measured by education level, employment type, employment status, and household income. The primary outcomes were vaccine hesitancy, reluctance, and confidence for COVID-19, influenza, and pneumococcal vaccines. Descriptive and inferential statistics were performed. Multivariable logistic regression was used to identify associations between SES and vaccine hesitancy while controlling for confounders such as age, gender, birthplace, and religion. RESULTS Among 157 participants, 12.1% reported vaccine hesitancy. There was no statistically significant association between vaccine hesitancy and education level (p = 0.68), employment status (p = 1), employment type (p = 0.48), and household income (p = 0.15). Multivariable logistic regression modeling confirmed that none of the SES predictor variables were associated with vaccine hesitancy. However, as exploratory finding, gender was found to be a significant predictor, with males having lower odds of vaccine hesitancy than females (Adjusted OR = 0.14; p < 0.05). Confidence in influenza and pneumococcal vaccines increased during the pandemic, from 62.34% to 70.13% and from 59.2% to 70.51%, respectively. For the COVID-19 vaccine, 73.1% of participants reported having "a lot of confidence" in taking vaccine. CONCLUSION Most sampled Asian-Americans in NJ have high confidence in taking COVID-19 vaccines, and there is no significant association between vaccine hesitancy and SES.
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Affiliation(s)
- Brijesh Rana
- School of Public Health, Rutgers, The State University of New Jersey, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA.
| | - Humberto R Jimenez
- Rutgers University Ernest Mario School of Pharmacy, 160 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - Zeba M Khan
- Rutgers University Ernest Mario School of Pharmacy, 160 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - Navaneeth Narayanan
- Rutgers University Ernest Mario School of Pharmacy, 160 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
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Angeletti PM, Marchi S, Trombetta CM, Altobelli E. Flu vaccine administration in the period before SARS-CoV-2 infection and its outcomes: An umbrella review. Prev Med Rep 2024; 38:102575. [PMID: 38283956 PMCID: PMC10820254 DOI: 10.1016/j.pmedr.2023.102575] [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: 10/11/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/30/2024] Open
Abstract
Objective The potential association between influenza vaccination and SARS-CoV-2 infection and related outcomes is still controversial. The aim of this umbrella review is to represent the impact of previous influenza vaccination and COVID-19 outcomes using evidence currently available in literature. Methods A literature search of MEDLINE, EMBASE, Scopus, Web of Science and Cochrane Library was conducted. The paper selection was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method by two-blinded authors. The quality of meta-analyses was assessed using the AMSTAR 2 scale (A MeaSurement Tool to Assess systematic Reviews). The outcomes investigated were SARS-CoV-2 infection after influenza vaccination, hospitalization, intensive care unit admission, mechanical ventilation and mortality. Results The literature research identified 7 ecological studies and 6 meta-analyses. All the ecological studies show a negative relationship between influenza vaccination and COVID-19. The meta-analyses suggest a protective action of influenza vaccination against SARS-CoV-2 infection. Regarding the outcomes evaluated, only two studies reported a statistically significant reduction of 12% and of 17% in hospitalization and intensive care unit admission, respectively. Regarding mechanical ventilation, three studies showed a risk reduction of 31%, 27% and 28%. A substantial reduction of mortality risk was also observed in one study. Conclusions These results suggest that influenza vaccination could be associated with reduced susceptibility to SARS-CoV-2 infection, mechanical ventilation and mortality. Our findings highlighted how the administration of flu vaccine in subjects at risk could lead to a reduction in mortality, particularly in the over 65y.
