Acceptance Of Influenza Vaccination Research Articles

A qualitative assessment of influenza vaccine uptake among children in Kenya

BackgroundInfluenza is a significant contributor to acute respiratory infections (ARI), and children < 5 years are at increased risk of severe influenza disease. In Kenya the influenza vaccine is not included in the Kenya Expanded Programme on Immunization (KEPI). To inform roll-out of a national influenza vaccination program, we implemented an influenza vaccine demonstration project in Nakuru and Mombasa counties in Kenya from 2019 to 2021 and set out to establish factors driving influenza vaccine acceptance and hesitancy among caregivers of children aged 6–23 months. MethodsUsing semi-structured questionnaires, we conducted eight focus group discussions among community members and twelve key informant interviews among healthcare workers to elicit both lay and expert opinions. Thematic analysis of the interviews was conducted using the World Health Organization’s “3 Cs” model of vaccine hesitancy to determine reasons for acceptance or hesitancy of the influenza vaccine. ResultsThe influenza vaccine was well received among community members and healthcare workers though concerns were raised. Vaccine hesitancy was fuelled by misconceptions about reasons for introducing the vaccine (confidence), perceptions that influenza was not a serious disease (complacency) and administrative fees required at some facilities (convenience). Despite the use of various advocacy, communication and social mobilisation strategies targeted at educating the community on the influenza disease and importance of vaccination, there remained a perception of inadequate reach of the sensitization among some community members. Contextual factors such as the COVID-19 pandemic affected uptake, and parents expressed concern over the growing number of vaccines recommended for children. ConclusionDespite lingering concerns, caregivers had their children vaccinated indicating that vaccine hesitancy exists, even among those who accepted the vaccine for their children. Efforts targeted at increasing confidence in and reducing misconceptions towards vaccines through effective communication strategies, are likely to lead to increased vaccine uptake.

Pharmacy-Based Influenza Vaccination: A Study of Patient Acceptance in Romania.

This study explores patient acceptance of influenza vaccination administered by pharmacists in Romania during the 2023 season, considering it a novel strategy to address gaps in knowledge. Pharmacy-based vaccination deviates from traditional methods, providing high-risk patients with full reimbursement and others with 50% reimbursement, allowing a choice between family doctors and pharmacies for vaccine administration. The survey includes 15 questions covering socio-demographic data, health information, vaccination preferences, and perceptions of pharmacy-based vaccinations. Respondents showed a positive inclination toward pharmacy-based vaccination, with 68% expressing favorable sentiments, but an awareness gap exists, as only 36% were aware of pharmacy-based vaccination availability. Challenges include a lack of patient awareness and understanding of benefits, emphasizing the need for structured pharmacist-patient dialogues. Legal changes, a defined funding mechanism, and collaboration are crucial for successful implementation. The study provides valuable insights into patient perceptions, contributing to discussions on optimizing influenza vaccination coverage in Romania and beyond and recognizing pharmacies' potential in achieving broader vaccination goals.

Enhancing Immunization Uptake for Influenza and Pertussis in Thai Pregnant Women through Educational Sessions

Objective: To describe influenza and pertussis vaccine uptake among pregnant women before and after receiving an educational session. Materials and Methods: An interventional study was conducted at a tertiary care hospital and a specialized obstetric hospital in Thailand. In the first phase, the medical records of the non-intervention pregnant women received antenatal care (ANC) at the study sites were reviewed. In the second phase, the pregnant women completed a questionnaire about their knowledge and factors for vaccine acceptance then enrolled into the intervention, received an educational session. The vaccine uptake between phases were compared using chi-square test. Potential factors of vaccine acceptance were examined using multivariate logistic regression. Results: Between May 2019 and July 2020, 785 pregnant women were enrolled with 375 in the non-intervention group and 410 in the intervention group. The median age of the pregnant women was 30 years (IQR of 26 to 34). Influenza vaccine uptake among the non-intervention group was 55.5% compared to 65.6% in the intervention group (p=0.004). The factor for influenza vaccine acceptance was the total number of visits at the ANC clinic at ten times or more (OR 1.38, 95% CI 1.04 to 1.84, p=0.03). Pertussis vaccine uptake was 52.8% in the non-intervention group compared to 67.0% in the intervention group (p=0.001). The factor for pertussis vaccine acceptance was receiving ANC at the tertiary care hospital (aOR 6.73, 95% CI 4.42 to 10.27). The most common reasons for not getting the vaccine were the concern of vaccine safety with 25.6% for influenza vaccine and 26.3% for pertussis vaccine. Conclusion: The educational session increased the vaccine uptake for influenza and pertussis in Thai pregnant women. Keywords: Immunization; Influenza; Pertussis; Pregnancy; Education

