Influenza vaccination uptake among high-risk target groups and health care workers in Spain and change from 2017 to 2020

Knowledge and Adherence to Lifestyle Habits to Prevent Complications Associated With Immunosuppression in Kidney Transplant Recipients: A Single-Center Survey

BACKGROUND

Chronic immunosuppression associated with certain lifestyle habits render kidney transplant (KT) recipients more susceptible to infection and cancer. We assessed the level of knowledge and adherence to safe living strategies to minimize the occurrence of posttransplant complications.

METHODS

Consecutive KT recipients were offered a self-administered questionnaire covering the following areas: demographics and socioeconomic factors; generic hygiene habits; sun exposure; smoking and alcohol consumption; vaccination status; animal contact and gardening; international travelling; and food safety and habits.

RESULTS

Between May 2019 and May 2021, 130 KT recipients responded the survey at a median of 61.5 posttransplant days (completion rate of 94.9%). Only 19.7% of participants visited the dentist at least every 3-6 months. Although the majority (88.5%) were aware of the need of sunscreen, only 23.3% used it throughout the year. Self-reported influenza vaccine uptake in the last session was 69.1%. Pet ownership was reported by 41.7% of participants, of which more than one-third had considered to give up the care of their animals. Gardening and international travel were uncommon. A notable proportion of participants acknowledged to consume the following products either "usually" or "often": raw or undercooked meat (12.4%), undercooked fish (24.8%), raw seafood (8.8%), homemade sausages or cured ham (51.5%), pâté or meat spreads (35.2%), and "ready-to-eat" salads (31.8%). Adherence was poorer among non-native-speaking patients and those with lower education and household incomes.

CONCLUSION

There is room for improvement in health education and promotion practices among KT recipients, particularly those with potential cultural and socioeconomic barriers.

Influenza, pneumococcal, and COVID-19 vaccination coverage and hesitancy in adults with psychiatric disorders

Background/Objectives

Patients with psychiatric disorders have high mortality and morbidity rates from infectious diseases, but low vaccination rates compared to the normal population. This study aimed to evaluate the vaccination rates for influenza, pneumococcal, and COVID-19 vaccines, and the levels of vaccine hesitancy among individuals with psychiatric disorders.

Methods

The study was a cross-sectional study among patients with psychiatric disorders. Participants' vaccination statuses for influenza, pneumococcal, and COVID-19 vaccines during the pandemic were assessed, along with their vaccine hesitancy levels using a vaccine hesitancy scale. Data were collected between 01.03.2024 and 27.11.2024.

Results

The study included 500 patients diagnosed with psychiatric disorders. Only 3.6% of the participants had received the influenza vaccine in the previous year, 3.0% reported regular influenza vaccinations, and 76.2% had received the COVID-19 vaccine during the pandemic. Among the participants at risk for pneumococcal infection (14%), the vaccination rate was only 2%. Patients with attention deficit hyperactivity disorder (ADHD) (45.0%) and anxiety disorder (17.2%) had the highest rates of regular influenza vaccination, while those with psychosis (13.6%) and depression (14.6%) had the lowest (p=0.010). COVID-19 vaccination rates during the pandemic were highest in ADHD (90.0%), bipolar disorder (81.1%), and depression (80.8%), and lowest in psychosis (54.5%) and obsessive-compulsive disorder (64.3%)(p=0.002). Women (p=0.001), participants with below university education levels (p=0.009), and patients with psychosis showed greater vaccine hesitancy. Patients with ADHD and bipolar disorder had the most positive attitudes toward vaccination (p=0.021). Positive attitudes were also linked to recent or regular influenza vaccinations and COVID-19 or pneumococcal vaccinations (p<0.05).

Conclusions

Low vaccination rates and high vaccine hesitancy in psychiatric patients, particularly those with psychosis, necessitate targeted strategies to improve immunization coverage in this population.

Hospitalization cost estimates of respiratory syncytial virus and influenza infections in adults in Spain, 2016-2019

Respiratory syncytial virus (RSV) is increasingly a recognized cause of severe respiratory infection among adults. This retrospective observational study compared the costs of RSV and influenza hospitalizations in adults aged ≥18 years admitted to the Spanish National Healthcare System between 2016 and 2019. Mean costs per hospitalization episode were compared using a multivariable log-gamma generalized linear model adjusted by age, risk group and calendar year. Total annual hospitalization costs were estimated from population incidence rates (for RSV we used model-based rates reported in a published study due to the substantial under-ascertainment of cases) and the mean cost per episode. ICD-10 codes identified a total of 11,662 adults hospitalized with RSV and 79,319 with influenza. The mean length of stay was longer for RSV than for influenza in low-risk patients aged 60-79 years, moderate-risk patients (those with chronic medical conditions) aged ≥50 years and in high-risk (those with immunocompromising conditions) patients aged <80 years. There were no differences in intensive care unit (ICU) admission (except for higher admission in high-risk RSV patients aged 70-79 years), ICU stay or in-hospital case fatality rate. Mean costs per hospitalization episode were also similar: RSV €3870 (95 % CI 3773-3942) vs influenza €3888 (95 % CI 3836-3931). Total annual costs for RSV-attributable hospitalizations were estimated at M€194, twice than that of influenza (M€83). Annual costs increased by 11 % over the study period for RSV and by 47 % for influenza. In 2019, adults aged ≥60 years and ≥ 70 years contributed 91 % and 82 %, respectively, of the total RSV-attributable hospitalization costs in adults. RSV has a significant economic burden to the Spanish National Healthcare System, likely greater than influenza. Efficacious RSV vaccines and antivirals have the potential for high public health impact.