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Affiliation(s)
- Paolo Matteo Angeletti
- Department of Life, Health and Environmental Sciences, Section of Epidemiology and Biostatistics Unit, University of L'Aquila, Piazzale Salvatore Tommasi 1, 67100 L'Aquila, Coppito (AQ), Italy
- Cardiovascular Department, UO of Cardiac Anesthesia of the IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | | | - Emma Altobelli
- Department of Life, Health and Environmental Sciences, Section of Epidemiology and Biostatistics Unit, University of L'Aquila, Piazzale Salvatore Tommasi 1, 67100 L'Aquila, Coppito (AQ), Italy
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Kapoula GV, Vennou KE, Bagos PG. Influenza and Pneumococcal Vaccination and the Risk of COVID-19: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:3086. [PMID: 36553093 PMCID: PMC9776999 DOI: 10.3390/diagnostics12123086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022] Open
Abstract
A number of studies have investigated the potential on-specific effects of some routinely administered vaccines (e.g., influenza, pneumococcal) on COVID-19 related outcomes, with contrasting results. In order to elucidate this discrepancy, we conducted a systematic review and meta-analysis to assess the association between seasonal influenza vaccination and pneumococcal vaccination with SARS-CoV-2 infection and its clinical outcomes. PubMed and medRxiv databases were searched up to April 2022. A random effects model was used in the meta-analysis to pool odds ratio (OR) and adjusted estimates with 95% confidence intervals (CIs). Heterogeneity was quantitatively assessed using the Cochran's Q and the I2 index. Subgroup analysis, sensitivity analysis and assessment of publication bias were performed for all outcomes. In total, 38 observational studies were included in the meta-analysis and there was substantial heterogeneity. Influenza and pneumococcal vaccination were associated with lower risk of SARS-CoV-2 infection (OR: 0.80, 95% CI: 0.75-0.86 and OR: 0.70, 95% CI: 0.57-0.88, respectively). Regarding influenza vaccination, it seems that the majority of studies did not properly adjust for all potential confounders, so when the analysis was limited to studies that adjusted for age, gender, comorbidities and socioeconomic indices, the association diminished. This is not the case regarding pneumococcal vaccination, for which even after adjustment for such factors the association persisted. Regarding harder endpoints such as ICU admission and death, current data do not support the association. Possible explanations are discussed, including trained immunity, inadequate matching for socioeconomic indices and possible coinfection.
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Affiliation(s)
- Georgia V. Kapoula
- Department of Biochemistry, General Hospital of Lamia, 35131 Lamia, Greece
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece
| | - Konstantina E. Vennou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece
| | - Pantelis G. Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece
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Jiang B, Huang Q, Jia M, Xue X, Wang Q, Yang W, Feng L. Association between influenza vaccination and SARS-CoV-2 infection and its outcomes: systematic review and meta-analysis. Chin Med J (Engl) 2022; 135:2282-2293. [PMID: 36378238 PMCID: PMC9771237 DOI: 10.1097/cm9.0000000000002427] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND World Health Organization recommends that influenza vaccines should benefit as much of the population as possible, especially where resources are limited. Corona virus disease 2019 (COVID-19) has become one of the greatest threats to health systems worldwide. The present study aimed to extend the evidence of the association between influenza vaccination and COVID-19 to promote the former. METHODS In this systematic review, four electronic databases, including the Cochrane Library, PubMed, Embase, and Web of Science, were searched for related studies published up to May 2022. All odds ratios (ORs) with 95% confidence intervals (CIs) were pooled by meta-analysis. RESULTS A total of 36 studies, encompassing 55,996,841 subjects, were included in this study. The meta-analysis for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection provided an OR of 0.80 (95% CI: 0.73-0.87). The statistically significant estimates for clinical outcomes were 0.83 (95% CI: 0.72-0.96) for intensive care unit admission, 0.69 (95% CI: 0.57-0.84) for ventilator support, and 0.69 (95% CI: 0.52-0.93) for fatal infection, while no effect seen in hospitalization with an OR of 0.87 (95% CI: 0.68-1.10). CONCLUSION Influenza vaccination helps limit SARS-CoV-2 infection and severe outcomes, but further studies are needed. REGISTRATION PROSPERO, CRD42022333747.
