Flu Vaccination Coverage Research Articles

Group A Streptococcus infections in children and adolescents in the post-COVID-19 era: a regional Italian survey

BackgroundDespite the worldwide increasing incidence of Group A Streptococcus (GAS) infections reported since December 2022, data on noninvasive GAS (nGAS) infections in the post COVID-19 era are limited. By a self-reported survey performed in an outpatient setting, we investigated the number and clinical features of GAS infections, the diagnostic work-up and the type of treatment utilized. In addition, the rate of influenza vaccination was evaluated.MethodsIn June 2023 family pediatricians involved in the study sent the survey to parents of patients aged 0–16 years. The survey included questions on GAS infections that occurred from January 1 to May 31, 2023.ResultsAmong 3580 children, 20.3% had a GAS infection (0,8% < 1 year, 16,4% 1–3 years, 42,3% 3–6 years, 26,5% 6–9 years, 11,4%, 9–12 years, and 2,6% 12–16 years). Symptoms reported were sore throat (76.9%), fever (75.2%), tonsillar exudate (25.2%), lymphadenopathy (21.8%), and scarlet fever (14.7%). A single patient was hospitalized due to GAS meningitis.Twenty four percent of children had more than one GAS infection. In this group, frequencies of symptoms reported in the first and in the following infection were similar, except for fever and scarlet fever which were less frequent during relapses. GAS was identified by rapid antigen detection test in 81.0% of children. Eighty-nine per cent of children were treated with antibiotics, mostly amoxicillin/clavulanate (40.4%) and amoxicillin (39.4%). Thirty four percent of children received influenza vaccine. No difference was observed among immunized and not immunized regarding the number and characteristics of GAS infection. ConclusionsWe reported a certain prevalence of nGAS infections in children, mainly those aged 3–6 years age, who were mostly characterized by a low score of symptoms, and in most of the cases diagnosed and treated using a microbiological test as confirmatory tool.In this new clinical setting, a national study would be useful to reach more significant data for the definition of a correct diagnosis and clinical management of nGAS infections in children. Moreover, it is important to improve flu vaccination campaign and coverage to protect children from coinfections that could worsen the disease and misdiagnose the etiology of pharyngitis.

Intent to receive flu vaccine and influenza vaccination coverage among health professionals during 2019, 2020 and 2021 campaigns in Côte d’Ivoire

Vaccination of healthcare workers against influenza is a crucial strategy to reduce transmission amongst vulnerable populations, facilitate patient uptake of vaccination, and bolster pandemic preparedness. Globally, vaccination coverage of health workers varied from 10 % to 88 %. Understanding health workers’ knowledge and acceptance of the influenza vaccine, particularly among physicians, is crucial for the fine-tuning and continued success of influenza vaccination campaigns.We conducted a cross-sectional survey of 472 health workers in Abidjan, Côte d'Ivoire, to inform subsequent subnational and national introductions of influenza vaccine and subsequent campaigns targeting health workers in 2019 (14302), 2020 (14872), and 2021 (24473). Using a purposive sample of university hospitals, general hospitals, rural, and urban health facilities, we interviewed a convenience sample of health workers aged 18 years and older. Physicians had the lowest intention to receive the influenza vaccine (58 %), while nurses (78 %) and midwives (76 %) were the most willing. Across all occupations, intention to receive vaccination increased if the vaccine was offered for free or if recommended by the Ministry of Health. 76 % of respondents believed that the influenza vaccine could prevent illness in health workers.Communication strategies, including about the benefits of influenza vaccination, could raise awareness and acceptance among health workers prior to vaccination campaigns. Influenza vaccination coverage rates between 2019 and 2021 were on par with rates of intention to receive vaccination in the 2018 survey; in 2019, 2020, and 2021, coverage among physicians was 73 %, 73 %, and 52 % and coverage among nurses and midwives was 86 %, 86 %, and 74 % respectively.Improving health workers’ knowledge and acceptance of the influenza vaccine, particularly among physicians, is crucial for the continued success of influenza vaccination campaigns.