Acceptability, cost-effectiveness, and capacity of a facility-based seasonal influenza vaccination among high-risk groups: a study protocol in selected tertiary care hospitals of Bangladesh

BackgroundIn Bangladesh, seasonal influenza imposes considerable disease and economic burden, especially for those at high-risk of severe disease. The most successful approach for influenza prevention is the administration of a vaccine. Many poor and middle-income nations, including Bangladesh, do not have a national strategy or program in place for seasonal influenza vaccines, despite the World Health Organization’s (WHO) advice to prioritize high-risk populations. Additionally, there is a scarcity of substantial data on the cost-effectiveness of seasonal influenza vaccination in these countries. The aim of our study is to determine acceptability, health beliefs, barriers, and intention of receiving influenza vaccine among high-risk populations, assess the cost-effectiveness of implementing a facility-based seasonal influenza vaccination programme, and investigate the required capacity for a potential seasonal influenza vaccination programme.MethodsWe will undertake this study following STROBE guidelines. We will conduct the study in inpatient and outpatient departments of three selected tertiary-level hospitals leveraging the ongoing hospital-based influenza surveillance (HBIS) platform. The study population will include the WHO-defined four high-risk groups excluding healthcare workers: children six months to eight years, pregnant women, elderly ≥ 60 years, and adults with chronic diseases. We will collect quantitative data on participants’ acceptability, health beliefs, barriers, and vaccination intentions using the health belief model (HBM) from patients meeting the criteria for high-risk populations attending two public tertiary-level hospitals. In one of the two public tertiary-level hospitals, we will arrange an influenza vaccination campaign before the influenza season, where the vaccine will be offered free of cost to high-risk patients, and in the second hospital, vaccination will not be offered. Both the vaccinated and unvaccinated participants will then be followed-up once a month for one year to record any influenza-like illness, hospitalization, and death. Additional data for objective two will be collected from patients with symptoms of influenza-like illness (ILI) and severe acute respiratory infection (SARI) at one public and one private hospital to determine both direct and indirect costs associated with influenza illness. We will estimate the required number of influenza vaccines, safe injections, and total storage volume utilizing secondary data. We will use a deterministic Markov decision-analytic model to estimate the cost-effectiveness of facility-based influenza vaccination in Bangladesh.DiscussionThe results of this study will enable the National Immunization Technical Advisory Group and the Ministry of Health & Family Welfare of Bangladesh to decide what steps to take to develop and implement an influenza vaccination strategy targeting high-risk populations.Trial registrationThe Clinicaltrials.gov registration number is NCT05996549. The registration for the protocol version 2.0 took place in August 2023, with the initial participant being enrolled in March 2022.

Australian healthcare personnel acceptance of the seasonal influenza vaccine: a qualitative exploration