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Affiliation(s)
- Binshan Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Qiangru Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Mengmeng Jia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Xinai Xue
- Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Qing Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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Almadhoon HW, Hamdallah A, Elsayed SM, Hagrass AI, Hasan MT, Fayoud AM, Al-Kafarna M, Elbahnasawy M, Alqatati F, Ragab KM, Zaazouee MS, Hasabo EA. The effect of influenza vaccine in reducing the severity of clinical outcomes in patients with COVID-19: a systematic review and meta-analysis. Sci Rep 2022; 12:14266. [PMID: 35995930 PMCID: PMC9395333 DOI: 10.1038/s41598-022-18618-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 08/16/2022] [Indexed: 11/09/2022] Open
Abstract
Recent evidence suggests that vaccination against influenza may reduce the clinical outcomes of COVID-19. This study looked at the link between influenza vaccination and the severity of COVID-19 infection. We searched five databases until August 2021. We included studies that reported the relationship between influenza vaccination and COVID-19 outcomes. We pooled the data as risk ratio (RR) or mean difference (MD), with 95% confidence intervals (CIs), the data pooled using fixed and random effects models according to the heterogeneity of results. Sixteen observational studies with 191,496 COVID-19 patients were included. In terms of mechanical ventilation, our analysis showed a significant favor for the influenza vaccinated group over the non-vaccinated group (RR = 0.72, 95% CI [0.54, 0.96], P = 0.03). However, the analysis indicated no statistically significant differences between vaccinated and non-vaccinated groups in the term of mortality rate (RR = 1.20, 95% CI [0.71, 2.04], P = 0.50), hospital admissions (RR = 1.04, 95% CI [0.84, 1.29], P = 0.75), intensive care admissions (RR = 0.84, 95% CI [0.44, 1.62], P = 0.60). There were no significant differences between those who had received the influenza vaccine and those who had not in COVID-19 clinical outcomes, except for mechanical ventilation which showed a significantly lower risk in the influenza vaccinated group compared to the non-vaccinated one. However, future research is encouraged as our data have limitations, and the influenza vaccine is regularly updated. Also, this does not exclude the importance of the influenza vaccine during the COVID-19 pandemic.
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Affiliation(s)
- Hossam Waleed Almadhoon
- Faculty of Dentistry, Al-Azhar University - Gaza, Gaza Strip, Palestine.,International Medical Research Association (IMedRA), Cairo, Egypt
| | - Aboalmagd Hamdallah
- Faculty of Medicine, Al-Azhar University, Damietta, Egypt.,International Medical Research Association (IMedRA), Cairo, Egypt
| | - Sarah Makram Elsayed
- Faculty of Medicine, October 6 University, Giza, Egypt.,International Medical Research Association (IMedRA), Cairo, Egypt
| | - Abdulrahman Ibrahim Hagrass
- Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt.,International Medical Research Association (IMedRA), Cairo, Egypt
| | - Mohammed Tarek Hasan
- Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt.,International Medical Research Association (IMedRA), Cairo, Egypt
| | - Aya Mamdouh Fayoud
- Faculty of Pharmacy, Kafr El Sheikh University, Kafr El Sheikh, Egypt.,International Medical Research Association (IMedRA), Cairo, Egypt
| | - Mohammed Al-Kafarna
- Faculty of Pharmacy, Al-Azhar University - Gaza, Gaza Strip, Palestine.,International Medical Research Association (IMedRA), Cairo, Egypt
| | - Mohammad Elbahnasawy
- Faculty of Medicine, Alexandria University, Alexandria, Egypt.,International Medical Research Association (IMedRA), Cairo, Egypt
| | - Fadel Alqatati
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Khaled Mohamed Ragab
- Faculty of Medicine, Minia University, Minia, Egypt.,International Medical Research Association (IMedRA), Cairo, Egypt
| | - Mohamed Sayed Zaazouee
- Faculty of Medicine, Al-Azhar University, Assiut, Egypt.,International Medical Research Association (IMedRA), Cairo, Egypt
| | - Elfatih A Hasabo
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan. .,International Medical Research Association (IMedRA), Cairo, Egypt.
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