Quadrivalent Live-Attenuated Influenza Vaccine in Milan preschools: an Italian experience of school-located flu vaccination within the 2022–2023 season

BackgroundIn Italy, since the 2020–2021 flu season, the flu vaccine recommendation was extended to all children aged 6 months to 6 years and quadrivalent Live-Attenuated Influenza Vaccine (qLAIV) was introduced. Since school-aged children are important carriers of annual influenza epidemics, a school-based influenza vaccination program may potentially increase vaccine uptake. Recent studies, conducted in the UK and the US, show that school-based vaccination can reach higher percentage of paediatric vaccination coverage compared to children vaccinated in other settings.MethodsDuring 2022–2023 flu season in 9 preschools located in Milan healthcare personnel vaccinated children with qLAIV at the end of a school day. A Google Form questionnaire was administered to preschoolers’ parents of all preschools within the Municipality of Milan.ResultsIn the preschools engaged in the vaccination program, 233 out of 1939 children were vaccinated (12%). Among these, 61 (26.2%) had never been vaccinated for influenza before. Vaccination coverage was 11.5% for Italian children and 14.3% for children coming from an immigrant background.We collected 3659 questionnaire responses, divided according to study participation status (371 from preschools that participated in the vaccination program and 3288 from other preschools in Milan). 57% of the families who answered to the questionnaire vaccinated their children for flu. qLAIV accounted for 85.6% of vaccinations. We observed a statistically significant difference in the percentage of vaccinated children between those attending a school participating in the project (67.9%) and children attending other schools (56%) (p < 0.001). Vaccination was administered by family pediatricians (48.9%), in vaccination centers (34.8%), in vaccine hubs (11.3%), in schools (2.6%), by private pediatricians (1.6%) and in other settings (0.7%). Focusing on the responses from families whose children attend schools participating in the vaccination program, 21.8% stated that the vaccination was provided in school.ConclusionAccording to our experience, in Italy, at the moment, only the cooperation between health providers and alternative settings, including schools, may expand flu vaccination coverage. In particular, schools are to be considered a place to inform and reach out to families, useful to increase vaccination coverage.

A Latent Profile Analysis of COVID-19 and Influenza Vaccine Hesitancy among Economically Marginalized Hispanic Mothers of Children under Five Years of Age in the US.

Rates of COVID-19 and influenza vaccine coverage among Hispanic young children continue to be low in comparison to other racial and ethnic groups in the United States. This study utilized a person-centered approach to understand COVID-19 and influenza vaccination hesitancy for young children under the age of five among 309 economically marginalized Hispanic mothers. Drawing on the cultural health belief model, in 2022, following FDA approval of the COVID-19 vaccine for young children, a latent profile analysis was conducted from which three profiles emerged. The Low Acculturation group (Profile 1), was notable for lower acculturation, moderate cultural medical mistrust, lower access to vaccines, and higher financial security. Compared to Profile 1, the two remaining profiles had higher acculturation and lower levels of financial security, but differed in that the High Acculturation group (Profile 2) had higher vaccine accessibility and the Moderate Acculturation group (Profile 3) had higher cultural medical mistrust. Relative to other profiles, Low Acculturation mothers were more likely to plan to vaccinate their child against current and seasonal COVID-19 and seasonal influenza, report that their child's health provider recommended the COVID-19 shot and reported lower COVID-19 and influenza vaccine mistrust. However, they also reported lower vaccine accessibility and moderate levels of cultural medical mistrust. The study highlights the importance of developing person-centered public health strategies that draw on Hispanic cultural values and consider diversity within lower income Hispanic populations to increase future pediatric COVID-19 and flu vaccination coverage among young Hispanic children.