Abstract Aim Australian healthcare personnel (HCP) are a vulnerable, yet essential cohort prioritised for seasonal influenza vaccination (SIV). Despite extensive SIV programs, and other health protective behaviours, high levels of influenza exposure contribute to almost 23% of HCP being infected each season. In that context, understanding determinants that maximise SIV uptake among HCP is an important but under-explored area. Subject and methods We conducted 14 semi-structured interviews with Australian HCP, primarily those most involved with vaccination procedures, including nurses, midwives, pharmacists, and medical practitioners. The question guide development was based on constructs from the Triandis Theory of Interpersonal Behaviour and an integrative review. All interviews were transcribed verbatim with the application of Braun and Clarke’s reflexive thematic analysis to identify and explore pertinent themes. Results Six distinct but inter-related themes were associated with HCP seasonal influenza vaccination behaviour. Most significantly, professional responsibility and identity appeared highly associated with positive vaccine intention, followed by vaccination convenience and ease of access. Protection, habit, risk perception, and experience and knowledge were also found to influence HCP decision making around SIV. Vaccination complacency, not hesitancy, was described as impeding the progression of vaccination intention (acceptance) to vaccine behaviours (uptake). Conclusion Findings suggest interventions that foster professional identity, leverage camaraderie and a ‘duty of care’ to protect others may enhance SIV intention. While improved access to SIV in the workplace could promote positive vaccination behaviour, particularly if triggers or nudges are applied to prompt the vaccination habit in the presence of SIV acceptance.

Comparing factors influencing seasonal influenza vaccine acceptance and intentions among Chinese university students residing in China and UK: A cross-sectional study

ABSTRACT University students, who face an elevated risk of influenza due to close living quarters and frequent social interactions, often exhibit low vaccine uptake rates. This issue is particularly pronounced among Chinese students, who encounter unique barriers related to awareness and access, emphasizing the need for heightened attention to this problem within this demographic. This cross-sectional study conducted in May-June 2022 involved 1,006 participants (404 in the UK, 602 in Mainland China) and aimed to explore and compare the factors influencing influenza vaccine acceptance and intentions between Chinese university students residing in the UK (C-UK) and Mainland China (C-M). The study employed a self-administered questionnaire based on the Theoretical Domains Framework and Capability Opportunity Motivation-Behavior model. Results revealed that approximately 46.8% of C-UK students received the influenza vaccine in the past year, compared to 32.9% of C-M students. More than half in both groups (C-UK: 54.5%, C-M: 58.1%) had no plans for vaccination in the upcoming year. Knowledge, belief about consequences, and reinforcement significantly influenced previous vaccine acceptance and intention in both student groups. Barriers to vaccination behavior included insufficient knowledge about the influenza vaccine and its accessibility and the distance to the vaccine center. Enablers included the vaccination behavior of individuals within their social circles, motivation to protect others, and concerns regarding difficulties in accessing medical resources during the COVID-19 pandemic. The findings of this study offer valuable insights for evidence-based intervention design, providing evidence for healthcare professionals, policymakers, and educators working to enhance vaccination rates within this specific demographic.

Influenza vaccine uptake and its determinants among adult population in the Kingdom of Bahrain: a cross-sectional study to identify areas for intervention

PurposeSeasonal influenza epidemics accounted for significant morbidity and mortality loads worldwide despite the availability of a safe vaccine as an efficient tool against severity of the disease. However, the uptake of the latter was sub-optimal. This study aims to identify predictors and barriers related to seasonal influenza vaccine uptake in the Kingdom of Bahrain.Design/methodology/approachA cross-sectional study enrolled 502 individuals attending primary healthcare centers in Bahrain for ambulatory care between July and August 2022. The data were collected using an interviews-based questionnaire which included questions on demographic data, knowledge and attitudes and practices toward influenza vaccine. The authors identified the barriers as well as the determinants of the vaccine uptake and its recommendation to others.FindingsThe mean age of participants was 35.07 years (SD = 13.9). Most of the respondents were Bahraini (86.5%) and 53.4 % were females. The results revealed that 34.1% have previous information about the influenza vaccine and 36.9% versus 69.9% are willing to receive the vaccine or advice it to others, respectively. Determinants of vaccine uptake were identified.Originality/valueThis study confirmed a sub-optimal influenza vaccine acceptance in the general community of Bahrain despite a global access in primary care. Health professionals need to be more proactive in mobilizing the community and particularly females toward influenza vaccination.

Impact of Actively Offering Influenza Vaccination to Frail People during Hospitalisation: A Pilot Study in Italy.

