The Impact of Patient's Socio-Demographic Characterictics, Comorbidities and Attitudes on Flu Vaccination Uptake in Family Practice Settings

Knowledge, Attitude, and Barriers Influencing Seasonal Influenza Vaccination Uptake

Background

Seasonal influenza is an acute respiratory infection caused by influenza viruses that are highly contagious and circulate in all parts of the world. It gives rise to an estimated 3 to 5 million cases of severe illness and about 250,000 to 500,000 deaths globally each year. Influenza tends to cause epidemics with serious illness and death among high-risk groups such as children aged 5 years and younger, pregnant women, elderly ≥65 years of age, and with chronic medical conditions. According to the Centers for Disease Prevention and Control (CDC), all people who are 6 months old and above are recommended to receive the seasonal influenza vaccine annually. Despite the fact that influenza vaccine is readily available, and the severity of the disease is known to adversely affect the individual's quality of life and well-being, vaccination uptake rates are still low, contributing to the increased burden of the disease worldwide.

Objectives

To measure the influenza vaccine uptake among residents of Riyadh Province, Saudi Arabia, that determines their attitude, knowledge, and beliefs regarding the vaccine.

Methods

A cross-sectional study was conducted using a self-administered structured questionnaire distributed online targeting residents of Riyadh Province, Saudi Arabia, from 1st of August 2019 till 30th of September 2019. Participants were selected through volunteer sampling. The questionnaire included demographic data including age, gender, occupation, education level, marital status, and comorbidities. It also included questions regarding knowledge, attitude, and beliefs regarding influenza vaccine. After collection of data, statistical analyses were conducted by using Statistical Package for Social Sciences (SPSS) version 19.0. A P value of <0.05 was considered statistically significant.

Results

Our study included 503 participants, with age ranging from 18 to 65 years old and 324 (64%) were females. 100 participants (19.9%) had comorbid conditions, and 223 (44.3%) have been vaccinated against influenza in the past. A large portion of participants (41.2%) were familiar with seasonal influenza vaccination from the media. The knowledge part of the questionnaire showed that 302 (60%) participants knew how often they should receive the vaccine and 313 (62.2%) participants knew that the vaccine is provided freely in all of Saudi Arabia. In terms of belief and attitude, 371 participants (73.8%) thought they were susceptible to the disease and 365 (73.8%) believed that influenza vaccine is beneficial, while 446 participants (88.7%) thought that the general public need more knowledge and awareness on the scientific facts of influenza vaccine. Regarding barriers, 295 participants (58.6%) wanted to avoid vaccines and 252 (50.1%) were concerned about the vaccine's adverse effects. Participants with frequent health checkups and those who had previous knowledge on the availability of the vaccine for free were more likely to be vaccinated. Vaccinated participants (44.3%) were asked if they were willing to take the vaccine again when it is due, 158 (70.9%) answered yes. Those who elicited symptomatic reaction to the vaccine (26.0%) were less inclined to take it again (P = 0.035).

Conclusion

We concluded that there is a low influenza vaccine uptake rate among our study population, considering that the barriers most commonly chosen by participants are solvable with health education and campaigns oriented towards delivering facts about the vaccine and dispelling misinformation; such measures are highly recommended and are postulated to carry a great benefit that should target common misconceptions identified in this study.

Methodological Errors in Clinical Studies Published by Medical Journals of Ex-Yugoslav Countries

INTRODUCTION

Certain methodological principles should be inexcusably followed when designing clinical or observational research to avoid bias and presentation of results that do not reflect the truth about the phenomenon that is the object of the study.

AIM

The aim of this study was to compare the methodological quality of clinical trials and observational studies published in medical journals from ex-Yugoslav countries indexed in Pubmed/MEDLINE.

METHODS

Clinical studies published in medical journals of ex-Yugoslav countries were retrieved from the Pubmed/MEDLINE database, and the sample for analysis was randomly chosen from the retrieved publications. The rate of the most common errors in the design of clinical/observational studies was established by a careful reading of the sampled publications and their checking against predefined criteria.

RESULTS

The studies published in two countries that are now member states of the European Union (Slovenia and Croatia) have significantly higher citation rates, impact factor, and methodological quality scores than studies from other ex-Yugoslav countries. While publications from Croatia show clear improvement trend throughout the last two decades, which is visible also in the last 10 years in Slovenia and Bosnia and Herzegovina, quality of clinical research published in journals from Serbia was stagnating in the same period.

CONCLUSIONS

There are significant differences in methodological quality and scientometric characteristics of clinical research published in medical journals of ex-Yugoslav countries that could be mitigated by more intensive training of clinical researchers in statistics and research design, as well as by more rigorous editorial practices.

Beliefs, attitudes, and barriers associated with the uptake of the seasonal influenza vaccine among patients visiting primary healthcare clinics

OBJECTIVES

To explore beliefs, attitudes, and barriers associated with uptake of the seasonal influenza vaccine among visitors to primary healthcare clinics.

METHODS

This was a cross-sectional, self-administered questionnaire-based study of 300 people visiting Family Medicine Centers, King Abdulaziz Medical City, Riyadh, Saudi Arabia, between May 2017 and October 2017.

RESULTS

Most respondents reported that they never get vaccinated (63.3%), but most intend to get the vaccination in future. Only 7.7% of respondents had ever experienced side-effects from the influenza vaccine. Reported barriers to vaccination include: a desire to avoid medication, the fact that the Ministry of Health has not made vaccination obligatory, concerns about the side-effects of the vaccine, the belief that one is at low risk of acquiring influenza, and the idea that influenza is a simple disease with no need for prevention. The rate of vaccination was higher among males than females. More females than males said they refused the influenza vaccine because of concerns about side effects or having a phobia of injections.

CONCLUSION

Although most respondents said they were concerned about influenza and believed the vaccine to be effective, this study revealed a low rate of influenza vaccination. More public education and better arrangements for vaccination are required in the healthcare setting to overcome several reported barriers to vaccination.

Barriers of Influenza Vaccination Intention and Behavior - A Systematic Review of Influenza Vaccine Hesitancy, 2005 - 2016

BACKGROUND

Influenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake.

OBJECTIVE

This review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area.

METHODS

Thirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination.

RESULTS

Most studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups.

CONCLUSION

Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.