Abstract
BackgroundUnderstanding knowledge and sentiment toward influenza and vaccination is important for effective health messages and prevention strategies. We aimed to characterize knowledge, attitudes, and practices surrounding influenza illness and vaccination in two South African communities and explore reasons for vaccine hesitancy.MethodsHousehold primary caregivers in Soweto and Klerksdorp townships were interviewed about knowledge of influenza and intention to receive an influenza vaccine using a structured questionnaire. Factors associated with unwillingness to receive vaccine were explored using multivariable regression.ResultsWe interviewed representatives of 973 households in Soweto and 1,442 in Klerksdorp. Most respondents in Soweto (692, 71%) and Klerksdorp (1247, 87%) thought weather or cold caused influenza. While most would get a free influenza vaccine, those unwilling to receive vaccine had concerns about efficacy (Soweto: 19%; Klerksdorp: 19%) and safety (Soweto: 17%; Klerksdorp: 10%). In Soweto, females (aRR 2·0, 95% CI 1·3–3·2) and those with higher household income (aRR 1·8, 95% CI 1·2–2·7) were less willing to receive vaccine. In Klerksdorp, more educated respondents (aRR 1·6, 95% CI 1·1–2·4) were less willing to receive vaccine; households reporting an HIV‐positive member were more willing to receive vaccine (aRR 0·3, 95% CI 0·1–0·8).ConclusionsAlthough findings suggest most community participants were amenable to influenza vaccination, knowledge gaps were present. Emphasizing the importance of influenza as a health problem and addressing vaccine safety and efficacy concerns may improve uptake. Populations less amenable to vaccination, including those with higher education and income, may benefit from targeted messaging efforts.
Highlights
Understanding knowledge and sentiment toward influenza and vaccination is important for effective health messages and prevention strategies
Among South Africans of 65 years of age or older, the rate of excess mortality due to pneumonia and influenza is estimated at 340 deaths per 100 000 population;[4] this influenza-attributable mortality rate is even higher among young adults with AIDS in South Africa, at an estimated 570 deaths per 100 000.5 In addition, HIV-positive South Africans have been shown to be at greater risk for severe influenza illness.[6]
Some knowledge gaps and misconceptions about influenza illness and vaccination were identified in these communities, most participants reported a willingness to receive an influenza vaccine
Summary
Understanding knowledge and sentiment toward influenza and vaccination is important for effective health messages and prevention strategies. We aimed to characterize knowledge, attitudes, and practices surrounding influenza illness and vaccination in two South African communities and explore reasons for vaccine hesitancy. Influenza is an important cause of morbidity and mortality globally and in South Africa. Vaccination and antiviral treatment may mitigate the impact of influenza in South Africa. Annual vaccination for seasonal influenza has been recommended in South Africa a 2016 The Authors.
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