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Lu Y, Fu X, Xu L, Lu J. Knowledge, attitudes, and perceptions of influenza vaccine among pregnant women in Minhang District, Shanghai. Hum Vaccin Immunother 2024; 20:2368944. [PMID: 38932738 PMCID: PMC11212563 DOI: 10.1080/21645515.2024.2368944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
This study aimed to assess the attitudes and willingness of pregnant women to receive the influenza vaccine and the factors influencing their decisions. A sample survey was conducted among pregnant women receiving prenatal care at various medical institutions in Minhang District, Shanghai, from March to June 2023. The survey included inquiries about demographic information, knowledge, and perception of influenza disease and influenza vaccine. Logistic regression models and chi-square tests were used to analyze the data. 6.9% (78/1125) of participants considered receiving the influenza vaccine during pregnancy. Participants with graduate education or above (OR = 4.632, 95%CI: 1.046-20.517), non-office workers (OR = 2.784, 95%CI: 1.560-4.970), and participants whose spouses were not office workers (OR = 0.518, 95% CI: 0.294-0.913) were significantly associated with high intent to vaccinate. Participants with superior knowledge (>30 points) exhibited greater willingness (p < .001). Participants who viewed post-influenza symptoms as mild had a significantly lower willingness to vaccinate during pregnancy (2.3%), compared to those who disagreed (p = .015). Conversely, those recognizing a heightened risk of hospitalization due to respiratory diseases in pregnant women post-influenza were significantly more inclined to vaccinate during pregnancy (8.8%) (p = .007). Participants recognizing benefits uniformly expressed willingness to receive the influenza vaccine during pregnancy (p < .001), while those perceiving barriers uniformly rejected vaccination (p < .001). Higher education, non-office worker status, and having an office worker spouse correlate with greater willingness to receive the influenza vaccine during pregnancy. Enhanced knowledge and accurate perceptions of influenza and its vaccine influenced willingness. Accumulating knowledge about influenza and its vaccine fosters accurate perceptions. Notably, overall willingness to vaccinate during pregnancy remains low, likely due to safety concerns, and lack of accurate perceptions. Targeted health education, improved communication between healthcare providers and pregnant women, and campaigns highlighting vaccine benefits for mothers and children are essential.
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Affiliation(s)
- Yan Lu
- Prevention and Health Department, Xinzhuang Community Health Service Center, Shanghai, China
| | - Xiaoya Fu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan University School of Public Health, Shanghai, China
| | - Ling Xu
- Obstetrics and Gynecology, Minhang District Central Hospital, Shanghai, China
| | - Jia Lu
- Comprehensive Prevention and Control Office, Minhang District Center for Disease Control and Prevention, Shanghai, China
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Wu D, Jin C, Bessame K, Tang FFY, Ong JJ, Wang Z, Xie Y, Jit M, Larson HJ, Chantler T, Lin L, Gong W, Yang F, Jing F, Wei S, Cheng W, Zhou Y, Ren N, Qiu S, Bao J, Wen L, Yang Q, Tian J, Tang W, Tucker JD. Effectiveness of a pay-it-forward intervention compared with user-paid vaccination to improve influenza vaccine uptake and community engagement among children and older adults in China: a quasi-experimental pragmatic trial. THE LANCET. INFECTIOUS DISEASES 2022; 22:1484-1492. [PMID: 35868342 PMCID: PMC9492551 DOI: 10.1016/s1473-3099(22)00346-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND China has low seasonal influenza vaccination rates among priority populations. In this study, we aimed to evaluate a pay-it-forward strategy to increase influenza vaccine uptake in rural, suburban, and urban settings in China. METHODS We performed a quasi-experimental pragmatic trial to examine the effectiveness of a pay-it-forward intervention (a free influenza vaccine and an opportunity to donate financially to support vaccination of other individuals) to increase influenza vaccine uptake compared with standard-of-care user-paid vaccination among children (aged between 6 months and 8 years) and older people (≥60 years) in China. Recruitment took place in the standard-of-care group until the expected sample size was reached and then in the pay-it-forward group in primary care clinics from a rural site (Yangshan), a suburban site (Zengcheng), and an urban site (Tianhe). Participants were introduced to the influenza vaccine by project staff using a pamphlet about influenza vaccination and were either asked to pay out-of-pocket at the standard market price (US$8·5-23·2; standard-of-care group) or to donate any amount anonymously (pay-it-forward group). Participants had to be eligible to receive an influenza vaccine and to have not received an influenza vaccine in the past year. The primary outcome was vaccine uptake. Secondary outcomes were vaccine confidence and costs (from the health-care provider perspective). Regression methods compared influenza vaccine uptake and vaccine confidence between the two groups. This trial is registered with ChiCTR, ChiCTR2000040048. FINDINGS From Sept 21, 2020, to March 3, 2021, 300 enrolees were recruited from patients visiting three primary care clinics. 55 (37%) of 150 people in the standard-of-care group (40 [53%] of 75 children and 15 [20%] of 75 older adults) and 111 (74%) of 150 in the pay-it-forward group (66 [88%] of 75 children and 45 [60%] of 75 older adults) received an influenza vaccine. People in the pay-it-forward group were more likely to receive an influenza vaccine compared with those in the standard-of-care group (adjusted odds ratio [aOR] 6·7 [95% CI 2·7-16·6] among children and 5·0 [2·3-10·8] among older adults). People in the pay-it-forward group had greater confidence in vaccine safety (aOR 2·2 [95% CI 1·2-3·9]), importance (3·1 [1·6-5·9]), and effectiveness (3·1 [1·7-5·7]). In the pay-it-forward group, 107 (96%) of 111 participants donated money for subsequent vaccinations. The pay-it-forward group had a lower economic cost (calculated as the cost without subtraction of donations) per person vaccinated (US$45·60) than did the standard-of-care group ($64·67). INTERPRETATION The pay-it-forward intervention seemed to be effective in improving influenza vaccine uptake and community engagement. Our data have implications for prosocial interventions to enhance influenza vaccine uptake in countries where influenza vaccines are available for a fee. FUNDING Bill & Melinda Gates Foundation and the UK National Institute for Health Research.
