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Du P, Jin S, Lu S, Wang L, Ma X, Wang J, Huang R, Luo Q, Yang S, Feng X. Strategies to increase the coverage of influenza and pneumonia vaccination in older adults: a systematic review and network meta-analysis. Age Ageing 2024; 53:afae035. [PMID: 38476102 DOI: 10.1093/ageing/afae035] [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: 05/28/2023] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND It is urgent to implement interventions to increase vaccination rates of influenza/pneumonia vaccines in older adults, yet the effectiveness of different intervention strategies has not been thoroughly evaluated. OBJECTIVE We aimed to assess the effectiveness of intervention strategies for increasing the coverage of influenza/pneumonia vaccination in older adults. METHODS PubMed, Web of Science, Cochrane Library, Embase, China Biology Medicine disc, China National Knowledge Infrastructure and Wanfang were searched from 1 January 2000 to 1 October 2022. RCTs that assessed any intervention strategies for increasing influenza/pneumonia vaccination coverage or willingness in older adults were included. A series of random-effects network meta-analysis was conducted by using frequentist frameworks. RESULTS Twenty-two RCTs involving 385,182 older participants were eligible for further analysis. Eight types of intervention strategies were evaluated. Compared with routine notification, health education (odds ratio [OR], 1.85 [95%CI, 1.19 to 2.88]), centralised reminder (OR, 1.63 [95%CI, 1.07 to 2.47]), health education + onsite vaccination (OR, 2.89 [95%CI, 1.30 to 6.39]), and health education + centralised reminder + onsite vaccination (OR, 20.76 [95%CI, 7.33 to 58.74]) could effectively improve the vaccination rate. The evidence grade was low or very low due to the substantial heterogeneity among studies. CONCLUSIONS Our findings suggest that health education + centralised reminder + onsite vaccination may potentially be an effective strategy regardless of cost, but the evidence level was low. More rigorous trials are needed to identify the association between strategies and vaccination rates among older adults and to integrate such evidence into clinical care to improve vaccination rates.
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Affiliation(s)
- Peipei Du
- School of Intelligent Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Shuyan Jin
- Health Department, Shenzhen Maternity and Child Healthcare Hospital, Guangzhou, China
| | - Shuya Lu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Li Wang
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Xiaofeng Ma
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Jie Wang
- School of Medicine, Jinan University, Guangzhou, China
| | - Runting Huang
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Qingyue Luo
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Shu Yang
- School of Intelligent Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xixi Feng
- School of Public Health, Chengdu Medical College, Chengdu, China
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Barati M, Jormand H, Khazaei S, Bashirian S, Sadri M, Afshari M. Factors affecting subsequent dose of COVID-19 vaccine uptake based on BASNEF model among older adults. BMC Infect Dis 2024; 24:18. [PMID: 38166817 PMCID: PMC10763401 DOI: 10.1186/s12879-023-08903-8] [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: 09/04/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Vaccination is a primary prevention approach to preventing disease by disconnecting the transmission chain. The current study utilized a BASNEF model framework to identify factors influencing subsequent doses of COVID-19 vaccination among older adults. METHODS This cross-sectional study was performed in the west of Iran in May 2022. The participants were selected via multi-stage sampling. Finally, 1120 participants contributed to the present study. The questionnaire consisted of three sections: a) Socio-demographic characteristics, b) cognitive impairments tests, and c) Questionnaire about the subsequent dose of COVID-19 vaccine uptake based on the BASNEF model. Data were analyzed using the software IBM AMOS-20 and SPSS-23 via one-way analysis of variance (ANOVA) and independent sample T-tests were used, too. The significance level of statistical tests was regarded as less than 0.05. RESULTS The presented results of analyzing 50% of the variance of vaccination intention as the dependent variable (R square = 0.497) and 10% of the behavior variance as the dependent variable (R square = 0.104) can be explained based on the BASNEF model. The enabling factors (β = 0.636, p < 0.001) and the intention (β = 0.322, p < 0.001) were important factors for subsequent doses of COVID-19 vaccine uptake in older adults. CONCLUSION So, planning and implementing promotional intervention programs for older people (over 65; 80), females, illiterate, widows and divorced, good economic status, and urban areas is essential. It seems that enabling factors such as free vaccinations, vaccination inaccessible places such as public social security agencies, social supports such as involvement of the government and physicians, and improving information by the medium or knowledge-sharing experience, which can be further used to enhance the acceptance of subsequent doses of COVID-19 uptake in older adults.
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Affiliation(s)
- Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences and Department of Public Health, Asadabad School of Medical sciences, Asadabad, Iran, Hamadan, IR, Iran
| | - Hanieh Jormand
- Urology and Nephrology Research Center, Hamadan University of Medical Sciences, Hamadan, IR, Iran.
| | - Salman Khazaei
- Department of Epidemiology, School of Public and Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, IR, Iran
| | - Saeed Bashirian
- Department of Public Health, School of Public Health and Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, IR, Iran
| | - Mohadeseh Sadri
- Iranian Research Center on Aging, University of Social Walfare and Rehablitation Sciences, Tehran, IR, Iran
| | - Maryam Afshari
- Department of Public Health, School of Public Health and Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, IR, Iran
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Factors Influencing the Uptake of Seasonal Influenza Vaccination among Community-Dwelling Older Adults during COVID-19: A Mixed Methods Study. Vaccines (Basel) 2023; 11:vaccines11030641. [PMID: 36992225 DOI: 10.3390/vaccines11030641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/24/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
Background: Despite making the influenza vaccine accessible and affordable, vaccination rates remained low among community-dwelling older adults. Therefore, this study aimed to explore the factors influencing vaccine uptake and the impact of COVID-19 on vaccine uptake among community-dwelling older adults in Singapore. Methods: A mixed methods study involving a survey and semi-structured interviews were conducted between September 2020 and July 2021. Community-dwelling older adults aged ≥ 65 years were recruited from 27 Community Nurse Posts. Data on participants’ demographics, health condition(s), vaccination status, attitudes towards influenza infections and vaccinations, willingness to pay, intention for future vaccination and source of information were collected via the survey. Semi-structured interviews were conducted to understand vaccination experiences, key enablers and barriers, and the impact of COVID-19 on vaccine uptake. All interviews were analysed using Braun and Clarke’s thematic analysis. Quantitative data were analysed using descriptive statistics, chi-square tests and multinomial logistic regressions. Results: A total of 235 participants completed the survey. Living arrangement was a statistically significant contributing factor for influenza vaccine uptake (ꭓ2= −0.139; p = 0.03). Participants who lived alone were 2.5 times more likely to be vaccinated than those living with others (OR = 2.504, 95% CI: 1.294–4.842, p = 0.006). Avoidance of getting infected (82.5%), avoidance of transmission to others (84.7%), and advice from healthcare professionals to receive vaccination (83.4%) were key enablers, while concerns about possible side effects (41.2%), the effectiveness of the vaccine (42.6%), and not having enough information (48.1%) were barriers. Twenty participants were interviewed. The findings were congruent with the survey results. Five themes were identified as follows: (1) Perceived importance of influenza vaccination, (2) Sphere of influence, (3) Healthcare schemes and medical subsidies, (4) Psychological impediments, and (5) Inconsistent emphases at various touch points. Conclusions: Greater public health efforts are needed to reach out to the larger population of older adults of different living arrangements and those concerned about the possible side effects and effectiveness of the influenza vaccine. Healthcare professionals need to provide more information to address these concerns, especially during COVID-19, to encourage vaccine uptake.
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Perroud JM, Soldano S, Avanceña ALV, Wagner A. Adult vaccination uptake strategies in low- and middle-income countries: A systematic review. Vaccine 2022; 40:5313-5321. [PMID: 35953323 DOI: 10.1016/j.vaccine.2022.07.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/23/2022] [Accepted: 07/25/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Evidence-based strategies can maximize vaccination intent and uptake among adults. This systematic review summarizes the existing literature on strategies to improve vaccination intent and uptake among adults in low- and middle-income countries (LMICs) to inform future implementation in various populations and contexts. METHODS Eligible studies were identified through a systematic search in Medline, Embase, Cochrane Libraries, as well as grey literature databases published between January 2010 and March 2021. The search was limited to studies in LMICs that evaluated adult vaccination interventions. Data were extracted from the included studies and evaluated against the World Health Organization's Behavioral and Social Drivers of Vaccination Framework. The National Institutes of Health study quality assessment tools were used to evaluate study quality. RESULTS The initial literature review identified 2,854 records, 22 of which met the inclusion criteria. The majority (n = 19 or 86%) of studies were from middle-income countries, with the remaining studies (n = 3 or 13%) set in low-income countries. The majority (15/22, 68%) of interventions were multi-component. 82% (18/22) of studies addressed thoughts and feelings, 59% (13/22) addressed social processes, and 73% (16/22) addressed practical issues. Five studies reported primary outcomes of vaccination intent, and the remaining 17 reported vaccine uptake. 36% (8/22) of the studies cited statistically significant positive intervention effects on vaccination intent or uptake. Few of the included studies (6/22, 27%) were RTCs, and most studies (15/22, 68%) were of poor study quality. The studies reporting the highest increase in vaccination intent and uptake were multi-component interventions that addressed all three determinants of vaccination. DISCUSSION The results of this review highlight levers that can be used to encourage vaccine intent and uptake in the ongoing rollout of COVID-19 vaccines, as well as the deployment of other vaccines to adult populations in LMICs. Of the included studies, multicomponent interventions were most effective, mainly when targeting multiple determinants of vaccination. However, poor study quality indicates the need for additional research to validate these findings.