Flu vaccination coverage in Italy in the COVID-19 era: A fuzzy functional k-means (FFKM) approach

BackgroundIn Europe, flu vaccination coverage has decreased, and there are complex barriers to overcome to vaccinate against flu. Many studies have been conducted to estimate vaccination coverage. The COVID-19 pandemic threatens to disrupt immunization programs in many countries, including Italy, where vaccination against the flu is recommended but not mandatory. This paper aims to understand changes in flu vaccine uptake in Italian regions. MethodsUsing functional data analysis and fuzzy functional k-means clustering, we investigated changes in flu vaccine coverage in Italian regions before (2010–2019) and after (2020–2022) the COVID-19 vaccination period. ResultsThe period of COVID-19 pandemic brought an increase in vaccine coverage globally. Elbow's method determined that the optimal number of clusters in vaccination uptake is 2. Apulia, Basilicata, Emilia Romagna, Liguria, Molise, Tuscany, and Umbria in 2019 belong less to the group with low flu vaccination uptake (G1) but increase their tendency to belong to this group over time: they decrease their propensity to be vaccinated for flu. For others, it seems that COVID-19 served as a push to increase flu vaccination coverage rates. Sicily appears to be the region that has responded best to the pandemic, changing its membership value from 2019 to 2022. ConclusionThe present study highlights that the COVID-19 era has resulted in a higher flu vaccination coverage rate. Moreover, the regional level's improvement or worsening in flu vaccination coverage rate is not affected by the historical gap and socio-cultural and economic differences prevailing among Italian regions.

Effects of Vaccine Literacy, Health Beliefs, and Flu Vaccination on Perceived Physical Health Status among Under/Graduate Students.

Physicians highlight that receiving the flu vaccine is critical, especially during the COVID-19 pandemic period. Younger groups' flu vaccination coverage is very low, and this tendency is potentially related to a lower level of vaccine literacy and perceptions toward vaccination. This study investigated the relationship between flu vaccine literacy, health beliefs, and flu vaccinations (benefit, barrier, severity, and susceptibility) and their impact on perceived health status controlling for socioeconomic factors. It used the Health Belief Model andHealth Literacy Skills Framework with under/graduate students (N = 382) in Ohio, U.S. Path analyses were performed to examine the causal process using SPSS and Amos 23.0. Indicators of CFI, RMSEA, SRMR, and the chi-square/df of the path models were good-acceptable. Vaccine literacy directly impacted on health beliefs and vaccination. Susceptibility belief directly influenced perceived health status. The mediation effects of health beliefs (benefit, barrier) between vaccine literacy and vaccination were confirmed. The study highlights the need for healthcare providers and governments to work together to improve flu vaccine literacy and reduce negative perceptions toward vaccination among younger populations. Educational programs and official communication channels can be used to address concerns and provide accurate information about vaccines to increase flu vaccination rates and protect public health.

Vaccination and Voting Patterns in the U.S.: Analysis of COVID-19 and Flu Surveys From 2010 to 2022

The study assessed the relationship between COVID-19 and influenza (flu) vaccination and voting patterns during the pandemic and the time trends between flu vaccination and voting patterns. Flu and COVID-19 vaccination coverage were analyzed using National Immunization Surveys for flu (Years 2010-2022) and COVID-19 (National Immunization Surveys Adult COVID-19 Module 2021-2022), Centers for Disease Control and Prevention surveillance of COVID-19 vaccination coverage (2021-2022) and U.S. COVID-19 Trends and Impact Survey (2021-2022). The study described the correlations between state-level COVID-19 and flu vaccination coverage, examined individual-level characteristics of vaccination for COVID-19 and for flu using logistic regression (COVID-19 Trends and Impact Survey May-June 2022), and analyzed flu vaccination coverage by age (National Immunization Surveys for flu 2010-2022) and its relationship with voting patterns. There was a strong correlation between state-level COVID-19 vaccination coverage and voting share for the Democratic candidate in the 2020 presidential elections. COVID-19 vaccination coverage in June 2022 was higher than flu vaccination coverage, and it had a stronger correlation with voting patterns (R=0.90 vs R=0.60 in COVID-19 Trends and Impact Survey). Vaccinated people were more likely to be living in a county where the majority voted for the Democratic candidate in 2020 elections both for COVID-19 (adjusted OR=1.77, 95% CI=1.71, 1.84) and for flu (adjusted OR=1.27, 95% CI=1.23, 1.31). There is a longstanding correlation between voting patterns and flu vaccination coverage, which varies by age, with the strongest correlation in the youngest ages. There are existing prepandemic patterns between vaccination coverage and voting patterns. The findings align with research that has identified an association between adverse health outcomes and the political environment in the U.S.