Despite the worldwide recommendations for influenza immunisation, vaccination coverage for patients exposed to the highest risk of severe complications is still far from the optimal target. The need to take advantage of alternative methods to provide vaccination is essential. This study presents a hospital-based strategy which offers influenza vaccination to inpatients at discharge. This study was conducted during the 2022-2023 influenza season at the University Hospital of Palermo. A questionnaire was administered to identify the determinants for the acceptance of influenza vaccination in the frail population. Overall, 248 hospitalised patients were enrolled, of which 56.1% were female and 52.0% were over 65 years of age. The proportion of patients vaccinated against influenza during hospitalisation was 62.5%, an increase of 16% in influenza vaccination uptake among frail people in comparison with the previous influenza season (46.8% vaccinated during the 2021-22 influenza season). Factors significantly associated with vaccination acceptance were the following: to have received influenza vaccine advice from hospital healthcare workers (OR = 3.57, p = 0.001), to have been previously vaccinated for influenza (OR = 3.16 p = 0.005), and to have had a low level of education (OR = 3.56, p = 0.014). This study showed that offering influenza vaccination to hospitalised patients could be an effective strategy to increase vaccination coverage in the most vulnerable population, and these findings could be useful for planning and improving future influenza vaccination campaigns.

Knowledge, attitudes, and practices (KAP) toward seasonal influenza vaccine among college students under the COVID-19 pandemic in South China.

The control measures of the coronavirus disease 2019 (COVID-19) pandemic had influenced the activity of the influenza virus, and we were wondering the knowledge, attitudes, and practices (KAP) toward seasonal influenza vaccine among college students were having at the context of the COVID-19 pandemic. Online questionnaire survey of the college students was conducted and the data was collected anonymously, cross-sectional study were used to describe the distribution of the KAP. There were 815 respondents in our study. Most participants have a high recognition of the effectiveness and safety of the influenza vaccine. However, a low awareness rate of influenza vaccine knowledge and vaccination rate (18%) against influenza was observed among college students. The education level and major would have a higher weight on the influence of KAP among the college students. Binary logistic regression analysis showed that the sex (OR = 2.163, p < .001), age (OR = 2.242, p < .001), heard of the influenza vaccine (OR = 2.655, p = .014), and "How necessary do you think vaccinating every year is?" (OR = 3.947, p < .001) of the college students were the main factors that affect the KAP on influenza vaccination. Our study provided an insight into the KAP of influenza vaccine among college students in South China. The vaccination rate and acceptability of influenza vaccine in college students are higher than that in the whole population.

Acceptance of Routine Vaccines in Pregnancy during the COVID-19 Pandemic.

This study aimed to evaluate the rates of vaccination against infectious diseases (Tetanus, Diphtheria, and Pertussis [Tdap] and influenza) in pregnancy during the coronavirus disease 2019 (COVID-19) pandemic compared to contemporary historical controls. This was a retrospective cohort study comparing rates of Tdap and influenza vaccination in pregnant people who received care at NYU Langone Health and delivered from September 1, 2020, to January 31, 2021 ("COVID cohort") to the same period the prior year ("2019 cohort"). Demographic information, trimester of initiation of prenatal care, insurance status, and medical comorbidities were evaluated. Outcomes were analyzed using chi-square, Fisher's exact test, and multivariable logistic regression, with significance of p < 0.05. In total, 1,713 pregnant people were included. Compared to historical controls, the COVID cohort differed in age, race, timing of initiation of prenatal care, insurance status, and medical comorbidities. After adjusting for these covariates, pregnant people were significantly more likely to accept influenza vaccine in the COVID cohort (adjusted odds ratio [aOR] 1.7, 95% confidence interval [CI] 1.27-2.29) and had similar Tdap acceptance (aOR 1.5, 95% CI 0.99-2.17). However, this trend was not observed for the entire obstetric population; public insurance status and medical comorbidities were associated with lower vaccine rates during the pandemic. For those who had public insurance, rates of influenza vaccination decreased from 83% in 2019 to 40% during COVID (aOR 0.16, 95% CI 0.10-0.24) and for Tdap rates decreased from 93 to 54% (aOR 0.13, 95% CI 0.08-0.21). During the COVID-19 pandemic era, pregnant people at large were more likely to accept the influenza vaccine. However, this trend did not apply to Tdap, and high-risk groups with public insurance and medical comorbidities. This study highlights potential disparities in vaccination rates, which need to be accounted for when evaluating national vaccine trends. These data support increased efforts in vaccine counseling for high-risk populations. · Antenatal flu vaccination increased during the pandemic.. · Antenatal Tdap vaccination was unchanged during the pandemic.. · High-risk pregnant patients had decreased vaccine uptake.. · High-risk subgroups were not included in overarching vaccination trends..

