Vaccine history, gender and influenza vaccination in a household context

How cyberchondria and decision self-efficacy shapes the acceptability of COVID-19 vaccine: A gender-based comparison

Objective

Alarmingly, the individuals' reach and coverage to get vaccinated in developing regions during the pandemic is a massive challenge for concerned authorities. This study aimed to demonstrate how cyberchondria play a significant role in a classical health belief model. Cyberchondria may influence cognitive factors (e.g. self-efficacy), which may contribute to an increase in attitude-behavior gap. Especially in the context of a health-centric scenario, it may discourage individuals to take protective measures.

Method

By using the cross-sectional research design, the authors conducted a quantitative survey in Pakistan and collected 563 responses from 303 male respondents (rural = 91; urban = 212) with (Urban M:35.5, standard deviation (SD):13.4) and rural M:37.5, SD:8.4).

Result

The findings indicate that decision self-efficacy among males is stronger than that in females. It dominates other determinants, which can dampen the individuals' intentions to get vaccinated. For instance, the effect of conspiracies and perceived seriousness was noted nonsignificant and weak. In females, perceived seriousness was stronger determinant than in males. In addition, the negative effect of decision self-efficacy was noted in the case of females, and conspiracy and cyberchondria had a negative role.

Conclusion

This study highlights valuable implications for future research in infodemic, health communication and health literacy, and practical implications for regulatory bodies and public administration.

Is disgust proneness prospectively associated with influenza vaccine hesitancy and uptake?

Although various demographic and psychosocial factors have been identified as correlates of influenza vaccine hesitancy, factors that promote infectious disease avoidance, such as disgust proneness, have been rarely examined. In two large national U.S. samples (Ns = 475 and 1007), we investigated whether disgust proneness was associated with retrospective accounts of influenza vaccine uptake, influenza vaccine hesitancy, and eventual influenza vaccine uptake, while accounting for demographics and personality. Across both studies, greater age, higher education, working in healthcare, and greater disgust proneness were significantly related to greater likelihood of previously receiving an influenza vaccine. In Study 2, which was a year-long longitudinal project, disgust proneness prospectively predicted influenza vaccine hesitancy and eventual vaccine uptake during the 2020–2021 influenza season. Findings from this project expand our understanding of individual-level factors associated with influenza vaccine hesitancy and uptake, highlighting a psychological factor to be targeted in vaccine hesitancy interventions.

Intention to get vaccinated against COVID-19 among the general population in France: Associated factors and gender disparities

As the coronavirus disease 2019 (COVID-19) spreads across the world, the rapid distribution of an effective vaccine and its acceptability among the population constitute priorities for health authorities. This study aimed to document attitudes of the general population toward a future vaccine against COVID-19. We used the national COCONEL surveys conducted during the lockdown to identify factors associated with vaccine refusal, in the whole population, and separately among men and women. We investigate the role of socioeconomic and demographic factors as well as exposure to COVID-19. Among the 5,018 participants, 24.0% reported their intention to refuse the vaccine. Thinking this vaccine would not be safe, being against vaccination in general, and perceiving COVID-19 to be harmless were the three main reasons given to explain vaccine refusal. Women were more likely to refuse the vaccine, especially due to a reluctance toward vaccination in general or the perception that a COVID-19 vaccine would not be safe. Some factors associated with the intention to refuse the vaccine were the same among men and women such as a lack of prior vaccination against influenza, and concern over being infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), while others differed slightly according to gender such as age, and high prevalence of COVID-19 in their region of residence. Authorities should therefore guarantee that all the necessary precautions are taken before marketing the vaccine and communicate transparently on the process of its development, and on the coverage rate required to reach herd immunity.Abbreviation: EHI: Equivalized Household Income per month; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2.

A Retrospective Analysis of Gender-Based Difference in Adherence to Influenza Vaccination during the 2018-2019 Season

Introduction:

Improving flu vaccination rates in the general population is an important and effective strategy toward reducing morbidity, mortality, and the cost of seasonal influenza. In order to optimize immunization strategies, factors associated with decreased vaccination rates need to be explored. The literature suggests that there is a gender difference in the rate of influenza vaccination but is limited to population-based survey studies and also is inconsistent as to which gender has a higher rate of vaccination. The purpose of this study was to evaluate for a gender-based difference in the rate of influenza vaccination among patients who presented for an annual physical examination during the 2018 to 2019 influenza season.