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Affiliation(s)
- Janamarie M Perroud
- Department of Health Management and Policy, School of Public Health, University of Michigan. 1415 Washington Heights, SPH II, Ann Arbor, MI 48109, USA.
| | - Shad Soldano
- School of Public Health, University of Michigan, 1415 Washington Heights, SPH II, Ann Arbor, MI 48109, USA
| | - Anton L V Avanceña
- Department of Health Management and Policy, School of Public Health, University of Michigan. 1415 Washington Heights, SPH II, Ann Arbor, MI 48109, USA
| | - Abram Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, SPH II, Ann Arbor, MI 48109, USA
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Trust in the public health system as a source of information on vaccination matters most when environments are supportive. Vaccine 2022; 40:4693-4699. [PMID: 35753840 DOI: 10.1016/j.vaccine.2022.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/06/2022] [Accepted: 06/02/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To understand whether health insurance coverage of vaccine costs and discussing vaccination with a healthcare provider are necessary for trust in CDC (Centers for Disease Control) to increase the uptake of the vaccine. METHOD A nationally representative sample of 2,549 adults from the United States answered questions about trust in CDC, insurance coverage, interactions with healthcare providers, and risk perceptions, and then provided longitudinal reports of actual vaccination against influenza during the course of the 2018-19 flu season. RESULTS Trust in CDC as a source of information on vaccines was a strong precursor of vaccination. According to multilevel regressions, however, this effect was localized to respondents who had insurance coverage or whose providers discussed the vaccine with them. Further, the effect of trust was even stronger when both insurance coverage and healthcare provider discussions were present. CONCLUSIONS Environmental factors supportive of vaccination increased the positive influence of trust in CDC on vaccine uptake by almost 50 percent. Insurance companies and healthcare providers can promote vaccination by covering the costs of vaccination and discussing vaccines in personalized conversations with patients.
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Modi BH, Pretorius D, Francis JM. A study on willingness to take the COVID-19 vaccine at a tertiary institution community in Johannesburg, South Africa. Afr J Prim Health Care Fam Med 2022; 14:e1-e7. [PMID: 35924625 PMCID: PMC9350184 DOI: 10.4102/phcfm.v14i1.3252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/25/2022] [Accepted: 03/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background South Africa is aiming to achieve herd immunity against the coronavirus disease 2019 (COVID-19) by the first quarter of 2022. The success of the COVID-19 vaccination roll-out depends primarily on the willingness of the population to take the vaccines. Aim This study aimed to examine the willingness to take the COVID-19 vaccine, along with the factors of concern, efficacy and preferences of the individual, which may increase the willingness to be vaccinated. Setting This study was conducted at the University of the Witwatersrand, Johannesburg, amongst adult students and academic and professional staff. Methods A cross-sectional online survey from 27 July 2021 to 14 August 2021 was conducted. We performed descriptive and inferential analysis to determine the factors associated with willingness to take the COVID-19 vaccine. Results A total of 2364 participants responded to a survey link and 82.0% were students, 66.8% were in the 18–29 years age band and females represented 64.0%. A total of 1965 participants (83.3%) were willing to receive a COVID-19 vaccine, the most preferred vaccines were Pfizer (41%) and J&J (23%), local pharmacy (29%) and General Practitioner (GP) (17%) were the preferred places for vaccination and the trusted sources of information on COVID-19 vaccines were the general practitioners (40.6%) and specialists (19.2%). Perceptions that vaccines are safe (adjusted odds ratio [aOR] = 31.56, 95% confidence interval [CI]: 16.02–62.12 for affirmative agreement) and effective (aOR = 5.92, 95% CI: 2.87–12.19 for affirmative agreement) were the main determinants of willingness to taking a COVID-19 vaccine. Conclusion It is imperative to reinforce the message of COVID-19 vaccine safety and efficacy and to include the GPs and the community pharmacies in the vaccination roll-out in South Africa.
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Affiliation(s)
- Bhadrashil H Modi
- Division of Family Medicine, Department of Family Medicine and Primary Care, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa; and, College of Medicine, Cape Town, South Africa; and, Private Practice Family Physician, Johannesburg.
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Li K, Yu T, Seabury SA, Dor A. Trends and Disparities in the Utilization of Influenza Vaccines Among Commercially Insured US Adults During the COVID-19 Pandemic. Vaccine 2022; 40:2696-2704. [PMID: 35370018 PMCID: PMC8960160 DOI: 10.1016/j.vaccine.2022.03.058] [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: 11/06/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/25/2022]
Abstract
Objectives Little is known about how the coronavirus disease 2019 (COVID-19) pandemic affected influenza vaccine utilization and disparities. We sought to estimate changes in the likelihood of receiving an influenza vaccine across different demographic subgroups during the COVID-19 pandemic. Methods In this cohort study, we analyzed influenza vaccine uptake from 2019 to 2020 using Optum commercial insurance claims data. Eligible individuals were aged 18 or above in 2018 and continuously enrolled from 08/01/2018 through 12/31/2020. Multivariable logistic regressions were fitted for the individual-level influenza vaccine uptake. Adjusting for demographic factors and medical histories, we estimated probabilities of receiving influenza vaccines before and after the COVID-19 pandemic across demographic subgroups. Results From August to December 2019, unadjusted influenza vaccination rate was 42.3%, while in the same period of 2020, the vaccination rate increased to 45.9%. Females had a higher vaccination rate in 2019 (OR: 1.16, 95% CI 1.15–1.16), but the increase was larger for males. Blacks and Hispanics had lower vaccination rates relative to whites in both flu seasons. Hispanics showed a greater increase in vaccination rate, increasing by 7.8 percentage points (p < .001) compared to 4.4 (p < .001) for whites. The vaccination rate for Blacks increased by 5.2 percentage points (p < .001). All income groups experienced vaccination improvements, but poorer individuals had lower vaccination rates in both seasons. The most profound disparities occurred when educational cohort were considered. The vaccination rate increased among college-educated enrollees by 8.8 percentage points (p < .001) during the pandemic compared to an increase of 2.8 percentage points (p < .001) for enrollees with less than a 12th grade education. Past influenza infections or vaccination increased the likelihood of vaccination (p < .001). Conclusions The COVID-19 pandemic was associated with increased influenza vaccine utilization. Disparities persisted but narrowed with respect to gender and race but worsened with respect to income and educational attainment.
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The Uptake and Vaccination Willingness of COVID-19 Vaccine among Chinese Residents: Web-Based Online Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10010090. [PMID: 35062751 PMCID: PMC8780410 DOI: 10.3390/vaccines10010090] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 02/01/2023] Open
Abstract
Objective: To investigate the uptake and vaccination willingness of the COVID-19 vaccine among Chinese residents and analyze the difference and factors that impact vaccination. Methods: The snowball sampling method was used to distribute online questionnaires. Relevant sociodemographic data along with the circumstances of COVID-19 vaccination were collected from the respondents. The χ2 test, independent samples t test and binary logistic regression analysis were used to analyze the data. Results: Among 786 respondents, 84.22% had been vaccinated. Over 80% of the vaccinated population have completed all the injections because of supporting the national vaccination policies of China, while the unvaccinated population (23.91%) is mainly due to personal health status. Meanwhile, statistical analysis revealed that the main predictors of not being vaccinated were younger age (3 to 18 years old), personal health status, and lower vaccinated proportion of family members and close friends (p < 0.05). Conclusions: There was a high level of uptake of the COVID-19 vaccine in China, and people who have not been vaccinated generally had a low willingness to vaccinate in the future. Based on our results, it suggested the next work to expand the coverage of the COVID-19 vaccination should be concentrated on targeted publicity and education for people who have not been vaccinated.