Peri-Pandemic Acceptance of Influenza and COVID-19 Vaccination by Swiss Healthcare Workers in Primary Care 2020/21: A Cross-Sectional Study.

Objectives: To assess and compare influenza and COVID-19 vaccination uptake of Swiss healthcare workers (HCWs) in primary care 2020/21. Methods: Influenza and COVID-19 vaccination uptake and recommendation behaviours of HCWs in the primary care were assessed using an online semi-structured questionnaire. Associations between vaccination rates and age, language, gender, profession, vaccination history, vaccination training and recommendation behaviours were evaluated using descriptive and multivariable logistic regression analyses. Results: Vaccinated against COVID-19 in 2020/21 were 91.8% of the 1,237 participating HCWs, while 60.1% were vaccinated against influenza. Physicians and pharmacists presented the highest influenza vaccination rates (87.3%, 73.7%, respectively) compared to nurses (45.8%) and medical practice assistants (52.5%) while COVID-19 vaccination rates were high across all professions. Influenza and COVID-19 vaccination rates were significantly associated with age, profession, vaccination history, vaccination training and recommendation behaviours. Conclusion: Acceptance for influenza vaccination has increased during the pandemic but is lower than that for COVID-19 among the HCWs. Demographics, vaccination status and vaccination training impact the vaccination behaviour among HCWs and should be considered in future campaigns to increase vaccination uptake.

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

ABSTRACT 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.

Influenza immunization of healthcare personnel in the post-COVID-19 pandemic era: Still a lot to do!

Healthcare-associated influenza is frequently encountered in healthcare settings with significant morbidity and mortality among vulnerable patients, absenteeism among healthcare personnel (HCP), and interruption of healthcare services. Numerous investigations indicate that nosocomial outbreaks are often traced to HCP. Despite the international and national endorsements, seasonal influenza vaccine acceptance among HCP continues suboptimal worldwide. Infection control is the major objective for healthcare risk management in order to guarantee patient safety, limit the cost of hospitalization and assurance health management in controlling influenza seasons. Vigilance and anticipation are required as globally we are moving from a reactive COVID-19 pandemic response phase to one of planning for the co-circulation of viral respiratory infections. Declining to understand HCP perception of influenza risk and acceptance of vaccination might have impact patient safety as well as healthcare services.

Evaluation of intentions to get vaccinated against influenza, COVID 19, pertussis and to get a future vaccine against respiratory syncytial virus in pregnant women