Moderate effectiveness of influenza vaccine in outpatient settings: A test-negative study in Beijing, China, 2023/24 season

INTRODUCTION

The objective of our study was to estimate the influenza vaccine effectiveness for 2023/24 epidemic of co-circulating influenza A(H3N2) and B(Victoria) viruses in Beijing, China.

METHODS

The surveillance-based study included all swabbed patients through influenza virological surveillance in Beijing, between October 2023 and March 2024. A Test-Negative Design(TND) was used to estimate influenza vaccine effectiveness(VE) against medically- attended laboratory-confirmed influenza in outpatient settings, also calculated the influenza vaccination rate(IVR). Cases were influenza-like illness (ILI) patients who tested positive for influenza, and controls were ILI who influenza negative patients.

RESULTS

A total of 18,665 ILI patients were enrolled and swabbed. Among them, 6362(34.1 %) tested positive for influenza, major epidemic strain was A(H3N2) and B(Victoria). The overall IVR was 8.7 %, and the differences of IVR by gender, age, region, chronic conditions and month of onset were statistically significant(P<0.05). The adjusted VE against all influenza was moderate at 44.8 %, with the highest for B (Victoria) at 52.2 %, the highest for 19-59 age at 72.4 %, and the highest when vaccinated only in current season at 48.3 %.

CONCLUSION

Our study suggested the influenza vaccine has moderate effectiveness, with the best VE against B(Victoria), followed by A(H3N2) and A(H1N1)pdm09 in Beijing, 2023/24 season. Meanwhile, the influenza VE was relatively high in school-age children and the elderly. Consistent long-term studies are required in the future to evaluate the protect effect of influenza vaccine.

Impact of the COVID-19 Pandemic on Influenza Vaccination Coverage of Healthcare Personnel in Alicante, Spain

Influenza is a health problem and vaccination is the most effective measure to prevent it. The objective of this study was to evaluate the impact of the COVID-19 pandemic on vaccination coverage (VC) against influenza in healthcare workers (HCWs). A cross-sectional study was conducted at the Dr. Balmis University General Hospital in the province of Alicante (Spain), in which vaccination data were collected retrospectively. Adverse effects (AEs) were detected via telephone call between 15 and 30 days after vaccination. The existence of significant changes in VC between the different seasons studied was evaluated using Chi square with a statistical significance level of p < 0.05. A total of 8403 HCWs vaccinated throughout the different seasons were studied. The vaccination coverage of HCWs for influenza pre-COVID-19 pandemic (2019/20 season) was 51.9%; increased during the pandemic to 67.9% (2020/21 season) and 65.5% (2021/22 season); and, after the pandemic, it decreased to 42.7% (2022/23 season) (p < 0.05). The most frequent reason for vaccination during the periods evaluated was "self-protection", followed by "protection of patients" and "protection of family members". Of all HCWs evaluated, 26.6% (1460/5493) reported at least one AE. During the COVID-19 pandemic, HCWs' influenza vaccination coverage fluctuated considerably. There has been an increase in VC during the most critical moments of the pandemic, both in the 2020/21 and 2021/22 seasons, which has, subsequently, decreased in the 2022/2023 season, to levels below pre-pandemic (2019/2020 season), which justifies implementing specific measures to recover VC in Spain.

Influenza Vaccination Coverage among People with Self-Reported Cardiovascular Diseases-Findings from the Hungarian Implementation of the European Health Interview Survey

Worldwide, cardiovascular diseases are the leading cause of mortality. This has significant implications for public health. Influenza, a common infectious disease, poses an increased risk for individuals with chronic conditions, such as cardiovascular diseases. However, little is known about influenza vaccination coverage in this group. This study utilized data from the Hungarian implementation of the European Health Interview Survey to assess influenza vaccination coverage and its determinants among cardiovascular respondents from 2009 to 2019. The findings reveal a downward trend in the vaccination rates over the years (from 24% to 21%), despite the availability of free vaccination in Hungary for this high-risk population. The main factors influencing low influenza vaccine uptake were identified, as follows: young age, a lower level of education, good self-perceived health status, smoking, a lower frequency of medical visits, and not suffering from respiratory diseases. Addressing these disparities necessitates targeted vaccination strategies supported by enhanced education, better access to healthcare services, and the promotion of preventive healthcare measures. Improving vaccination coverage among patients with cardiovascular diseases is imperative for reducing influenza-related morbidity and mortality. This highlights the importance of comprehensive public health interventions and healthcare provider engagement in promoting vaccination among groups at increased risk.