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Kaambwa B, Chen G, Khadka J, Milte R, Mpundu-Kaambwa C, Woods TJ, Ratcliffe J. A preference for quality: Australian general public's willingness to pay for home and residential aged care. Soc Sci Med 2021; 289:114425. [PMID: 34673356 DOI: 10.1016/j.socscimed.2021.114425] [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: 05/06/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 02/04/2023]
Abstract
In Australia and many other countries internationally, aged care services are provided to older people in their own homes or residential care facilities. The majority of these services are funded by the federal government using taxpayer contributions from the general public. However, the monetary value Australians place on aged care services, and the factors that predict this value, have not been examined. We, therefore, sought to determine the general public's willingness to pay (WTP) for aged care services and examine which factors influence this WTP. A cross-sectional contingent valuation survey was administered to a nationally representative cohort of 10,285 Australians between September and October 2020 from the general population aged 18 years and over. Respondents were asked to indicate their WTP values for satisfactory and high-quality aged care services to be provided in the future. A two-part regression model was used to explain what factors explained variation in WTP. In total, 80% (61%) of respondents were willing to pay to access satisfactory (high) quality home care (counterpart figures for residential care were 64% (45%)). On average, respondents were willing to pay between $126 and $158 ($145 and $237) per week to receive satisfactory-quality (high-quality) home care and between $333 and $520 ($308 and $680) per week for satisfactory-quality (high-quality) residential care. Respondents were willing to pay an additional $120 per week on average to access high-quality aged care. Higher WTP values were generally associated with being younger, male, recent experience with aged care through a close family member accessing aged care and ability to pay. These results suggest general public support for payment of individual co-contributions to access aged care services in the future.
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Affiliation(s)
- Billingsley Kaambwa
- Health Economics, College of Medicine & Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, South Australia, 5042, Australia.
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Victoria, 3145, Australia
| | - Jyoti Khadka
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Sturt North Building, Sturt Road, Bedford Park, South Australia, 5042, Australia; Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, 5000, Australia
| | - Rachel Milte
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Sturt North Building, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Christine Mpundu-Kaambwa
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Sturt North Building, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Taylor-Jade Woods
- Health Economics, College of Medicine & Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, South Australia, 5042, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Sturt North Building, Sturt Road, Bedford Park, South Australia, 5042, Australia
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Zhou R, Zeng Q, Yang H, Xu Y, Tan G, Liu H, Wang L, Zhou H, Zhang M, Feng J, Jin T, Zhang X, Wang J, Zhang X, Gao F, Yang C, Bu B, Li C, Zhang M, Dong H, Lin A, Liu W, Wu L, Wang M, Tang Y, Wang H, Long Y, Wang Z, Zheng W. Status of Immunotherapy Acceptance in Chinese Patients With Multiple Sclerosis: Analysis of Multiple Sclerosis Patient Survival Report 2018. Front Neurol 2021; 12:651511. [PMID: 33897605 PMCID: PMC8060470 DOI: 10.3389/fneur.2021.651511] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/03/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: The prevalence of multiple sclerosis (MS) in China is low, although it has been increasing recently. Owing to the paucity of data on immunotherapy acceptance in the Chinese population, we conducted this study to analyze factors affecting the acceptance of immunotherapy and selection of disease-modifying therapies (DMTs) based on personal and clinical data of patients with MS. Methods: In this study, data were obtained from the Multiple Sclerosis Patient Survival Report 2018, which was the first national survey of patients with MS in China. There were 1,212 patients with MS from 31 provinces who were treated at 49 Chinese hospitals over a 4-month period from May 2018 to August 2018, and the patients were asked to complete online questionnaires to assess their understanding of the disease. Results: In general, highly educated patients with frequent relapses were more willing to receive treatment regardless of DMTs or other immunotherapy, and patients with more understanding of the disease opted to be treated. Younger patient population, patients with severe disease course, and those with more symptoms were likely to choose the treatment. Moreover, a higher proportion of women chose to be treated with DMTs than with other immunotherapies. Conclusions: Education status and patient awareness of the disease impact the treatment acceptance in Chinese patients with MS. Therefore, we call for improving the awareness of MS disease and social security to help patients to improve their quality of life.
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Affiliation(s)
- Ran Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qiuming Zeng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Huan Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yan Xu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guojun Tan
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hongbo Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lihua Wang
- Department of Neurology, The Second Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Hongyu Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Meini Zhang
- Department of Neurology, The First Affiliated Hospital of Shanxi Medical University, Taiyuan, China
| | - Jinzhou Feng
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tao Jin
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Xinghu Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiawei Wang
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xu Zhang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Feng Gao
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Chunsheng Yang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bitao Bu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunyang Li
- Department of Neurology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Min Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiqing Dong
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Aiyu Lin
- Department of Neurology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Weibin Liu
- Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lei Wu
- Department of Neurology, General Hospital of the People's Liberation Army, Beijing, China
| | - Manxia Wang
- Department of Neurology, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Yulan Tang
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Honghao Wang
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Youming Long
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhe Wang
- Department of Neurology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Weihong Zheng
- Department of Neurology, Affiliated Zhongshan Hospital, Xiamen University, Xiamen, China
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Li P, Hayat K, Jiang M, Pu Z, Yao X, Zou Y, Lambojon K, Huang Y, Hua J, Xiao H, Du F, Shi L, Zhai P, Ji W, Feng Z, Gong Y, Fang Y. Impact of video-led educational intervention on the uptake of influenza vaccine among adults aged 60 years and above in China: a study protocol for a randomized controlled trial. BMC Public Health 2021; 21:222. [PMID: 33499830 PMCID: PMC7839176 DOI: 10.1186/s12889-021-10220-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 01/12/2021] [Indexed: 11/15/2022] Open
Abstract
Background Influenza is a global health threat to older adults, and the influenza vaccine is the most effective approach to prevent influenza infection. However, influenza vaccination coverage among Chinese older adults is far less than in developed countries such as the United States (4.0% vs. 64.9%). This study aims to increase influenza vaccination coverage in Chinese adults ≥60 years using a video-led educational intervention conducted by medical students. Methods A cluster randomized controlled trial will be conducted in 4 districts of Xi’an city, Shaanxi Province, China, using a stratified sampling approach. Adults aged ≥60 years will be recruited from 8 community hospitals. A self-administered questionnaire of knowledge, attitudes, and practices (KAP) will be employed to record the KAP score. During the 6-month interventional period, participants in the intervention group will receive educational videos focused on influenza and influenza vaccination, coupled with a group discussion conducted by the medical students. For those in the control group, no intervention will be provided. The outcomes measured in both groups will be the influenza vaccination coverage and the KAP scores of all participants. Discussion Medical students are more likely to educate older adults about scientific knowledge of influenza and its vaccine compared to clinical practitioners, who, most of the time, remain over-occupied due to the extensive workload. Video-led counseling and education could be a useful option to optimize older adults’ understanding of influenza and influenza vaccination. This eventually could improve the uptake of influenza vaccine among Chinese older adults. Trial registration Chinese Clinical Trial Registry; ChiCTR2000034330; Registered 3rd July 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10220-1.
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Affiliation(s)
- 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China.,Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, 54000, Pakistan
| | - 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Zhaojing Pu
- 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Yamin Zou
- Department of Pharmacy, the Hospital of Xi'an Jiaotong University, Xi'an, 710049, China
| | - Krizzia Lambojon
- 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Yifan Huang
- 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Jinghua Hua
- 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Hanri Xiao
- 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Fulei Du
- 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Li Shi
- 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Panpan Zhai
- 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Wenjing Ji
- 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China
| | - Zhitong Feng
- 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, 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 Centre for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, 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 Centre for Health Reform and Development Research, Xi'an, 710061, China. .,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, China's Western Technological Innovation Harbor, Xi'an, 710061, China.
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12
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Erazo CE, Erazo CV, Grijalva MJ, Moncayo AL. Knowledge, attitudes and practices on influenza vaccination during pregnancy in Quito, Ecuador. BMC Public Health 2021; 21:72. [PMID: 33413252 PMCID: PMC7791889 DOI: 10.1186/s12889-020-10061-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 12/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses in pregnant women and their children. In Ecuador, the coverage of seasonal influenza vaccination in pregnant women is low. The aim of this study was to assess the knowledge, attitudes, and practices (KAP) of pregnant women toward influenza vaccination in Quito-Ecuador. Methods A cross-sectional study enrolled 842 women who delivered at three main public gynecological-obstetric units of the Metropolitan District of Quito. A questionnaire regarding demographics, antenatal care, risk conditions and knowledge, attitudes and practices related to influenza vaccination was administered. We examined factors associated with vaccination using log-binomial regression models. Results A low vaccination rate (36.6%) against influenza was observed among pregnant women. The factors associated with vaccination included the recommendations from health providers (adjusted PR: 15.84; CI 95% 9.62–26.10), belief in the safety of the influenza vaccine (adjusted PR: 1.53; CI 95% 1.03–2.37) and antenatal care (adjusted PR: 1.21; CI 95% 1.01–1.47). The most common reasons for not vaccinating included the lack of recommendation from health care providers (73.9%) and lack of access to vaccine (9.0%). Conclusions Health educational programs aimed at pregnant women and antenatal care providers have the most potential to increase influenza vaccination rates. Further studies are needed to understand the barriers of health care providers regarding influenza vaccination in Ecuador. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10061-4.