IntroductionPregnant women (PW) are at increased risk of complications due to seasonal influenza and Covid-19. Immunization during pregnancy against pertussis and respiratory syncytial virus (RSV) protects newborns from severe diseases. Our aim was to assess intentions to get vaccinated against seasonal influenza, COVID-19, pertussis and RSV in PW and to identify factors associated with intentions. MethodsCross-sectional survey in PW followed at a University Hospital in France assessing their knowledge, and attitudes toward vaccination against influenza, Covid-19, and RSV during pregnancy. Primary outcome was intention to receive each vaccine or potential vaccine. Univariable and multivariable analysis were carried out to identify factors associated with intentions to get vaccinated for each vaccine. ResultsAmong the 1199 PW followed during the study period, 310 completed the questionnaire. Intentions to get vaccinated were respectively 43.9 %, 36.8 %, 36.1 % and 39.4 % against influenza, Covid-19, pertussis and RSV. Overall confidence in vaccines using 5C-model, recommendation by a healthcare professional (HCP), good knowledge about diseases and vaccines and previous influenza vaccination were associated with flu vaccine acceptance with respective adjusted odds ratios and 95 % Confidence Intervals (aOR) 1.69 (1.09–2.61) by one-point increase in confidence score, 4.89 (2.24–10.7), 1.56 by one-point increase in knowledge score (1.26–1.93), 13.5 and (5.3–34.3). Confidence was also associated with Covid-19 and RSV vaccine acceptance with respective aOR and 95 % CI 2.63 (1.7–4.07) and 1.92 (1.3–2.84). For pertussis, previous flu vaccination or pertussis vaccination in the last 5 years were predictors of pertussis vaccine acceptance during the pregnancy with respective aOR and 95 % CI 1.97 (1.1–3.84) and 2.9 (1.6–5.18). ConclusionConfidence is associated with seasonal influenza, COVID-19 and RSV vaccines acceptance in pregnant women. Receiving a recommendation from a HCP was strongly associated with acceptance of influenza vaccine. Recent vaccination against pertussis was not a barrier to pertussis vaccine acceptance during pregnancy.

Acceptance of influenza vaccination and associated factors among teachers in China: A cross-sectional study based on health belief model

ABSTRACT Teachers played an important role on the transmission of influenza in schools and communities. The study aims to investigate the influenza vaccination coverage and the factors determining flu vaccination acceptance among teachers in Hangzhou, China. A total of 1039 junior high school teachers in Hangzhou were recruited. The self-made questionnaire was used to investigate the influenza vaccine coverage among teachers and the influencing factors of influenza vaccination acceptance. Univariate analysis using the chi-square test and multivariable analysis using binary logistic regression were conducted to determine the relative predictors. The Influenza vaccine coverage among teachers was 5.9% (62/1039). 52.9% of teachers had the intention to receive influenza vaccine, 25.3% (247/977)/21.8% (213/977) of participants was hesitant/did not have the intention to get influenza vaccine. The top three sources for teachers to gain knowledge about influenza were website (72%), TV/radio (66.1%) and social media (58%). Whether get influenza vaccination before, knowledge about influenza and influenza vaccine, the beliefs for the likelihood of catching flu, the severity of getting flu, the effectiveness of influenza vaccine, the possibility of side effects after vaccination, and the troublesome of vaccination, doctors’ recommendation, as well as the situation of vaccination among other teachers were the associated factors of influenza vaccination acceptance. The influenza vaccination coverage was low but the intentions were relatively high among junior high school teachers. Future research should focus on the relationship between vaccination acceptance and behavior to increase influenza vaccination rates.

Association between acceptance of routine pregnancy vaccinations and COVID-19 vaccine uptake in pregnant patients

COVID-19 vaccination is a key approach to reduce morbidity and mortality in pregnant patients and their newborns. Anti-vaccine sentiment has recently increased with unclear impact on pregnant patients. We examined the association between acceptance of tetanus-diphtheria-acellular pertussis (Tdap) and influenza vaccines, considered to be routine pregnancy vaccines, and COVID-19 vaccine acceptance. Secondarily, we identified other predictors of COVID-19 vaccine uptake and described pregnancy outcomes in patients who were and were not vaccinated during pregnancy. A retrospective cohort study of all patients who delivered at a single site from December 2020 - March 2022. Demographic, pregnancy, neonatal, and vaccination data were abstracted from the electronic medical record, which imports vaccine history from the California Immunization Registry. The relationship between influenza and Tdap vaccine acceptance, other baseline characteristics, and COVID-19 vaccine uptake was assessed using univariable and multivariable regression analysis. Of the 7857 patients who delivered during the study period, 4410 (56.1%) accepted the COVID-19 vaccine. Of those who received the COVID-19 vaccine, 3363 (97.6%) and 3049 (88.5%) received influenza and Tdap vaccines, respectively. Patients were more likely to receive the COVID-19 vaccine if they had advanced maternal age, obesity, Asian race, and private insurance. After adjustment for baseline differences, COVID vaccine acceptance was associated with receipt of Tdap (aOR 2.10, 95% CI 1.90-2.33) and influenza vaccines (aOR 2.83, 95% CI 2.55-3.14). There were no differences in preterm birth, low birthweight, and NICU admission between patients who received and did not receive the COVID-19 vaccine. Patients were more likely to accept COVID-19 vaccination if they received Tdap or influenza vaccinations. Older age, obesity, Asian race, and private insurance were independent predictors of vaccine uptake. Disparities in COVID-19 vaccination uptake bear further exploration to guide efforts in equitable and widespread vaccine distribution.