Expert consensus on monitoring antimicrobial stewardship in French nursing homes using assessed reimbursement database indicators.

Monitoring the appropriateness of antibiotic prescriptions with indicators based on reimbursement data is required to guide antibiotic stewardship (AMS) interventions in nursing homes (NHs). Quantity metrics (QMs) monitor the volume of prescriptions while proxy indicators (PIs) reflect the appropriateness of antibiotic use. Our objectives were: (i) to provide a relevant consensual set of indicators to be used in French NHs; and (ii) to assess the feasibility of their implementation at the national and local scale. Nine French professional organizations implicated in AMS in NHs were asked to nominate at least one member to create a national expert panel of 20 physicians. Twenty-one recently published QMs and 11 PIs were assessed by the expert panel. Indicators were evaluated using a RAND-modified Delphi procedure comprising two online surveys and a videoconference meeting. Indicators were kept in the final list if >70% of stakeholders validated their relevance for estimating the volume (QMs) and appropriateness (PIs) of prescriptions. Of the 21 QM indicators submitted to the panel, 14 were selected, describing the consumption of antibiotics overall (n = 3), broad-spectrum (n = 6) and second-line antibiotics (n = 2). The three remaining QMs evaluated the route of administration (n = 1) and urine culture prescriptions (n = 2). Ten PIs (six modified, two rejected, one new) were selected to assess the appropriateness of prescriptions for urinary tract infections (n = 2), seasonal variations in prescriptions (n = 2), repeated prescriptions of fluoroquinolones (n = 1), cephalosporins' route of administration (n = 1), duration of treatment (n = 1), rate of second-line antibiotics (n = 1), co-prescriptions with non-steroidal anti-inflammatory drugs (n = 1), and flu vaccine coverage (n = 1). The panel was in favour of using these indicators for regional and facility level AMS programmes (91%), feedback to NH prescribers (82%), benchmarking by health authorities (55%) and public reporting at the facility level (9%). This consensual list of indicators, covering a wide range of frequent clinical situations, may be used as part of the French national AMS strategy for monitoring antibiotic prescriptions in NHs at the national and local levels. Regional AMS networks might manage this selected list to guide personalized action plans with concrete objectives of reducing the quantity and improving the quality of antibiotic prescriptions.

Knowledge, attitudes and adherence towards influenza and other vaccinations among healthcare workers at the University Hospital of Palermo, Italy, during the first COVID-19 pandemic season (2020/2021).

Increasing adherence to influenza vaccination among healthcare workers is a public health priority, stated that actually remains far below than international recommendations. During the 2020/2021 pandemic season, COVID-19 vaccines were not yet available until the end of December 2020, and influenza vaccines were the only one available to protect against seasonal respiratory diseases. The main objective of the present study was to assess knowledge, attitudes and adherence to influenza and other vaccinations recommended by the National Immunization Plan 2017-2021 for healthcare workers. Enrollment lasted from October and December 2020 at the vaccination unit of the University Hospital of Palermo. Data were collected through an anonymous and self-administered questionnaire, divided into 5 sections and 31 items. Among 734 healthcare professionals that completed the survey, a significantly higher adherence to influenza vaccination was observed among healthcare workers that were more prone to receive COVID-19 vaccination (OR=4.02; 95% CI: 1.63-9.91). Moreover, higher influenza vaccination rates were observed among healthcare professionals that received influenza vaccination during previous 2019/2020 season (OR=15.3; 95% CI: 5.17-45.1) and that were favorable to the possible impact on increasing adherence of influenza mandatory vaccination (OR=4.88; 95% CI: 2.43-9.80). Propensity of healthcare workers to undergo vaccinations recommended in the National Immunization Plan increased during the first pandemic season. At the end of the vaccination season, flu vaccination coverage reached highest rates ever at the University Hospital of Palermo (around 60%), remaining anyway below the recommended minimum value of 75%. During next seasonal flu vaccination campaigns, it becomes essential to promote communication and information strategies to increase flu vaccination among healthcare workers, also focusing on co-administration with the anti-COVID-19 booster/seasonal doses.