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Affiliation(s)
- Carlos E Erazo
- Centro de Investigación para la Salud en América Latina (CISeAL), Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador
| | - Carlos V Erazo
- Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador
| | - Mario J Grijalva
- Centro de Investigación para la Salud en América Latina (CISeAL), Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador.,Department of Biomedical Sciences, Infectious and Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, 45701, USA
| | - Ana L Moncayo
- Centro de Investigación para la Salud en América Latina (CISeAL), Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Apartado, 1701-2184, Quito, Ecuador.
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13
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Le XTT, Nguyen HT, Le HT, Do TTT, Nguyen TH, Vu LG, Nguyen CT, Hoang MT, Tran BX, Latkin CA, Ho CSH, Ho RCM. Rural-urban differences in preferences for influenza vaccination among women of childbearing age: implications for local vaccination service implementation in Vietnam. Trop Med Int Health 2020; 26:228-236. [PMID: 33164300 DOI: 10.1111/tmi.13515] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Pregnant women and new mothers are among the most vulnerable to seasonal influenza; however, little is known about their preferences for flu vaccination. We examined the rural-urban differences in uptake, demand and willingness to pay (WTP) for influenza vaccination among women of childbearing age, to assess the feasibility of implementing locally produced vaccines in Vietnam. METHODS A cross-sectional study was performed in both urban and rural areas of Hanoi in 2018. Socio-demographic characteristics, history of vaccination, demand and WTP for influenza vaccines were obtained. A multivariate logistic regression model was employed to identify the associated factors. RESULTS Of 750 participants, 29.9% had had flu shots in the current or previous flu season and 64.3% indicated demand for this vaccine. The median of the maximum amount of WTP for influenza vaccination services was US$ 8.5 (IQR: 8.5-17.0). Women living in rural areas had a significantly lower uptake and higher demand, and were willing to pay less than women in urban locations (21.1% vs. 36.6%; 69% vs. 60.2%; and US $8.5 vs. US $11.7, respectively). For urban participants, factors associated with higher demand and WTP for flu shots included having ANC in health facilities and having been vaccinated against influenza in the past; for rural women, these factors were having suffered from influenza and hearing about it. CONCLUSIONS This study informs the feasibility of implementing locally produced influenza vaccines in Vietnam. Educational programs, along with counselling services and government subsidies, should be implemented to improve the coverage, demand and WTP for the vaccine.
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Affiliation(s)
- Xuan T T Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Hien T Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Huong T Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Toan T T Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Thang H Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Linh G Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Cuong T Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Men T Hoang
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Bach X Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Institute for Health Innovation and Technology, National University of Singapore, Singapore
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14
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Harapan H, Wagner AL, Yufika A, Setiawan AM, Anwar S, Wahyuni S, Asrizal FW, Sufri MR, Putra RP, Wijayanti NP, Salwiyadi S, Maulana R, Khusna A, Nusrina I, Shidiq M, Fitriani D, Muharrir M, Husna CA, Yusri F, Maulana R, Rajamoorthy Y, Groneberg DA, Müller R, Mudatsir M. Acceptance and willingness to pay for a hypothetical vaccine against monkeypox viral infection among frontline physicians: A cross-sectional study in Indonesia. Vaccine 2020; 38:6800-6806. [PMID: 32861468 PMCID: PMC9628749 DOI: 10.1016/j.vaccine.2020.08.034] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 08/01/2020] [Accepted: 08/14/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND A clinical trial is ongoing to evaluate the safety and efficacy of a monkeypox vaccine among healthcare workers (HCWs). The critical question that needs to be addressed is whether HCWs are willing to accept and purchase this vaccine. The objective of this study was to evaluate the acceptance and willingness to pay (WTP) for the vaccine among HCWs. METHODS From May to July 2019, a cross-sectional study was conducted among registered general practitioners (GPs) in Indonesia. A contingent valuation method was employed to evaluate the WTP. Besides acceptance and WTP, various explanatory variables were also collected and assessed. A logistic regression and a multivariable linear regression were used to explore the explanatory variables influencing acceptance and WTP, respectively. RESULTS Among 407 respondents, 391 (96.0%) expressed acceptance of a free vaccination. The mean and median WTP was US$ 37.0(95%CI:US$ 32.76-US$ 41.23) and US$ 17.90(95%CI:US$ 17.90-US$ 17.90), respectively. In an unadjusted analysis, those 30 years old or younger had 2.94 times greater odds of vaccine acceptance compared to those who were older (95%CI: 1.07-8.08). Location of alma mater, type of workplace, length of individual medical experience, and monthly income of GPs were all significantly associated with WTP. CONCLUSION Although the vast majority of GPs would accept a freely provided vaccine, they were also somewhat price sensitive. This finding indicates that partial subsidy maybe required to achieve high vaccine coverage, particularly among GPs at community health centres or those with a shorter duration of medical practice.
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Affiliation(s)
- Harapan Harapan
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia; Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia; Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
| | - Abram L Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Amanda Yufika
- Department of Family Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia
| | - Abdul M Setiawan
- Department of Microbiology, Faculty of Medicine and Health Sciences, Maulana Malik Ibrahim State Islamic University of Malang, Malang, East Java 65144, Indonesia
| | - Samsul Anwar
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia
| | - Sri Wahyuni
- Faculty of Medicine, Universitas Malikussaleh, Lhokseumawe, Aceh 24531, Indonesia
| | | | - Muhammad R Sufri
- Banda Aceh Port Health Office, Ministry of Health, Aceh Besar, Aceh 23352, Indonesia
| | - Reza P Putra
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia
| | | | - Salwiyadi Salwiyadi
- Department of Internal Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh 23111, Indonesia
| | - Razi Maulana
- Department of Obstetrics and Gynecology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh 23111, Indonesia
| | | | - Ina Nusrina
- Department of Health Service, District Health Office, Aceh Besar, Aceh 23912, Indonesia
| | - Muhammad Shidiq
- Nusa Jaya Community Health Center, Halmahera Timur, North Maluku 97863, Indonesia
| | - Devi Fitriani
- Teunom Community Health Center, Aceh Jaya, Aceh 23653, Indonesia
| | - Muharrir Muharrir
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia
| | - Cut A Husna
- Department of Microbiology, Universitas Malikussaleh, Lhokseumawe, Aceh 24531, Indonesia
| | - Fitria Yusri
- Faculty of Medicine, Universitas Malikussaleh, Lhokseumawe, Aceh 24531, Indonesia
| | - Reza Maulana
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia
| | - Yogambigai Rajamoorthy
- Department of Economics, Faculty of Accountancy and Management, Universiti Tunku Abdul Rahman, Kajang, Selangor 43200, Malaysia
| | - David Alexander Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | - Ruth Müller
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany; Unit of Medical Entomology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Mudatsir Mudatsir
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia; Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia; Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia
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15
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Rauh LD, Lathan HS, Masiello MM, Ratzan SC, Parker RM. A Select Bibliography of Actions to Promote Vaccine Literacy: A Resource for Health Communication. JOURNAL OF HEALTH COMMUNICATION 2020; 25:843-858. [PMID: 33719890 DOI: 10.1080/10810730.2021.1878312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In this bibliography, the researchers provide an introduction to the available evidence base of actions to promote vaccine literacy. The research team organized interventions to create a tool that can inform health communicators and practitioners seeking a resource focused on strategy and implementation design for actions that support vaccine literacy. This scoping bibliography is honed specifically to respond to the urgency of the current pandemic, when supporting and increasing vaccine literacy offers promise for achieving the critically needed high levels of vaccination. Over the course of the coming months and year, this bibliography will be a dynamic and "living" document hosted and maintained on vaccineliteracy.com.