High caregiver adverse childhood experiences are associated with pediatric influenza and COVID-19 vaccination uptake.

Factors surrounding vaccine uptake are complex. Although anxiety, which could influence vaccination decisions, has been associated with adverse childhood experiences (ACEs), little is known about links between caregiver ACEs and pediatric vaccine uptake. We evaluated associations between caregivers' ACEs and decisions to vaccinate their children with influenza and COVID-19 vaccines. A cross-sectional study of caregivers of patients ≥6 months at one pediatric primary care center was performed. Caregivers completed a 19-question survey examining caregiver ACEs, influenza vaccine acceptance and beliefs, and intention to vaccinate their child with the COVID-19 vaccine. Demographic characteristics, social risks (e.g., housing and food insecurity), and vaccination data for children present with each caregiver were extracted from the electronic health record. Statistical analyses included chi-square tests for categorical and t-tests for continuous variables. A total of 240 caregivers participated, representing 283 children (mean age of 5.9 years, 47% male). Twenty-four percent (n=58) had high ACEs (≥4). Of those with high ACEs, 55% accepted pediatric influenza vaccination compared to 38% with low ACEs (p=0.02). Those with high ACEs had more positive attitudes toward influenza vaccine safety and efficacy (p≤0.02). Those with high, compared to low, ACEs were also more likely to accept COVID-19 vaccination (38% vs. 24%; p=0.04). Pediatric influenza vaccination rates and intention to vaccinate children against COVID-19 differed between caregivers with high and low ACEs: those with more ACEs were more likely to vaccinate. Further studies assessing the role of caregiver ACEs on vaccine decision-making are warranted.

The Influence of the COVID-19 Pandemic on Seasonal Influenza Vaccine Uptake Among Patients Visiting a University Hospital in Saudi Arabia.

Influenza vaccination is a subject of importance in Saudi Arabia. The study measured the uptake of annual influenza vaccination from 2019 to 2021 among patients attending outpatient clinic of a University Hospital. Materials and methods: A cross-sectional study design was used, and the questionnaire was administered by trained interviewers. Descriptive and inferential statistics were done using the Statistical Package for the Social Sciences (SPSS) version 21 (IBM, Armonk, New York). Results: The three-year annual influenza vaccine uptake for 2019-2021 was 19.7%, 11.4%, and 14.2%, respectively. In the year 2022, only 28.2% of the patients were offered influenza vaccines by their physicians, and among those offered, 49.6% showed vaccine acceptance. Higher vaccine acceptance was significantly associated with past episodes of influenza infection (p<0.001) and vaccination history before the COVID-19 pandemic (p<0.001). Lower acceptance of the influenza vaccine was observed during the pandemic (p<0.001) and lower uptake among those who were not offered influenza vaccines (p=0.02). No association was found between influenza vaccine acceptance and smoking status, chronic illness, history of COVID-19 infection, or living with those susceptible to influenza. Reasons for vaccine denial include an assumption of not being at risk, a lack of information about the vaccine, and a fear of side effects. The COVID-19 pandemic has had a detrimental effect on annual influenza vaccination. Efforts must be taken to increase influenza vaccination among vulnerable groups.