Methods:

In this multi-site, retrospective chart review, a total of 1193 patients (608 female and 585 male) who underwent an annual physical examination in April of 2019 were included. Baseline medical information was collected, as well as demographic characteristics and influenza vaccination status. The proportion of patients who underwent influenza vaccination was compared between males and females using multivariable logistic regression models; odds ratios (ORs) were estimated.

Results:

The likelihood of influenza vaccination was significantly higher in females (62.8%) compared to males (53.2%) in both unadjusted analysis (OR = 1.49, P < .001) and in multivariable analysis adjusting for the potential confounding influences of clinic location, BMI, insurance type, and occupation (OR = 1.42, P = .005). Interestingly, a higher influenza vaccination rate for females compared to males was observed in patients age<60 years (OR = 1.70, P = .025) and between ages 60 and 75 (OR = 1.66, P = .009), but not for patients older than 75 years (OR = 1.12, P = .66).

Conclusion:

Our findings indicate that the rate of influenza vaccination is higher for females than for males who presented for an annual preventive physical exam and who are younger than 75 years old.

Predictors of influenza vaccination among elderly: a cross-sectional survey in Greece

BACKGROUND

Senior individuals are particularly vulnerable to influenza. Research suggests that protection against the virus and its transmission in this high-risk group of the population can be achieved by active immunization against the pathogen.

AIMS

To explore and analyze the attitudes, knowledge and behavior of people over the age of 60 on influenza vaccination.

POPULATION AND METHODS

This cross-sectional survey included people over the age of 60 who were eligible candidates for the influenza vaccine from 3 regions from Northern and 1 region from Southern Greece. A self-completed questionnaire based upon the Theory of Planned Behaviour, the Motivation for Vaccination (MoVac-flu) and the Vaccination Advocacy Scale (MovAd) was administered to the participants. Demographic characteristics and information about health status were also obtained.

RESULTS

The final sample included 318 participants with mean age of 70.7 years. More than half of the participants (56.6%) had received a flu vaccine in 2018 while 50.8% received it annually in previous years. Behavioral (p < 0.001), normative (p < 0.001), and control beliefs (p < 0.001), promoted the uptake of the vaccine and the increased intention score (p < 0.001) was associated with increased probability of vaccination. Greater age (p = 0.001) and frequent visits to the doctors (p = 0.003) had a positive influence upon the uptake of the vaccine.

CONCLUSIONS

Only a small proportion of those over the age of 60 had received the influenza vaccine. This finding is worrying, as it indicates the impact that a future outbreak of seasonal influenza could exert upon vulnerable groups. There is an urgent need for further, better and more evidence-based information from healthcare professionals to achieve greater vaccination coverage in the community.

Influence of age, sex and hospitalisation on the administration of tuberculosis medication: an evaluation of routine data from a German health insurer

Background

So far, there is no reliable information on the drugs actually taken by tuberculosis patients. With billing data from a large German health insurance company, valid data from practice will be used for analysis. The objective here is to use the claims data of a health insurer to gain an insight into the prescriptions issued to patients with tuberculosis in Germany.

Methods

The study design encompasses a longitudinal, analytical observational study of selected insurance holders. Descriptive analyses of the outpatient drug supply of pulmonary tuberculosis patients are determined for 6 payroll years. We have studied whether different doses of tuberculosis medication are associated with age, sex, inpatient status and comorbidity. Quantile regression is used as a method to identify subgroups or characteristic dosages.

Results

The number of defined daily doses prescribed per patient varies among insurance holders and encompasses widely differing timeframes. Higher doses are observed with increasing age, as well as in patients with tuberculosis-related hospitalisations. The sex of the patient has no identifiable effect on the prescribed doses for any of the first-line tuberculosis drugs. Comorbidity partially has a significant impact on the duration and intensity of tuberculosis drug prescriptions.

Factors associated with influenza vaccination in Japanese elderly outpatients

BACKGROUND

Elderly patients benefit from influenza vaccination, but the number of Japanese elderly patients who are vaccinated is insufficient. Several factors are associated with influenza vaccination acceptance, but little is known about Japanese elderly outpatients. The purpose of this study was to examine factors associated with influenza vaccination in elderly outpatients in Japan.