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Affiliation(s)
- Lauren D Rauh
- Department of Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Hannah S Lathan
- Department of Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | | | - Scott C Ratzan
- Department of Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Ruth M Parker
- Division of General Medicine, Emory University School of Medicine, Atlanta, GA, USA
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16
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Robin RC, Noosorn N, Alif SM. Secondhand Smoking Among Children in Rural Households: A Community Based Cross-Sectional Study in Bangladesh. Osong Public Health Res Perspect 2020; 11:201-208. [PMID: 32864311 PMCID: PMC7442452 DOI: 10.24171/j.phrp.2020.11.4.09] [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] [Indexed: 11/05/2022] Open
Abstract
Objectives This study aimed to determine the factors associated with reducing exposure to secondhand smoke among children in households of rural Bangladesh. Methods A cross-sectional study of 410 smokers and non-smokers, in 6 villages of Munshigonj district was conducted. Data were collected randomly using a self-administrative questionnaire. Differences between variables were assessed using Chi-square or Fisher's exact test (as appropriate). Univariate and multivariate logistic regression models were used to investigate associations. All results were presented as unadjusted and adjusted odds ratios with a 95% confidence interval. The level of statistical significance was reached when p < 0.05. Results A smoker in the household was determined to be a risk factor associated with exposure of other household members to secondhand smoke (p < 0.001). Higher education, strict implementation of household smoke-free rules, a higher influence of social norms and culture, as well as moderate knowledge on exposure to secondhand smoke were considered as preventive factors associated with exposure of others in the home to secondhand smoke. Conclusion Exposure to secondhand smoke is an extensive and preventable risk factor for children, and reducing exposure to secondhand smoke will have a largely positive effect in the community. An effective public health intervention model may reduce secondhand smoking.
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Affiliation(s)
- Rishad Choudhury Robin
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Narongsak Noosorn
- Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Sheikh Mohammad Alif
- epartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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17
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Danziger J, Weinhandl E, Friedman D, Mukamal KJ. Racial and Ethnic Disparities in Seasonal Influenza Vaccination among Dialysis Facilities in the United States. J Am Soc Nephrol 2020; 31:2117-2121. [PMID: 32817310 DOI: 10.1681/asn.2020040483] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/29/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Racial and ethnic disparities in vaccination rates for seasonal influenza exist. Whether such disparities extend to patients with ESKD, who simultaneously are at risk for complications of infection and have extensive contact with health care providers, has not been investigated. METHODS To determine whether the proportion of patients vaccinated at a dialysis facility differs according to the facility's racial and ethnic composition, we examined dialysis facility data reported to the Centers for Medicare and Medicaid Services. The main outcome was the proportion of facility patients vaccinated for influenza among 6735 Medicare-certified facilities operating between 2014 and 2017. RESULTS Among dialysis facilities, the mean percentage of patients vaccinated during the influenza season was 72.1%. Facilities with higher proportions of Black and Hispanic patients had significantly lower vaccination percentages than less diverse facilities. The average proportion of patients vaccinated at each facility decreased significantly from 2014 to 2017 (a decrease of 1.05% vaccinated per year) and decreased significantly more so among facilities with higher minority proportions. The share of vaccinated patients in facilities in the quartile with the highest proportion of Black patients decreased 1.21% per year compared with a decrease of 0.88% per year in facilities in the quartile with the lowest proportion of Black patients. We found similar trends for Hispanic patients. CONCLUSIONS Rates of seasonal influenza vaccination are modestly but significantly lower among dialysis facilities with larger proportions of minority patients, and the gap seems to be widening over time. As wide-scale vaccination efforts grow more urgent amid the current COVID-19 pandemic, these disparities must be addressed to protect patients and communities equitably.
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Affiliation(s)
- John Danziger
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Eric Weinhandl
- Department of Pharmaceutical Care and Health Systems, University of Minnesota, Minneapolis, Minnesota.,Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | - David Friedman
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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18
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Mantel C, Chu SY, Hyde TB, Lambach P. Seasonal influenza vaccination in middle-income countries: Assessment of immunization practices in Belarus, Morocco, and Thailand. Vaccine 2020; 38:212-219. [PMID: 31699507 PMCID: PMC6961110 DOI: 10.1016/j.vaccine.2019.10.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 10/09/2019] [Accepted: 10/10/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Vaccines for the control of seasonal influenza are recommended by the World Health Organization (WHO) for use in specific risk groups, but their use requires operational considerations that may challenge immunization programs. Several middle-income countries have recently implemented seasonal influenza vaccination. Early program evaluation following vaccine introduction can help ascertain positive lessons learned and areas for improvement. METHODS An influenza vaccine post-introduction evaluation (IPIE) tool was developed jointly by WHO and the U.S. Centers for Disease Control and Prevention to provide a systematic approach to assess influenza vaccine implementation processes. The tool was used in 2017 in three middle-income countries: Belarus, Morocco and Thailand. RESULTS Data from the three countries highlighted a number of critical factors: Health workers (HWs) are a key target group, given their roles as key influencers of acceptance by other groups, and for ensuring vaccine delivery and improved coverage. Despite WHO recommendations, pregnant women were not always prioritized and may present unique challenges for acceptance. Target group denominators need to be better defined, and vaccine coverage should be validated with vaccine distribution data, including from the private sector. There is a need for strengthening adverse events reporting and for addressing potential vaccine hesitancy through the establishment of risk communication plans. The assessments led to improvements in the countries' influenza vaccination programs, including a revision of policies, changes in vaccine management and coverage estimation, enhanced strategies for educating HWs and intensified collaboration between departments involved in implementing seasonal influenza vaccination. CONCLUSION The IPIE tool was found useful for delineating operational strengths and weaknesses of seasonal influenza vaccination programs. HWs emerged as a critical target group to be addressed in follow-up action. Findings from this study can help direct influenza vaccination programs in other countries, as well as contribute to pandemic preparedness efforts. The updated IPIE tool is available on the WHO website http://www.who.int/immunization/research/development/influenza/en/index1.html.
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Affiliation(s)
| | - Susan Y Chu
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Terri B Hyde
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Philipp Lambach
- Initiative for Vaccine Research, World Health Organization, Geneva, Switzerland
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Abiye S, Yitayal M, Abere G, Adimasu A. Health professionals' acceptance and willingness to pay for hepatitis B virus vaccination in Gondar City Administration governmental health institutions, Northwest Ethiopia. BMC Health Serv Res 2019; 19:796. [PMID: 31690313 PMCID: PMC6833239 DOI: 10.1186/s12913-019-4671-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 10/23/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is a global public health problem. The burden of the disease is high in low and middle income countries like Ethiopia. However, for highly vulnerable groups such as health professionals, vaccination coverage is a major issue in the developing countries where health professionals are expected to pay for vaccination. Therefore, the objective of this study was to assess health professionals' acceptance and willingness to pay (WTP) and associated factors for vaccination against HBV. METHODS Cross-sectional study was conducted from March to April, 2017 in Gondar city administration governmental health institutions among 423 health professionals. Simple random sampling method was employed to select the study participants. Data were collected using self- administered questionnaire. Tobit model was used to analyze the determinants of WTP and the maximum amount of money the individuals might pay for HBV vaccination. P-value < 0.05 was considered statistically significant. RESULT A total of 423 health professionals (physicians, nurses, midwives, laboratory technicians/technologists, and others) participated in the study with a response rate of 100, and 62.4% of them were willing to pay for HBV vaccination. The mean amount of money the participants might pay for HBV vaccination was 325.83 ± 283.46 ETB (US$ 14.39 ± 12.52). The study indicated that the WTP for HBV vaccination of health professionals from health centers was 179.41 ETB less compared to health professionals from hospital. The WTP for HBV vaccination of the participants who had no experience of seeing previous patients with HBV was 157.87 ETB less compared to participants who had experience of seeing previous patients with HBV. As monthly income of the study participants increased by one ETB, the WTP was increased by 0.027 ETB. CONCLUSION The study revealed that the mean amount of money the participants might pay for HBV vaccination was much less than the market price for HBV vaccination. Type of workplace and experience of seeing/observing patients with HBV, and income were the predictors of WTP for HBV vaccination. Availing the vaccine with affordable cost in governmental health institutions may increase WTP of health professionals for HBV vaccination.
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Affiliation(s)
- Siwule Abiye
- University of Gondar Referral Hospital, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mezgebu Yitayal
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Giziew Abere
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asefa Adimasu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Sheldenkar A, Lim F, Yung CF, Lwin MO. Acceptance and uptake of influenza vaccines in Asia: A systematic review. Vaccine 2019; 37:4896-4905. [PMID: 31301918 DOI: 10.1016/j.vaccine.2019.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 06/04/2019] [Accepted: 07/02/2019] [Indexed: 12/17/2022]
Abstract
In Asia, the public health burden of influenza is significant despite the existence of efficacious influenza vaccines. Annual seasonal influenza vaccination can reduce the incidence of influenza significantly, yet influenza vaccination coverage remains low in this part of the world. As a densely populated region with varying climatic zones and a larger proportion of developing countries compared to the West, Asia is at increased risk of influenza. To provide a more comprehensive and nuanced understanding of the Asian region, the key objective of this systematic review is to examine the determinants of vaccination uptake in Asia, beyond that of existing studies that have largely been western-centric. We carried out a systematic review of peer-reviewed scientific research, examining the key determinants, acceptance and uptake of influenza vaccinations across Asia. A comprehensive search strategy was defined to capture studies that met the inclusion criteria of articles published in English, from 2008 to 2018, focusing on adult populations within Asia. A total of 83 relevant studies were appraised in this review. Analyses of the extant data confirmed that vaccination rates within Asia are low, and that most countries lack scientific research on vaccination behaviours. Studies were categorised into four different population groups: healthcare workers, high risk groups, general population and uniform groups. The motivators and deterrents for vaccine uptake varied according to population groups and characteristics. Both general populations and healthcare workers were concerned with vaccine safety and efficacy, and recommendations from health authorities were influential in vaccine uptake within the other populations. The findings suggest that further research is needed within a broader range of Asian countries to garner greater in-depth knowledge of vaccination behaviours in the region. In particular, influenza vaccination programs within Asia should focus on improving engagement more effectively, through greater relatability and transparency of data when educating the public.
