[Some thoughts on influenza vaccine and regular influenza vaccination for healthcare workers]

The relationship between influenza vaccine hesitancy and vaccine literacy among youth and adults in China

Objectives

The present study aimed to assess influenza vaccine hesitancy and vaccine literacy levels among youth and adults in China, as well as the association between them.

Methods

An online cross-sectional survey was conducted in Mainland China. Participants' total vaccine literacy and three sub-dimension vaccine literacy (knowledge literacy, competence literacy, and decision-making literacy) were assessed by a validated vaccine literacy scale. Having received influenza vaccination in the past three years or intending to accept it in next influenza season indicates less influenza vaccine hesitancy.

Results

Among 997 participants, a sub-optimal vaccine literacy was observed, with a mean score of 66.83 ± 10.27. Regression models 1-4 revealed that participants with middle (aOR: 1.431, P=0.039, 95% CI: 1.018~2.010) or high (aOR: 1.651, P=0.006, 95% CI: 1.157~2.354) total vaccine literacy, as well as those with high competence literacy (aOR: 1.533, P=0.017, 95% CI: 1.079~2.180), or high decision-making literacy (aOR: 1.822, P=0.001, 95% CI: 1.261~2.632) were more likely to have been vaccinated against influenza at least once in past three years. However, those with a high knowledge literacy were associated with a lower influenza vaccine rate (aOR: 0.676, P=0.046, 95% CI: 0.460~0.994). Regression models 5-8 revealed that participants with middle (aOR: 1.661, P=0.008, 95% CI: 1.142~2.414) or high total vaccine literacy (aOR: 2.645, P=0.000, 95% CI: 1.774~3.942), as well as those with middle (aOR: 1.703, P=0.005, 95% CI: 1.177~2.464) or high competence literacy (aOR: 2.346, P=0.000, 95% CI: 1.159~3.461), or high decision-making literacy (aOR: 2.294, P=0.000, 95% CI: 1.531~3.436) were more likely to express the willingness to receive the influenza vaccine in the next influenza season.

Conclusion

The participants' influenza vaccine hesitancy was negatively associated with their total vaccine literacy levels and two of the three sub-dimensions: competence literacy and decision-making literacy. Knowledge literacy suggested a positive or no relationship with influenza vaccine hesitancy.

The association between influenza vaccination and the perception of COVID-19 as well as COVID-19 vaccination behavior among community residents in Anhui province, China

Influenza is a significant public health threat associated with high morbidity and mortality globally. This study investigated the influenza vaccination rate (IVR) among community residents in Anhui province, China, and explored the association between participants' influenza vaccination and their key sociodemographic characteristics, perception of COVID-19 as well as COVID-19 vaccination behavior. We found that the IVR among respondents in Anhui province was 27.85% in 2020. Regression analyses revealed that males (OR = 1.41, 95% CI: 1.01 ~ 1.96), residents with above middle school education (OR = 1.88, 95% CI: 1.04 ~ 3.39), considered themselves likely to be infected with COVID-19 (OR = 1.53, 95% CI: 1.04 ~ 2.24), had received the COVID-19 vaccine (OR = 9.85, 95% CI: 3.49 ~ 27.78), did not plan to receive COVID-19 vaccine in the future (OR = 1.70, 95% CI: 1.17 ~ 2.47), and had no adverse reactions after COVID-19 vaccination (OR = 1.54, 95% CI: 1.04 ~ 2.27) were associated with a higher IVR. The acceptance of influenza vaccination was mainly associated with respondents' gender, education, perception of COVID-19, history of COVID-19 vaccination in city and countryside community residents in Anhui province.

Vaccination of Chinese health-care workers calls for more attention

Though China's health-care workers (HCWs) had totaled as many as 12.3 million by the end of 2018, vaccination rates among them are still low or just moderate. There are few vaccination programs specifically for them. Neither targeted systematic recommendations nor effective incentives are in place. The HCWs also have some knowledge or awareness gap in vaccination. Moreover, HCWs' exposure to and infection risk of vaccine-preventable diseases (VPDs) mount up, as a great number of unvaccinated Chinese patients crowd in a few large hospitals. So does the chance of a nosocomial VPDs outbreak. Therefore, receiving vaccines is an essential part of infection prevention and control for HCWs. China should pay more attention to the challenges and take substantial measures to address it in the "Healthy China" agenda.