Flu Vaccine Uptake in Caregivers and Noncaregivers: Implications for Policy and Practice

Caregivers are a critical and highly used health care resource. Caregivers may experience adverse health outcomes and practice less self-care, including obtaining vaccinations, while serving in their roles. Influenza (flu) is a common infectious disease responsible for millions of doctor visits, hospitalizations, and approximately 43,000 US deaths annually that can largely be prevented by receiving seasonal vaccinations. We aimed to estimate and compare the prevalence of flu vaccination among caregivers and noncaregivers. We hypothesized that caregivers would have a lower prevalence of flu vaccination than noncaregivers and that sociodemographic variables, health-related variables, and caregiving-specific characteristics would be associated with vaccine uptake. We analyzed Behavioral Risk Factor Surveillance System data from 2016 through 2018 on 154,170 respondents from 27 US states and the District of Columbia. We used bivariate analysis to estimate the difference in flu vaccination uptake among caregivers and noncaregivers and logistic regression to estimate differences after adjusting for individuals' characteristics. Logistic regression indicated no significant difference in flu vaccine uptake between caregivers and noncaregivers. Caregiving characteristics such as years in a caregiver role, weekly time spent caregiving, relationship to care recipient, and recipient's risk for flu complications were also nonsignificant. Sociodemographic factors such as marital status, income, health insurance coverage, and race had a significant impact on flu vaccine uptake. Although no significant differences in flu vaccine uptake were found between caregivers and noncaregivers, flu vaccine coverage remains low in both groups. Evidence-based programs and policies to improve vaccine coverage in the caregiver and general populations remains a public health priority.

Flu shot in the era of COVID-19 vaccination: findings from a research hospital of Rome

Abstract Influenza represents a major burden for public health. Healthcare workers (HCWs) are a priority target group for flu vaccination. During the COVID-19 pandemic, when SARS-CoV-2 vaccines were not yet available, susceptibility to influenza vaccination especially by HCWs increased. The aim of this study is to analyze the flu vaccination coverage among HCWs and to study which factors affected their adherence given the concomitant COVID-19 vaccination. The retrospective study was conducted in an Italian research hospital from October 2021 to January 2022. A total of 7,048 individuals was included. Age class, gender and job category variables were analyzed. Statistically significant differences among groups were tested through χ2 test. Univariate and multivariate analyses (p &amp;lt; 0,005) were performed to assess differences towards vaccination attitude. The flu vaccination coverage rate was 24.6%. Among the selected job categories, 29.8% of physicians, 19.9% of nurses and 19.7% of other HCWs were vaccinated with a statistically significant decrease (p &amp;lt; 0.001) across all categories respect with the last campaign. The findings of the logistic regression depicted that the 40-59 years old age class, compared with the youngest age class (OR 1.30, 95% CI 1.12-1.43) as well as being physician (OR 2.79, 95% CI 1.87-3.41) with the respect to being nurses, had a higher adherence to vaccination. Interestingly, being male, is associated with a statistically significant reduction (OR 0.71, 95% CI 0.59-0.87) in vaccination uptake. Study findings showed a several decline in the flu vaccination coverage comparing with previous campaigns, probably due to the concomitant administration of the booster dose against SARS-CoV-2. This alarm should not be underestimated and requires timely and innovative organizational approaches (i.e., combined vaccine). Further studies are needed to analyze the reasons for this poor adhesion and the strategies to be adopted to increase the awareness of the HCWs. Key messages • Reaching high coverage rates and restore a positive trend for the future campaign for flu vaccination it is essential strategy to protect HCWs themselves, their patients and the hospital community. • Decision-makers should implement consistent communication strategies to lessen vaccine hesitancy among HCWs.