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Affiliation(s)
- Anita Sheldenkar
- Wee Kim Wee School of Communication and Information, Nanyang Technological University (NTU), Singapore.
| | - Fann Lim
- Wee Kim Wee School of Communication and Information, Nanyang Technological University (NTU), Singapore
| | - Chee Fu Yung
- KK Women's and Children's Hospital (KKH), Singapore; Duke-NUS Graduate Medical School, Singapore
| | - May O Lwin
- Wee Kim Wee School of Communication and Information, Nanyang Technological University (NTU), Singapore
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Vayisoglu SK, Zincir H. The Health Action Process Approach-Based Program's Effects on Influenza Vaccination Behavior. J Nurse Pract 2019. [DOI: 10.1016/j.nurpra.2019.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Korkmaz P, Paşali Kilit T, Onbaşi K, Mistanoglu Ozatag D, Toka O. Influenza vaccination prevalence among the elderly and individuals with chronic disease, and factors affecting vaccination uptake. Cent Eur J Public Health 2019; 27:44-49. [PMID: 30927396 DOI: 10.21101/cejph.a5231] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Our aim is to evaluate influenza vaccination rates among the elderly and individuals with underlying chronic disease, and factors that affect vaccination uptake. METHODS The study comprised individuals aged 18-65 years with underlying chronic diseases, and individuals aged over 65 years. Literature-based questionnaires prepared by the researcher regarding vaccination were completed through face-to-face interviews by the principal investigator. RESULTS A total of 818 participants were included in the study, 257 (31.4%) were males. The mean age of participants was 57.47 ± 14.11 years; 274 (33.5%) were aged 65 years and over. One hundred and three (12.6%) participants stated that they received vaccinations against influenza annually, and 144 (17.6%) stated that they had vaccination against influenza in the 2015/16 or 2016/17 season. Fifty-two (19%) participants aged more than 65 years stated that they received vaccinations against influenza annually, 75 (27.4%) stated that they had vaccination against influenza in the 2015/16 or 2016/17 season. The most commonly determined reasons for not receiving vaccination were not knowing that it was necessary (34%) and believing that vaccination was not necessary because they were healthy (26%). Statistically significantly more participants who gained their knowledge from a physician were vaccinated than those whose knowledge came from other sources (p < 0.05). Participants who considered that they had sufficient information about influenza were vaccinated more frequently, the results were statistically significant (p < 0.05). CONCLUSION Informing target risk groups about influenza vaccination by physicians and increasing awareness about influenza may contribute to increasing vaccination rates.
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Affiliation(s)
- Pinar Korkmaz
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey
| | - Türkan Paşali Kilit
- Department of Internal Medicine, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey
| | - Kevser Onbaşi
- Department of Internal Medicine, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey
| | - Duru Mistanoglu Ozatag
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey
| | - Onur Toka
- Department of Statistics, Hacettepe University, Ankara, Turkey
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Pereira JA, Gilca V, Waite N, Andrew MK. Canadian older adults' perceptions of effectiveness and value of regular and high-dose influenza vaccines. Hum Vaccin Immunother 2018; 15:487-495. [PMID: 30204043 PMCID: PMC6422457 DOI: 10.1080/21645515.2018.1520580] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/15/2018] [Accepted: 08/30/2018] [Indexed: 01/06/2023] Open
Abstract
Influenza vaccination is an important public health intervention for older adults, yet vaccination rates remain suboptimal. We conducted an online survey of Canadians ≥ 65 years to explore satisfaction with publicly-funded standard-dose influenza vaccines, and perceptions of the need for a more effective product. They were provided with information about currently approved influenza vaccines, and were asked about their preferences should all formulations be available for free, and should the recently approved high-dose (HD) vaccine for seniors be available at a cost. From March to April 2017, 5014 seniors completed the survey; mean age was 71.3 ± 5.17 years, 50% were female, and 42.6% had one or more chronic conditions. 3403 (67.9%) had been vaccinated against influenza in the 2016/17 season. Of all respondents, 3460 (69%) were satisfied with the standard-dose influenza vaccines, yet 3067 (61.1%) thought that a more effective vaccine was/may be needed. If HD was only available at a cost, 1426 (28.4%) respondents would consider it, of whom 62.9% would pay $20 or less. If all vaccines were free next season, 1914 (38.2%) would opt for HD (including 12.2% of those who previously rejected influenza vaccines), 856 (17.1%) would choose adjuvanted vaccine, and 558 (11.1%) standard-dose vaccine. 843 (16.8%) of respondents were against vaccines, 451 (9.0%) had no preference and 392 (7.8%) were uncertain. Making this product available through publicly funded programs may be a strategy to increase immunization rates in this population.
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Affiliation(s)
| | - Vladimir Gilca
- Institut national de santé publique du Québec, Laval University, Quebec City, QC, Canada
| | - Nancy Waite
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Melissa K. Andrew
- Division of Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
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Parsons JE, Newby KV, French DP. Do interventions containing risk messages increase risk appraisal and the subsequent vaccination intentions and uptake? - A systematic review and meta-analysis. Br J Health Psychol 2018; 23:1084-1106. [PMID: 30225851 PMCID: PMC6767484 DOI: 10.1111/bjhp.12340] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 08/21/2018] [Indexed: 01/26/2023]
Abstract
Purpose There is good evidence that for many behaviours, increasing risk appraisal can lead to a change in behaviour, heightened when efficacy appraisals are also increased. The present systematic review addressed whether interventions presenting a risk message increase risk appraisal and an increase in vaccination intentions and uptake. Method A systematic search identified randomized controlled trials of interventions presenting a risk message and measuring risk appraisal and intentions and uptake post‐intervention. Random‐effects meta‐analyses investigated the size of the effect that interventions had on vaccination risk appraisal and on vaccination behaviour or intention to vaccinate, and the size of the relationship between vaccination risk appraisal and vaccination intentions and uptake. Results Eighteen studies were included and 16 meta‐analysed. Interventions overall had small significant effects on risk appraisal (d = 0.161, p = .047) and perceptions of susceptibility (d = 0.195, p = .025), but no effect on perceptions of severity (d = −0.036, p = .828). Interventions showed no effect on intention to vaccinate (d = 0.138, p = .195) and no effect on vaccination behaviour (d = 0.043, p = .826). Interventions typically did not include many behaviour change techniques (BCTs), with the most common BCT unique to intervention conditions being ‘Information about Health Consequences’. Few of the included studies attempted to, or successfully increased, efficacy appraisals. Conclusions Overall, there is a lack of good‐quality primary studies, and existing interventions are suboptimal. The inclusion of additional BCTs, including those to target efficacy appraisals, could increase intervention effectiveness. The protocol (CRD42015029365) is available from http://www.crd.york.ac.uk/PROSPERO/. Statement of contribution What is already known on this subject? Previous research indicates that an increase in risk appraisal is associated with increased uptake in health‐related behaviours. Research suggests that interventions increasing risk appraisal have a greater effect on intention when elements of efficacy appraisals are simultaneously increased. What does this study add? This is the first systematic review to examine the effect of interventions on risk appraisal and vaccination uptake using only experimental studies. Limitations of the interventions themselves, and those caused by study methods and reporting, mean that the potential value of this type of review is lost. Instead, its value is in shining a light on the paucity of experimental studies in this area, and the quality of methods and reporting used. Future experimental studies should examine interventions that focus exclusively on increasing risk and efficacy appraisal compared to controls, use conditional measures of risk, and improve reporting to enable both more accurate coding of intervention content and more accurate assessments of study bias.