METHODS

During the 2017-2018 influenza season, outpatients from one hospital and one clinic in Kitaibaraki City, Ibaraki, Japan, participated in this study. Patients answered a self-report questionnaire exploring factors such as their vaccination status during the 2017-2018 season, past influenza vaccination, perceived susceptibility to influenza and adverse events of the vaccine, perceived vaccine efficacy, physician recommendations. Multivariable logistic regression analyses were conducted to identify factors associated with vaccination.

RESULTS

Of 377 patients, 316 (83.8%) responded, and the vaccination rate was 57%. Eighty-three patients (27.0%) reported that their physician recommended the influenza vaccine. In multivariate analysis, influenza vaccination was associated with higher age (odds ratio (OR) 1.09, 95% confidence interval (CI) 1.03-1.14), physician recommendations (OR 2.49, 95% CI 1.18-5.25), low perceived susceptibility to vaccine-related adverse events (OR 0.33, 95% CI 0.15-0.74), and belief in vaccine efficacy (OR 4.73, 95% CI 2.08-10.8).

CONCLUSIONS

Influenza vaccination was associated with belief in vaccine efficacy, perceived susceptibility to vaccine-related adverse events, physician recommendations, and older age. Increasing the frequency of physician recommendations may lead to increased vaccination coverage.

Self-reported influenza vaccination rates and attitudes towards vaccination among health care workers: results of a survey in a German university hospital

OBJECTIVES

The objective of this survey was to analyse vaccination rates and attitudes towards vaccination among health care workers (HCWs). The period prevalence of self-reported acute respiratory infections in the influenza season 2014/2015 was examined.

STUDY DESIGN

A cross-sectional study was conducted among HCWs of a German university hospital using an anonymised questionnaire. Recruitment was performed by providing all medical and nursing staff a paper questionnaire with an invitation to participate.

METHODS

Descriptive aggregated data were generated from digitalised questionnaires for all variables. Differences in categorical variables were analysed by Chi-squared test. Textual data were analysed by an iterative process based on the grounded theory by Glaser and Strauss.

RESULTS

The response rate was 31% (677/2186). Probable influenza was described by 9% (64/677) of the participants. The overall self-reported vaccination rate was 55% (366/666). Self-reported vaccination rate was higher in physicians (172/239, 72%) than in nursing staff (188/418, 45%). HCWs in paediatrics (103/148, 70%) more likely received vaccines than HCWs in surgery (31/84, 37%). Most vaccinations were provided by medical staff on the wards (164/368, 45%). Self-reported lost work-time due to adverse events after vaccination was low (6/336, 2%). Eight categories for vaccine refusal were identified, whereof doubts about effectiveness and indication of the vaccine was most frequently mentioned (72/202, 36%).

CONCLUSIONS

Efforts to promote vaccination should focus on nursing staff and should provide scientific evidence on effectiveness, adverse effects, and the benefits of health care workers' vaccination for patients. Administering vaccines at the workplace proved to be a successful strategy in our setting. Studies are needed to assess the frequency of influenza causing disease in HCWs.

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.

Influenza vaccination in older people with diabetes and their household contacts

BACKGROUND

People with diabetes are at a higher risk of influenza infections and severe complications. The vaccination of close contacts could offer indirect protection to people with diabetes; this is known as "herd immunity." The aim of this study is to investigate the vaccination rates of people with diabetes and their household contacts in Hong Kong.

RESEARCH DESIGN AND METHODS

Face-to-face interviews with 158 patients diagnosed with Type 2 diabetes and aged ⩾65years were conducted in clinics. Telephone interviews were then conducted with 281 adult household contacts.

RESULTS

Seasonal influenza vaccination rates were 54.5% and 27.4%, in people with diabetes and their contacts, respectively. The vaccination status of patients was not significantly associated with the vaccination of their household contacts (p=0.073). Among household contacts, children or the elderly, the partners or couples of patients, and those with more hours of daily contact, or with chronic conditions, were associated with higher vaccination rates. However, only age remained significant after adjusting for confounding factors in logistic regression models.

CONCLUSIONS

The low vaccination rates of people with diabetes and their close contacts highlight the need to promote vaccination in susceptible populations and to educate the public about herd immunity.