Flu vaccination coverage in healthcare workers during a 3-year period in the context of the pandemic

Abstract Background Vaccination of healthcare workers (HCWs) against seasonal influenza is considered the most effective way to protect HCWs and maintain essential healthcare services during influenza epidemics. With the present study we aimed to evaluate the efficacy of measures implemented during the three flu campaigns of 2018/19, 2019/20 and 2020/21 in a university hospital in Pisa, Italy, through the assessment of vaccination coverage (VC) in HCWs and to assess attitudes toward flu vaccination. Methods Flu VC was stratified according to sex, age, job and vaccination status for each season and the association between each variable and vaccination status was explored. In 2020, a survey collecting data on knowledge and attitudes on flu vaccination was distributed. Results Starting from the 2018/19 campaign, an increasing flu VC rate was registered: contained in 2019/20 (from 11.6% to 14.3%, Δ%=23.1) and significant (VC = 39.6%, Δ%=177.6) in 2020/21 as compared with the previous year. Physicians were the professionals most willing to get vaccinated during all seasons. Considering age the situation changed greatly over the study period, with VC rising in 2020/21 in those age groups marked by low VC in previous years (&amp;lt;30 and 41-50 years old, Δ%=293). Having been vaccinated in the previous year represented the most important variable to predict likelihood of accepting flu jab. However, while previously vaccinated HCWs were 13 times more likely to get the flu jab in 2019/20 compared with the others; in 2020/21 they were only 3 times. Only half of HCWS considered themselves at higher risk of contracting influenza compared to the general population, while 71% totally agreed that receiving the flu jab in 2020/21 was more important than the previous years due to COVID. Conclusions A significant increase in VC was observed in 2020/21, especially among those sub-groups with consistently lower uptake in previous years, due to the COVID pandemic that positively influenced vaccination uptake. Key messages • This study evaluates the impact of subsequent flu vaccination campaigns implemented in a large university hospital in Italy through the assessment of flu VC among HCWs. • A significant increase in flu VC among HCWs was observed in 2020/21, especially in those categories characterized by lower VC rates in the previous years, more likely due to the COVID-19 pandemic.

Flu and Covid-19: is there adherence to vaccination in target groups?

Abstract Background In Italy, the flu vaccine is recommended and free for target groups (adults≥60 years old, fragile people, healthcare workers, pregnant women). During the 2020/2021 flu season, an increased vaccination coverage (+6,9%) was observed compared to the previous season, also due to the Covid-19 pandemic. We aimed to investigate how strong the adherence to the flu vaccine was by the vulnerable groups and assess if the Covid-19 vaccination campaign may have influenced the rate of flu vaccines. Methods At the beginning of autumn 2021 we conducted an online survey among the population of Tuscany. We collected data on demographics, health status (pregnancy, vulnerable), flu and COVID-19 vaccinations coverage and health information sources. In addition, we performed a descriptive and a risk factors analysis to assess correlation between our variables with R v 4.0.0. Significance level was set at p &amp;lt; 0.05. Results Among 408 participants, 248 (61%) belong to a vulnerable group and are recommended to receive the flu vaccine, 229 (56%) usually get the flu vaccine, 386 (95%) got the Covid-19 vaccine, 267 (65%) choose and trust the general practitioner (GP) as their health information source. There is a statistically significant association between being part of a vulnerable group and getting the seasonal flu vaccine (OR 6.63 95% CI 4.26-10.3 p &amp;lt; 0.001). In addition, getting the Covid-19 vaccine increases the likelihood of receiving the flu vaccine (2.90 95% CI 1.16-7.28 p = 0.018). Moreover, participants who trust their GP as their health information source (OR 1.63 CI 1.08-2.46 p = 0.019) are more likely to receive the flu vaccine; other information sources (TV, newspaper, social media) are not associated with the flu vaccine. Conclusions Our research shows that vulnerable groups get vaccinated against the flu. The increase in flu vaccine coverage may be due to the COVID-19 vaccines campaign. GPs play a crucial role in the health promotion, prevention and health literacy of patients. Key messages

Identifying factors associated with COVID-19 related deaths during the first wave of the pandemic in Europe.