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Thomas RE, Lorenzetti DL. Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database Syst Rev 2018; 5:CD005188. [PMID: 29845606 PMCID: PMC6494593 DOI: 10.1002/14651858.cd005188.pub4] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The effectiveness of interventions to increase influenza vaccination uptake in people aged 60 years and older varies by country and participant characteristics. This review updates versions published in 2010 and 2014. OBJECTIVES To assess access, provider, system, and societal interventions to increase the uptake of influenza vaccination in people aged 60 years and older in the community. SEARCH METHODS We searched CENTRAL, which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE, Embase, CINAHL, and ERIC for this update, as well as WHO ICTRP and ClinicalTrials.gov for ongoing studies to 7 December 2017. We also searched the reference lists of included studies. SELECTION CRITERIA Randomised controlled trials (RCTs) and cluster-randomised trials of interventions to increase influenza vaccination in people aged 60 years or older in the community. DATA COLLECTION AND ANALYSIS We used standard methodological procedures as specified by Cochrane. MAIN RESULTS We included three new RCTs for this update (total 61 RCTs; 1,055,337 participants). Trials involved people aged 60 years and older living in the community in high-income countries. Heterogeneity limited some meta-analyses. We assessed studies as at low risk of bias for randomisation (38%), allocation concealment (11%), blinding (44%), and selective reporting (100%). Half (51%) had missing data. We assessed the evidence as low-quality. We identified three levels of intervention intensity: low (e.g. postcards), medium (e.g. personalised phone calls), and high (e.g. home visits, facilitators).Increasing community demand (12 strategies, 41 trials, 53 study arms, 767,460 participants)One successful intervention that could be meta-analysed was client reminders or recalls by letter plus leaflet or postcard compared to reminder (odds ratio (OR) 1.11, 95% confidence interval (CI) 1.07 to 1.15; 3 studies; 64,200 participants). Successful interventions tested by single studies were patient outreach by retired teachers (OR 3.33, 95% CI 1.79 to 6.22); invitations by clinic receptionists (OR 2.72, 95% CI 1.55 to 4.76); nurses or pharmacists educating and nurses vaccinating patients (OR 152.95, 95% CI 9.39 to 2490.67); medical students counselling patients (OR 1.62, 95% CI 1.11 to 2.35); and multiple recall questionnaires (OR 1.13, 95% CI 1.03 to 1.24).Some interventions could not be meta-analysed due to significant heterogeneity: 17 studies tested simple reminders (11 with 95% CI entirely above unity); 16 tested personalised reminders (12 with 95% CI entirely above unity); two investigated customised compared to form letters (both 95% CI above unity); and four studies examined the impact of health risk appraisals (all had 95% CI above unity). One study of a lottery for free groceries was not effective.Enhancing vaccination access (6 strategies, 8 trials, 10 arms, 9353 participants)We meta-analysed results from two studies of home visits (OR 1.30, 95% CI 1.05 to 1.61) and two studies that tested free vaccine compared to patient payment for vaccine (OR 2.36, 95% CI 1.98 to 2.82). We were unable to conduct meta-analyses of two studies of home visits by nurses plus a physician care plan (both with 95% CI above unity) and two studies of free vaccine compared to no intervention (both with 95% CI above unity). One study of group visits (OR 27.2, 95% CI 1.60 to 463.3) was effective, and one study of home visits compared to safety interventions was not.Provider- or system-based interventions (11 strategies, 15 trials, 17 arms, 278,524 participants)One successful intervention that could be meta-analysed focused on payments to physicians (OR 2.22, 95% CI 1.77 to 2.77). Successful interventions tested by individual studies were: reminding physicians to vaccinate all patients (OR 2.47, 95% CI 1.53 to 3.99); posters in clinics presenting vaccination rates and encouraging competition between doctors (OR 2.03, 95% CI 1.86 to 2.22); and chart reviews and benchmarking to the rates achieved by the top 10% of physicians (OR 3.43, 95% CI 2.37 to 4.97).We were unable to meta-analyse four studies that looked at physician reminders (three studies with 95% CI above unity) and three studies of facilitator encouragement of vaccination (two studies with 95% CI above unity). Interventions that were not effective were: comparing letters on discharge from hospital to letters to general practitioners; posters plus postcards versus posters alone; educational reminders, academic detailing, and peer comparisons compared to mailed educational materials; educational outreach plus feedback to teams versus written feedback; and an intervention to increase staff vaccination rates.Interventions at the societal levelNo studies reported on societal-level interventions.Study funding sourcesStudies were funded by government health organisations (n = 33), foundations (n = 9), organisations that provided healthcare services in the studies (n = 3), and a pharmaceutical company offering free vaccines (n = 1). Fifteen studies did not report study funding sources. AUTHORS' CONCLUSIONS We identified interventions that demonstrated significant positive effects of low (postcards), medium (personalised phone calls), and high (home visits, facilitators) intensity that increase community demand for vaccination, enhance access, and improve provider/system response. The overall GRADE assessment of the evidence was moderate quality. Conclusions are unchanged from the 2014 review.
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Affiliation(s)
- Roger E Thomas
- University of CalgaryDepartment of Family Medicine, Faculty of MedicineHealth Sciences Centre3330 Hospital Drive NWCalgaryABCanadaT2N 4N1
| | - Diane L Lorenzetti
- Faculty of Medicine, University of CalgaryDepartment of Community Health Sciences3rd Floor TRW3280 Hospital Drive NWCalgaryABCanadaT2N 4Z6
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Winston K, Grendarova P, Rabi D. Video-based patient decision aids: A scoping review. PATIENT EDUCATION AND COUNSELING 2018; 101:558-578. [PMID: 29102063 DOI: 10.1016/j.pec.2017.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 10/06/2017] [Accepted: 10/16/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study reviews the published literature on the use of video-based decision aids (DA) for patients. The authors describe the areas of medicine in which video-based patient DA have been evaluated, the medical decisions targeted, their reported impact, in which countries studies are being conducted, and publication trends. METHOD The literature review was conducted systematically using Medline, Embase, CINAHL, PsychInfo, and Pubmed databases from inception to 2016. References of identified studies were reviewed, and hand-searches of relevant journals were conducted. RESULTS 488 studies were included and organized based on predefined study characteristics. The most common decisions addressed were cancer screening, risk reduction, advance care planning, and adherence to provider recommendations. Most studies had sample sizes of fewer than 300, and most were performed in the United States. Outcomes were generally reported as positive. This field of study was relatively unknown before 1990s but the number of studies published annually continues to increase. CONCLUSION Videos are largely positive interventions but there are significant remaining knowledge gaps including generalizability across populations. PRACTICE IMPLICATIONS Clinicians should consider incorporating video-based DA in their patient interactions. Future research should focus on less studied areas and the mechanisms underlying effective patient decision aids.
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Affiliation(s)
- Karin Winston
- Alberta Children's Hospital, 2800 Shaganappi Trail NW, Calgary, Alberta, T3B 6A8, Canada.
| | - Petra Grendarova
- University of Calgary, Division of Radiation Oncology, Calgary, Canada
| | - Doreen Rabi
- University of Calgary, Department of Medicine, Calgary, Canada
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Praphasiri P, Ditsungnoen D, Sirilak S, Rattanayot J, Areerat P, Dawood FS, Lindblade KA. Predictors of seasonal influenza vaccination among older adults in Thailand. PLoS One 2017; 12:e0188422. [PMID: 29186159 PMCID: PMC5706686 DOI: 10.1371/journal.pone.0188422] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 11/07/2017] [Indexed: 11/19/2022] Open
Abstract
Background In advance of a large influenza vaccine effectiveness (VE) cohort study among older adults in Thailand, we conducted a population-based, cross-sectional survey to measure vaccine coverage and identify factors associated with influenza vaccination among older Thai adults that could bias measures of vaccine effectiveness. Method We selected adults ≥65 years using a two-stage, stratified, cluster sampling design. Functional status was assessed using the 10-point Vulnerable Elders Survey (VES); scores ≥3 indicated vulnerability. Questions about attitudes towards vaccination were based on the Health Belief Model. The distance between participants’ households and the nearest vaccination clinic was calculated. Vaccination status was determined using national influenza vaccination registry. Prevalence ratios (PR) and 95% confidence intervals (CIs) were calculated using log-binomial multivariable models accounting for the sampling design. Result We enrolled 581 participants, of whom 60% were female, median age was 72 years, 41% had at least one chronic underlying illness, 24% met the criteria for vulnerable, and 23% did not leave the house on a daily basis. Influenza vaccination rate was 34%. In multivariable models, no variable related to functional status was associated with vaccination. The strongest predictors of vaccination were distance to the nearest vaccination center (PR 3.0, 95% CI 1.7–5.1 for participants in the closest quartile compared to the furthest), and high levels of a perception of benefits of influenza vaccination (PR 2.8, 95% CI 1.4–5.6) and cues to action (PR 2.7, 95% CI 1.5–5.1). Conclusion Distance to vaccination clinics should be considered in analyses of influenza VE studies in Thailand. Strategies that emphasize benefits of vaccination and encourage physicians to recommend annual influenza vaccination could improve influenza vaccine uptake among older Thai adults. Outreach to more distant and less mobile older adults may also be required to improve influenza vaccination coverage.
