Intention of receiving nasal spray influenza vaccine among unvaccinated nurses

Abstract

Background: In preparation for the 2018–2019 influenza season, US Centers for Disease Control and Prevention (CDC) updated its recommendation on the use of a nasal spray vaccine, a live attenuated influenza vaccine (LAIV), for individuals aged 2–49 years. This study aimed at evaluating the intention of previously unvaccinated nurses in receiving LAIV as an alternative to conventional injectable vaccines. Methods amd materials: Subsequent to the winter and summer influenza seasons of 2018–2019, a set of online questionnaire was administered to practising and student nurses at the 2 time-periods, with the collaboration of the Association of Hong Kong Nursing Staff. Demographics, work nature, vaccination uptake history and views on influenza vaccination were inquired in the questionnaire. Strong intention of receiving LAIV was the outcome variable assessed in unvaccinated nurses. Descriptive statistics and multivariable logistic regression were performed to determine their preference for LAIV and factors associated with the intention of getting vaccinated. Reasons for receiving LAIV were also identified. Results: Of 875 responses received, results of 750 nurses were eligible for analysis. The median age was 33 years (IQR = 29–40) and 88% were female. Overall, 47% have received influenza vaccination before either season of the year. Of the 401 unvaccinated nurses, 38%, 42% and 20% reported a strong, moderate and weak intention of receiving LAIV respectively, versus 20%, 38% and 42% for receiving conventional injectable vaccine, given the same cost and logistics. The level of understanding (odds ratio [OR] = 2.02; adjusted OR = 2.45) and perceived risk of influenza (OR = 2.48; adjusted OR = 3.05) were factors positively associated with strong intention after adjusting for the nurses’ demographics and excluding those expressing moderate intention. Three respondents (1% among vaccinated nurses) reported having received LAIV, with the major reasons of avoiding pain and side effects brought by injection and perceived effectiveness comparable to conventional injectable vaccines. Conclusion: Given a moderately high intention relative to conventional injectable vaccine, LAIV as an alternative, might help to expand the influenza vaccination coverage, which could be considered for incorporation into the influenza vaccination programme for nurses in Hong Kong.