AimTo clarify the high variability in COVID-19-related deaths during the first wave of the pandemic, we conducted a modeling study using publicly available data.Materials and methodsWe used 13 population- and country-specific variables to predict the number of population-standardized COVID-19-related deaths in 43 European countries using generalized linear models: the test-standardized number of SARS-CoV-2-cases, population density, life expectancy, severity of governmental responses, influenza-vaccination coverage in the elderly, vitamin D status, smoking and diabetes prevalence, cardiovascular disease death rate, number of hospital beds, gross domestic product, human development index and percentage of people older than 65 years.ResultsWe found that test-standardized number of SARS-CoV-2-cases and flu vaccination coverage in the elderly were the most important predictors, together with vitamin D status, gross domestic product, population density and government response severity explaining roughly two-thirds of the variation in COVID-19 related deaths. The latter variable was positively, but only weakly associated with the outcome, i.e., deaths were higher in countries with more severe government response. Higher flu vaccination coverage and low vitamin D status were associated with more COVID-19 related deaths. Most other predictors appeared to be negligible.ConclusionAdequate vitamin D levels are important, while flu-vaccination in the elderly and stronger government response were putative aggravating factors of COVID-19 related deaths. These results may inform protection strategies against future infectious disease outbreaks.

Flu and COVID-19 Vaccination: What Happens to the Flu Shot When the Campaigns Overlap? Experience from a Large Italian Research Hospital.

Influenza represents a threat to global health and health care workers (HCWs) have an increased risk of contracting the influenza virus in the workplace. The COVID-19 pandemic has brought back the importance of influenza vaccination, as the influenza virus can circulate together with SARS-CoV-2. The aim of this report is to describe the actual flu vaccination coverage among healthcare workers of a research hospital and the trend changes, with respect to the past flu vaccination campaigns, in light of the present pandemic and COVID-19 vaccination. A Pearson’s χ2 test was used to test the correlation of flu vaccination coverage, across all professional categories, between the last two years. A linear regression model was adopted to predict the total vaccination coverage of this year. A statistically significant decrease (p < 0.01) was observed in vaccination coverage among all the professional categories with a 50% reduction in vaccination trends between the last two years. Analyzing the data from the previous six flu vaccination campaigns, the expected value, according to the linear regression model, was estimated to be 38.5% while the observed value was 24%. The decrease in vaccination coverage may be due to the fear of the pandemic situation and especially to the uncertainty related to the consequences of a concurrent administration which may overload the immune system or may be more reactogenic. The COVID-19 pandemic represents an opportunity to promote and support large-scale influenza vaccination among HCWs through structured programs, adequate funding, and tailored communication strategies.

Barriers to Seasonal Influenza Vaccine Uptake in a Pediatric Inpatient Healthcare Setting After Implementation of Clinical Decision Support.

Every heatlhcare encounter is an opportunity to provide both acute care and health maintenance to children. A Clinical Decision Support (CDS) intervention was instituted in a tertiary pediatric health system to improve influenza vaccination rates during the 2019-2020 season among eligible children receiving care in an acute care inpatient healthcare setting. This study explores reasons for low vaccine uptake following implementation of a CDS aimed at improving vaccine administration as well as identifying possible solutions to improve flu vaccine coverage.

New tools to improve flu vaccination coverage in patients with risk factors

BackgroundInfluenza vaccination is one of the main interventions to prevent the flu. This study evaluates the impact of automated letter as a method of capturing patients at risk in influenza vaccination campaigns between 2013 and 2017. MethodsThis is a descriptive observational study in Sector I Zaragoza. Data analysis with SPSS and Excel. We studied 173 935 patients (>65 years old or with a risk factor) between 2011 and 2017, comparing the type of catchment used for vaccination. Centre 1 uses postal mail compared to Centre 2 that uses regular information channels. ResultsSignificant differences were observed, with an increase in vaccination in Centre 1 compared to Centre 2 (Centre 1: 29.59%; Centre 2: 19.76%, p < 0.001). Significant differences are found when comparing the vaccination rates in Centre 1 pre-post-intervention (P < 0.001). These differences are also significant when analysing the risk groups: >65 years, asthmatics, patients with COPD, diabetics, and patients with coronary heart disease. 78.3% of the Centre 1's surveys considerade quate the patient catchment via postal mail. ConclusionsSending a letter to those patients at risk of severe complications from influenza is an effective measure to increase influenza vaccination in the primary care setting.