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Affiliation(s)
- Prabda Praphasiri
- Influenza program, Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand
- * E-mail:
| | | | - Supakit Sirilak
- Technical Health Office, Thailand Ministry of Public Health, Nonthaburi, Thailand
| | | | - Peera Areerat
- Nakhon Phanom Provincial Health Office, Nakhon Phanom, Thailand
| | - Fatimah S. Dawood
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Kim A. Lindblade
- Influenza program, Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Ho HJ, Chan YY, Ibrahim MAB, Wagle AA, Wong CM, Chow A. A formative research-guided educational intervention to improve the knowledge and attitudes of seniors towards influenza and pneumococcal vaccinations. Vaccine 2017; 35:6367-6374. [PMID: 29031694 DOI: 10.1016/j.vaccine.2017.10.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/02/2017] [Accepted: 10/04/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Adult influenza and pneumococcal vaccination rates in Singapore are low, and factors influencing knowledge and attitudes of seniors towards influenza, pneumonia and their respective vaccines are not well-known. Our study aims to understand the barriers and facilitators towards getting influenza and pneumococcal vaccinations among seniors in Singapore, and subsequently inform the conduct of a relevant community-based educational intervention, as well as evaluate the intervention outcomes. METHODS We performed a mixed methods study with two components: Firstly, formative research was conducted among community-dwelling seniors, using focus group discussions (FGDs), to understand their knowledge and attitudes towards influenza, pneumonia and their respective vaccines. Next, a quantitative study was conducted to evaluate knowledge of seniors and the effectiveness of an educational intervention. RESULTS Four FGDs were organised with 32 participants, who were predominantly female, of lower educational background, and residing in government rental flats. Participants had varying levels of knowledge and many misconceptions about influenza, pneumonia and their respective vaccinations, with concerns about side effects and vaccine effectiveness. The formative research results were used to inform a community-based educational intervention for seniors. Our subsequent evaluation included 604 elderly participants, mainly from lower educational and socio-economic strata, who initially demonstrated poor knowledge scores (median score 5 out of 9, IQR 4-5). Following our intervention, median knowledge score improved to 7 (IQR 6-8) (p < .0001). Significant improvements in knowledge scores were observed across genders, age strata, education levels, and housing types. DISCUSSION Our formative research identified knowledge gaps among community-dwelling seniors which affected their attitudes towards vaccination uptake. Key findings were taken into consideration when implementing the educational intervention. Our community-based intervention was effective in improving knowledge and attitudes, and could be used as a cue to action for short-term behaviour changes.
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Affiliation(s)
- Hanley J Ho
- Department of Clinical Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore.
| | - Yin Ying Chan
- Department of Clinical Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - Muhamad Alif Bin Ibrahim
- Department of Clinical Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - Anurupa A Wagle
- Communicable Disease Education Department, Health Promotion Board, 3 Second Hospital Ave, Singapore 168937, Singapore
| | - Christina M Wong
- Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore; Behavioural, Clinical and Epidemiological Sciences, FHI 360, 359 Blackwell St Suite 200, Durham, NC 27701, USA
| | - Angela Chow
- Department of Clinical Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
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Harapan H, Anwar S, Bustamam A, Radiansyah A, Angraini P, Fasli R, Salwiyadi S, Bastian RA, Oktiviyari A, Akmal I, Iqbalamin M, Adil J, Henrizal F, Darmayanti D, Mahmuda M, Mudatsir M, Imrie A, Sasmono RT, Kuch U, Shkedy Z, Pramana S. Willingness to pay for a dengue vaccine and its associated determinants in Indonesia: A community-based, cross-sectional survey in Aceh. Acta Trop 2017; 166:249-256. [PMID: 27908746 DOI: 10.1016/j.actatropica.2016.11.035] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/25/2016] [Accepted: 11/27/2016] [Indexed: 10/20/2022]
Abstract
Vaccination strategies are being considered as a part of dengue prevention programs in endemic countries. To accelerate the introduction of dengue vaccine into the public sector program and private markets, understanding the private economic benefits of a dengue vaccine is therefore essential. The aim of this study was to assess the willingness to pay (WTP) for a dengue vaccine among community members in Indonesia and its associated explanatory variables. A community-based, cross-sectional survey was conducted in nine regencies of Aceh province, Indonesia, from November 2014 to March 2015. A pre-tested validated questionnaire was used to facilitate the interviews. To assess the explanatory variables influencing participants' WTP for a dengue vaccine, a linear regression analysis was employed. We interviewed 677 healthy community members; 476 participants (87.5% of the total) were included in the final analysis. An average individual was willing to pay around US-$ 4 (mean: US-$ 4.04; median: US-$ 3.97) for a dengue vaccine. Our final multivariate model revealed that working as a civil servant, living in the city, and having good knowledge on dengue viruses, a good attitude towards dengue, and good preventive practice against dengue virus infection were associated with a higher WTP (P<0.05). Our model suggests that marketing efforts should be directed to community members who are working in the suburbs especially as farmers. In addition, the results of our study underscore the need for low-cost quality vaccines, public sector subsidies for vaccinations, and intensifying efforts to further educate and encourage households regarding other dengue preventive measures, using trusted individuals as facilitators.
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Harapan H, Fajar JK, Sasmono RT, Kuch U. Dengue vaccine acceptance and willingness to pay. Hum Vaccin Immunother 2016; 13:786-790. [PMID: 27905832 DOI: 10.1080/21645515.2016.1259045] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The introduction of new vaccines is accompanied by a variety of challenges. Among these, very important ones concern the questions whether the public is willing to accept and willing to purchase the vaccine. Here we discuss factors associated with these questions in the context of vaccines that are becoming available against dengue virus infection. We reviewed published studies available from PubMed and Embase, conducting a meta-analysis when possible and narrative review when the data did not qualify for meta-analysis. We found that attitude toward vaccination and socioeconomic level had significant associations with dengue vaccine acceptance. In addition, socioeconomic level, knowledge, attitude and practice regarding dengue fever, having personally experienced dengue fever and vaccine price were associated with willingness to pay for dengue vaccine. To improve acceptance and willingness to pay for dengue vaccine, well-designed introduction programs that address the associated factors in a context-specific manner are essential.
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Affiliation(s)
- Harapan Harapan
- a Medical Research Unit , School of Medicine, Syiah Kuala University , Banda Aceh , Indonesia.,b Tropical Disease Centre, School of Medicine, Syiah Kuala University , Banda Aceh , Indonesia.,c Department of Microbiology , School of Medicine, Syiah Kuala University , Banda Aceh , Indonesia
| | - Jonny K Fajar
- a Medical Research Unit , School of Medicine, Syiah Kuala University , Banda Aceh , Indonesia
| | - R Tedjo Sasmono
- d Eijkman Institute for Molecular Biology , Jakarta , Indonesia
| | - Ulrich Kuch
- e Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University , Frankfurt am Main , Germany
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Poscia A, Stojanovic J, Ricciardi W. The sustainability of influenza vaccination programs: considerations and perspectives from Italy. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2016; 57:E9-E12. [PMID: 27346942 PMCID: PMC4910445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 02/25/2016] [Indexed: 11/02/2022]
Abstract
Influenza constitutes an annually recurring threat to society, from both the clinical and economic points of view. The impact of influenza is often underestimated, especially among frail elderly people, who are at increased risk of serious complications, including hospitalization and death. In Italy, around 10 million individuals aged 65 years and older are at risk of contracting influenza, and it can be estimated that the lack of a vaccination strategy would lead to more than 2 million cases and about 30,000 deaths. However, adherence to routinely recommended adult immunizations remains suboptimal despite the availability of safe and effective vaccines. Indeed, a monitoring program from the National Institute of Health in Italy has shown that influenza vaccination coverage in the elderly dropped to 49% in the 2014-2015 season, which is far below the maximum values (68%) recorded in the 2005-2006 season. The current situation in Italy imposes a need for greater sustainability in order to face the challenges related to the changing epidemiological situation, demographic transition and social transformations. Our review sums up the key elements of influenza vaccine sustainability and makes suggestions for improving the organizational structure of the present initiatives.
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Affiliation(s)
- A. Poscia
- Section of Hygiene, Institute of Public Health, Catholic University of Rome, Italy
| | - J. Stojanovic
- Section of Hygiene, Institute of Public Health, Catholic University of Rome, Italy
| | - W. Ricciardi
- Section of Hygiene, Institute of Public Health, Catholic University of Rome, Italy
- National Health Institute, Rome, Italy
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