Decomposing racial/ethnic disparities in influenza vaccination among the elderly

While persistent racial/ethnic disparities in influenza vaccination have been reported among the elderly, characteristics contributing to disparities are poorly understood. This study aimed to assess characteristics associated with racial/ethnic disparities in influenza vaccination using a nonlinear Oaxaca-Blinder decomposition method. We performed cross-sectional multivariable logistic regression analyses for which the dependent variable was self-reported receipt of influenza vaccine during the 2010-2011 season among community dwelling non-Hispanic African-American (AA), non-Hispanic White (W), English-speaking Hispanic (EH) and Spanish-speaking Hispanic (SH) elderly, enrolled in the 2011 Medicare Current Beneficiary Survey (MCBS) (un-weighted/weighted N=6,095/19.2 million). Using the nonlinear Oaxaca-Blinder decomposition method, we assessed the relative contribution of seventeen covariates - including socio-demographic characteristics, health status, insurance, access, preference regarding healthcare, and geographic regions - to disparities in influenza vaccination. Unadjusted racial/ethnic disparities in influenza vaccination were 14.1 percentage points (pp) (W-AA disparity, p<0.001), 25.7 pp (W-SH disparity, p<0.001) and 0.6 pp (W-EH disparity, p>.8). The Oaxaca-Blinder decomposition method estimated that the unadjusted W-AA and W-SH disparities in vaccination could be reduced by only 45% even if AA and SH groups become equivalent to Whites in all covariates in multivariable regression models. The remaining 55% of disparities were attributed to (a) racial/ethnic differences in the estimated coefficients (e.g., odds ratios) in the regression models and (b) characteristics not included in the regression models. Our analysis found that only about 45% of racial/ethnic disparities in influenza vaccination among the elderly could be reduced by equalizing recognized characteristics among racial/ethnic groups. Future studies are needed to identify additional modifiable characteristics causing disparities in influenza vaccination.

The relationship between influenza vaccination habits and location of vaccination

Although use of non-medical settings for vaccination such as retail pharmacies has grown in recent years, little is known about how various settings are used by individuals with different vaccination habits. We aimed to assess the relationship between repeated, annual influenza vaccination and location of vaccination. Study Design: We conducted a cross-sectional survey of 4,040 adults in 2010. Methods: We fielded a nationally representative survey using an online research panel operated by Knowledge Networks. The completion rate among sampled panelists was 73%. Results: 39% of adults reported that they have never received a seasonal influenza vaccination. Compared to those who were usually or always vaccinated from year to year, those who sometimes or rarely received influenza vaccinations were significantly more likely to be vaccinated in a medical setting in 2009–2010. Conclusions: Results indicate that while medical settings are the dominant location for vaccination overall, they play an especially critical role in serving adults who do not regularly receive vaccinations. By exploring vaccination habits, we can more appropriately choose among interventions designed to encourage the initiation vs. maintenance of desired behaviors.

Determinants of receiving the pandemic (H1N1) 2009 vaccine and intention to receive the seasonal influenza vaccine in Taiwan

OBJECTIVES

The paper examines the factors associated with both receiving pandemic (H1N1) 2009 vaccines and individuals' intentions to get the next seasonal influenza vaccine in Taiwan.

METHODS

We conducted a representative nationwide survey with in-person household interviews during April-July 2010. Multivariate logistic regression incorporated socio-demographic background, household characteristics, health status, behaviors, and perceptions of influenza and vaccination.

RESULTS

We completed interviews with 1,954 respondents. Among those, 548 (28.0%) received the pandemic (H1N1) 2009 vaccination, and 469 (24.0%) intended to get the next seasonal influenza vaccine. Receipt of the H1N1 vaccine was more prevalent among schoolchildren, the elderly, those who had contact with more people in their daily lives, and those who had received influenza vaccinations in previous years. In comparison, the intention to receive the next seasonal influenza vaccine tended to be stronger among children, the elderly, and those who reported less healthy status or lived with children, who received a seasonal influenza vaccination before, and who worried more about a possible new pandemic.

CONCLUSIONS

Children, the elderly, and those who had gotten seasonal flu shots before in Taiwan were more likely to both receive a pandemic H1N1 vaccination and intend to receive a seasonal influenza vaccine.