Analysis of the best strategies to promote flu vaccination coverage among healthcare professionals

ObjectiveThe flu represents a major public health issue. The flu vaccination rate among healthcare professionals has traditionally been lower than recommended by national health authorities, and there is also regional heterogeneity. The objective of the Gripetool project was to identify the most effective initiatives to promote influenza vaccination in Spain among healthcare workers. Material and methodsInformation was obtained through an online survey conducted among members of the Spanish Society of Primary Care Physicians (SEMERGEN) between July and November 2020, which had been previously validated by a committee of experts. A multiple linear regression analysis was performed to analyse the possible relationship between the vaccination coverage of health professionals and the different promotion measures reported in the survey. ResultsAccording to respondents (n = 385), the publication of vaccination recommendations (18.6%), the use of media and social networks (14.4%), and the active recruitment through email/letters (10.6%) are the most effective measures to increase vaccination rates. According to the statistical analysis, there are 10 measures that have a positive impact on the vaccination rate, the most relevant include the distribution of posters in health centres (17 percentage points increase, pp), the publication of vaccination recommendations (14 pp), and the development of protocols and guidelines (13 pp). ConclusionsThe most effective strategies to increase influenza vaccination comprehend actions at macro-, meso-, and micro levels to promote vaccination and communicate its benefits, exploiting the potential of new technologies.

The impact of mental distress on influenza vaccine coverage.

Influenza is a major cause of morbidity and mortality worldwide. The flu vaccine is the most important strategy to prevent influenza. Studies indicate that individuals with mental health disorders are at an increased risk of comorbid health conditions that predispose them to severe flu complications. This study examined the association between mental distress and influenza vaccine coverage among non-institutionalized adults in the United States. Data was analyzed from the 2016 Behavioral Risk Factor Surveillance System (BRFSS). The analytic sample (453,924) included those with valid information on health-related quality of life (HRQOL) and flu vaccine coverage. Bivariate analysis and logistic regression were performed. Those with infrequent mental distress had 1% (95% confidence interval [CI] 0.96,1.03) lower odds and those with frequent mental distress had 21% (95% CI 0.75,0.82) decrease odds of receiving the flu shot in comparison to those with no mental distress, given all else equal. A negative effect on influenza vaccination rates was observed with frequent mental distress when compared to those with no mental distress. Further studies are warranted to better understand this association.

Flu Vaccination Coverage and Predictors of Non-Vaccination in Military Health Corps Personnel 2016-2017 and 2019-2021.

(1) Background: Vaccination is the most effective intervention to control seasonal influenza morbidity and mortality. The present study aimed to determine the influenza vaccination coverage in the Military Health Corps personnel in the 2020–2021 season, as well as the time trend and the possible influence of the pandemic on coverage, in order to study the reasons that led to the non-vaccination of health professionals and to analyze adverse drug reactions (ADRs). (2) Methods: A descriptive, cross-sectional study was conducted from February to May 2021. All FAS CMS personnel were included. A self-administered questionnaire was sent by e-mail to the selected personnel. (3) Results: Vaccination coverage in the 2016–2017 season was 15.8% (n = 276), in the 2019–2020 season it was 17.41% (n = 424), and in the 2020–2021 season it was 24.22% (n = 590). The percentage of vaccinated men was higher than the percentage of women. In 2019 and 2020 the most vaccinated group was 31–40 years old. Lieutenants had the highest vaccination uptake in 2019 and 2020. The personnel with the highest uptake of vaccines were those in the specialty of nursing in each of 2016, 2019 and 2020, with >30 years of time worked in 2016. In terms of factors leading to refusal of vaccination, the most reported was “not considered a risk group” (23.0%), and the least reported was “avoidance of vaccine administration” (2.2%). Eighty individuals presented adverse reactions after vaccine administration (9.6%). (4) Conclusions: The rate of influenza vaccination among healthcare professionals was lower during the 2020 season compared to the previous season, but was expected to increase in the upcoming 2021 season.