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Affiliation(s)
- Dan Wu
- West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu, China; Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Chapel Hill Project-China, University of North Carolina, Guangzhou, China.
| | - Chenqi Jin
- Chapel Hill Project-China, University of North Carolina, Guangzhou, China; Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, China
| | - Khaoula Bessame
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Fanny Fong-Yi Tang
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Jason J Ong
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Faculty of Medicine, Central Clinical School, Monash University, Melbourne, VIC, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
| | - Zaisheng Wang
- Chapel Hill Project-China, University of North Carolina, Guangzhou, China; School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Yewei Xie
- Chapel Hill Project-China, University of North Carolina, Guangzhou, China; Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Mark Jit
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Heidi J Larson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Tracey Chantler
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Leesa Lin
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Wenfeng Gong
- Beijing Representative Office, Bill & Melinda Gates Foundation, Beijing, China
| | - Fan Yang
- Institute of Population Research, Peking University, Beijing, China
| | - Fengshi Jing
- Chapel Hill Project-China, University of North Carolina, Guangzhou, China; Guangdong Secondary Provincial General Hospital, Guangzhou, China
| | - Shufang Wei
- Chapel Hill Project-China, University of North Carolina, Guangzhou, China
| | - Weibin Cheng
- Guangdong Secondary Provincial General Hospital, Guangzhou, China
| | - Yi Zhou
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China; Faculty of Medicine, Macau University of Science and Technology, Macau Special Administrative Region, China
| | - Nina Ren
- Guangdong Secondary Provincial General Hospital, Guangzhou, China
| | - Shuhao Qiu
- Vaccination Clinic, Yangshan Health Centre, Qingyuan, China
| | - Jianmin Bao
- Fenghuang Community Health Service Centre, Zengcheng, China
| | - Liufen Wen
- Xinhua Community Health Service Centre, Guangzhou, China
| | - Qinlu Yang
- Community Health Centre, Guangzhou, China
| | - Junzhang Tian
- Guangdong Secondary Provincial General Hospital, Guangzhou, China
| | - Weiming Tang
- Chapel Hill Project-China, University of North Carolina, Guangzhou, China; Guangdong Secondary Provincial General Hospital, Guangzhou, China; Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
| | - Joseph D Tucker
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Chapel Hill Project-China, University of North Carolina, Guangzhou, China; Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
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Jiang M, Yao X, Li P, Fang Y, Feng L, Hayat K, Shi X, Gong Y, Peng J, Atif N. Impact of video-led educational intervention on uptake of influenza vaccine among the elderly in western China: a community-based randomized controlled trial. BMC Public Health 2022; 22:1128. [PMID: 35668438 PMCID: PMC9169441 DOI: 10.1186/s12889-022-13536-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 05/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Influenza vaccination coverage rate among the elderly is low in China. We aimed to evaluate the impact of video-led educational intervention on influenza vaccine uptake among the Chinese elderly. METHODS A randomized controlled trial was conducted in 8 communities of Xi'an, a representative city in western China. Elderly aged over 60 years were randomized to the control group and intervention group (12-minute video education on influenza and its vaccination). Participants' knowledge, attitudes, and practices (KAP) of influenza was assessed by using a questionnaire survey before and after the intervention. The primary outcomes were participants' willingness to get influenza vaccinated and their actual uptake rates in the 2020-21 flu season. Secondary outcomes were the variations of pre- and post-intervention KAP scores. Intention-to-treat analysis was performed to analyze the data, and sensitivity analyses were conducted to examine the robustness of the results. RESULTS A total of 350 people were enrolled, with 175 individuals for each group. Participants in the intervention group were more willing to receive influenza vaccination than those in the control group (64.6% vs. 51.4%, p<0.05). The influenza vaccination uptake rate occurred in 10.3% of participants in the intervention group and 3.4% in the control group (odds ratio, 3.23; 95% CI 1.25-8.32, p<0.001). The post-intervention KAP scores in the intervention group were significantly higher compared to those in the control group (p<0.001). CONCLUSION Video-led education was an effective and feasible approach to improve old people's willingness and uptake of influenza vaccination in western China.