The coverage of influenza vaccination and predictors of influenza non-vaccination in Danish cancer patients: A nationwide register-based cohort study

BACKGROUND

Influenza vaccination is recommended and provided free-of-charge to Danish citizens aged ≥65 years and to individuals with acquired immunodeficiency. We aimed to estimate influenza vaccination coverage and investigate predictors of influenza non-vaccination in Danish cancer patients.

METHODS

A nationwide cohort study of all Danish citizens aged ≥18 years with an incident cancer diagnosis between 2002 and 2017. Using national registries, we assessed information on influenza vaccination and potential predictors of influenza non-vaccination. We estimated adjusted prevalence ratios (aPR) of influenza non-vaccination for patients aged <65 years and ≥65 years.

RESULTS

We observed 269,863 patients during 840,876 influenza vaccination seasons. The influenza vaccination coverage was 14 % for cancer patients <65 years and 51 % for those ≥65 years. No influenza vaccination in the previous season was associated with non-vaccination in the current season (<65 years: aPR = 2.75, 95 %CI = 2.71-2.80; ≥65 years: aPR = 5.15, 95 %CI = 5.10-5.21). Haematological cancer patients receiving chemotherapy had lower vaccination prevalence compared with those not receiving chemotherapy.

CONCLUSIONS

The influenza vaccination coverage was low among cancer patients. Influenza non-vaccination in the previous season was the strongest predictor of not receiving influenza vaccination in the current season. Haematological cancer patients on current chemotherapy had lower vaccination prevalence than those not currently receiving chemotherapy.

Factors associated to influenza vaccination among hospital's healthcare workers in the Autonomous Community of Madrid, Spain 2021-2022

Influenza vaccination (IV) aims primarily to protect high-risk groups against severe influenza-associated disease and death. It is recommended in Spain for high-risk groups, including Healthcare workers (HCWs). However, vaccination uptake has been consistently below desirable levels. The objective of this study were to evaluate influenza vaccination coverage using data from the regional vaccination registry, during 2021-2022 season, among HCWs in public hospitals in Autonomous Community of Madrid (CAM) and to explore factors associated with influenza vaccination. We conducted a cross-sectional study using administrative data retrieved from the Regional Department of Health data repositories. A multilevel logistic regression model was designed to estimate Level 1 (individual) and Level 2 (contextual) variables that are associated with HCẂs vaccination. The study population was HCWs from 25 public hospitals in CAM who were active during the period of the influenza 2021-2022 vaccination campaign. The global influenza vaccination coverage (IVC) was 52.1 %. All study Level 1 variables were significantly associated with vaccine uptake. Greater IVC is associated with individual characteristics: female (OR1.14; 95 %CI 1.09-1.19), older age 59-69 years old (OR1.72; 95 %CI 1.60-1.84), born in Spain, medical staff, more than one high-risk condition (OR1.24; 95 %CI 1.10-1.40; respectively) and vaccinated in two previous campaigns (OR25.64; 95 %CI 24.27-27.09). IVC was highest among HCWs celiac disease (65.5 %) followed by diabetes mellitus (65.1 %) and chronic inflammatory disease (64.3 %). The hospital where the study subject worked also showed an effect on the vaccination uptake, although Level 2 variable (hospital complexity) was not positively associated. IVC in HCWs remains suboptimal. These findings may prove useful to tailor strategies to reach specific groups. It is recommended to delve into the identification of factors associated with the HCWs workplace that may have a positive impact on IV.

Low Levels of Influenza Vaccine Uptake among the Diabetic Population in Spain: A Time Trend Study from 2011 to 2020

(1) Background: In this work, we aim to describe influenza vaccine uptake among the diabetic population in Spain to assess the time trend from 2011 to 2020 and identify predictors of vaccine uptake among diabetes patients. (2) Methods: We conducted a descriptive cross-sectional study using the European Health Interview Survey for Spain (2014 and 2020) and the Spanish National Health Surveys (2011 and 2017). The independent variables analysed included socio-demographic characteristics, health-related variables and lifestyle variables. We matched each participant with diabetes with a non-diabetic participant based on age, sex, place of residence and year of survey. (3) Results: The overall coverage among diabetic adults was 52.1% compared to 40.6% for matched participants without diabetes (p < 0.01). The vaccine uptake among adults with diabetes was 52.6% in 2011, 54.38% in 2014 and 53.4% in 2017. The adjusted OR of having been vaccinated in 2020, with respect to 2011, was not significant at 0.87 (95% CI: 0.72–1.06). Factors such as being male, higher age, being affected by respiratory disease or cancer and being physically active were identified as positive predictors for influenza vaccination uptake, while smoking was a negative predictor. (4) Conclusions: The influenza vaccine uptake is below desirable levels among the adult diabetic population in Spain and has not improved from 2011 to 2020. More efforts should be made to increase influenza vaccine uptake in this high-risk group, especially for women, those aged 18–64 years, without other high-risk conditions and smokers.