93 SARS-CoV-2 Vaccine Acceptance and Uptake among Caregivers of Children 5-11 Years of Age: A Cross-sectional Survey

Abstract Background Although vaccination of children aged 5-11 years against SARS-CoV-2 is recommended in Canada, nearly half of Ontarian children this age remain unvaccinated. Objectives This study aimed to assess caregivers’ vaccine acceptance and uptake for children in this age group and to identify factors associated with vaccine non-acceptance in Ontario. Design/Methods A multi-language self-administered survey was sent to caregivers of children aged 5-11 years through schools and community health centres within the Toronto Area, from April 5th–July 4th, 2022. Socio-demographic characteristics, acceptance of routine childhood and influenza vaccines, and current SARS-CoV-2 vaccine status for parents and older siblings were collected. Data were analyzed using descriptive statistics and multivariable logistic regression. Results Overall, 807 caregivers of children aged 5-11 years answered the survey. Although 748 (93%) caregivers had received at least two doses of COVID-19 vaccine, only 618 (77%) had a child 5-11 years old who had received at least one dose of the vaccine. Adjusted odds ratios for vaccine acceptance were higher among caregivers older than 40 years of age, caregivers who were vaccinated against COVID-19 themselves, children living in areas with high vaccine coverage, and children who received at least one influenza vaccine in the past two years (see Figure 1, below). Caregivers reported seeking information on COVID-19 mostly from public health resources (76%), government organizations (58%), social media (58%), and family doctors or paediatricians (38%). The most common reasons among caregivers not to vaccinate children were concerns about long-term side effects (59%), wanting to wait until there is more experience with vaccinating children (41%), and concerns that vaccines were developed too quickly (39%) (Figure 2). Conclusion We describe factors associated with SARS-CoV-2 vaccine non-acceptance in caregivers of children 5-11 years old and the barriers to vaccine acceptance in this population. These findings provide insights on groups of caregivers that should be targeted for educational and public health interventions and identify parental concerns that ought to be addressed to increase vaccine confidence. Potential competing interests Dr. Shaun K. Morris has received honoraria for lectures from GlaxoSmithKline, was a member of ad hoc advisory boards for Pfizer Canada and Sanofi Pasteur, and is an investigator on an investigator-led grant from Pfizer, all unrelated to this study. This project is supported by a grant from the Public Health Agency of Canada’s Immunization Partnership Fund. 1The number of 668 cases were included in the model.2Caregivers were able to select multiple choices for their ethnicity, and Indigenous ethnic background was classified as mixed and other.3Children received at least one influenza vaccine in the past two years.4Vaccination coverage was based on the Forward Sortation Area from the Institute for Clinical Evaluative Sciences July 2022. 1187 caregivers of unvaccinated children against COVID-19 included and could choose multiple reasons not to vaccinate their children 5-11 years of age.

Acceptance and awareness regarding influenza vaccine among healthcare workers in a tertiary care centre, Kerala

Background: The seasonal Influenza is a contagious respiratory illness. The most important step in preventing flu is to get a flu vaccination each year along with everyday preventive actions. The objective of this research was to study the acceptance and awareness of Influenza vaccine among health care workers of a tertiary care centre, Kerala and to explore the preventive practices. Methods: This study was a hospital based cross sectional study conducted among 204 health care workers in a tertiary centre in Kerala. A simple random sampling technique was adopted. Data was collected using self-administered pretested semi structured questionnaires. Results: 165 (80.9%) are aware of the Influenza vaccine while 39 (19.1%) are not aware of the Influenza vaccine. 30 (14.7%) has received at least one dose of Influenza vaccine in last five years while 174 (85.2%) has not received the vaccine. 161(78.9%) says they are willing to get vaccinated against Influenza while 43(21.1%) are not willing to get vaccinated. Conclusions: Even though there is good awareness about Influenza vaccine, the number of vaccine recipients is less than ideal. However, majority are willing to take Influenza vaccine in the future which shows good acceptance.