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Affiliation(s)
- Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China. .,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China. .,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China. .,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China.
| | - Xuelin Yao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
| | - Pengchao Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
| | - Liuxin Feng
- Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
| | - Xinke Shi
- Health Science Center, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Yilin Gong
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
| | - Jin Peng
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
| | - Naveel Atif
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, 710061, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, 710061, China.,Shaanxi Center for Health Reform and Development Research, Xi'an, 710061, China.,Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, 712000, China
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Zhang P, Li Y, Wang H, Luo L, Wang P, Wang H, Li Q, Meng Z, Yang H, Liu Y, Zhou S, Li N, Zhang S, Bi J, Zhang J, Zheng X. COVID-19 Vaccine Hesitancy Among Older Adolescents and Young Adults: A National Cross-Sectional Study in China. Front Public Health 2022; 10:877668. [PMID: 35646783 PMCID: PMC9133905 DOI: 10.3389/fpubh.2022.877668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/05/2022] [Indexed: 01/19/2023] Open
Abstract
Background With promotion of COVID-19 vaccinations, there has been a corresponding vaccine hesitancy, of which older adolescents and young adults represent groups of particular concern. In this report, we investigated the prevalence and reasons for vaccine hesitancy, as well as potential risk factors, within older adolescents and young adults in China. Methods To assess these issues, an online survey was administered over the period from March 14 to April 15, 2021. Older adolescents (16–17 years old) and young adults (18–21 years old) were recruited nationwide from Wechat groups and results from a total of 2,414 respondents were analyzed. Socio-demographic variables, vaccine hesitancy, psychological distress, abnormal illness behavior, global well-being and social support were analyzed in this report. Results Compared to young adults (n = 1,405), older adolescents (n = 1,009) showed higher prevalence rates of COVID-19 vaccine hesitancy (16.5 vs. 7.9%, p < 0.001). History of physical diseases (p = 0.007) and abnormal illness behavior (p = 0.001) were risk factors for vaccine hesitancy among older adolescents, while only a good self-reported health status (p = 0.048) was a risk factor for young adults. Concerns over COVID-19 vaccine side effects (67.1%) and beliefs of invulnerability regarding infection risk (41.9%) were the most prevalent reasons for vaccine hesitancy. Providing evidence on the vaccine reduction of COVID-19 infection risk (67.5%), ensuring vaccine safety (56.7%) and the low risk of side effects (52.7%) were the most effective persuasions for promoting vaccinations. Conclusion In China, older adolescents showed a higher prevalence for vaccine hesitancy than that of young adults. Abnormal illness behavior and history of physical diseases were risk factors for vaccine hesitancy among these older adolescents, while social support represents an important factor which could help to alleviate this hesitancy.
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Affiliation(s)
- Panpan Zhang
- Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, China
- Department of Neurology, Puyang People's Hospital, Puyang, China
| | - Yan Li
- Department of Neurology, Yishui County People's Hospital, Linyi, China
| | - Huanchun Wang
- Department of Basic Medicine Teaching, Taishan Vocational College of Nursing, Taian, China
| | - Liyan Luo
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ping Wang
- Department of Neurology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Huimin Wang
- Department of Oral and Maxillofacial Surgery, Puyang People's Hospital, Puyang, China
| | - Qing Li
- Department of Neurology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zejing Meng
- Department of Public Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Hui Yang
- Department of Neurology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yuanhong Liu
- Department of Neurology, Puyang People's Hospital, Puyang, China
| | - Shiyue Zhou
- Department of Neurology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Nan Li
- Department of Neurology, Sishui County People's Hospital, Jining, China
| | - Shengnan Zhang
- Department of Neurology, Puyang People's Hospital, Puyang, China
| | - Jianzhong Bi
- Department of Neurology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jiewen Zhang
- Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Jiewen Zhang
| | - Xiaolei Zheng
- Department of Neurology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Xiaolei Zheng
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