Free Influenza Vaccination Research Articles

Effectiveness of a pay-it-forward intervention compared with user-paid vaccination to improve influenza vaccine uptake and community engagement among children and older adults in China: a quasi-experimental pragmatic trial

SummaryBackgroundChina has low seasonal influenza vaccination rates among priority populations. In this study, we aimed to evaluate a pay-it-forward strategy to increase influenza vaccine uptake in rural, suburban, and urban settings in China.MethodsWe performed a quasi-experimental pragmatic trial to examine the effectiveness of a pay-it-forward intervention (a free influenza vaccine and an opportunity to donate financially to support vaccination of other individuals) to increase influenza vaccine uptake compared with standard-of-care user-paid vaccination among children (aged between 6 months and 8 years) and older people (≥60 years) in China. Recruitment took place in the standard-of-care group until the expected sample size was reached and then in the pay-it-forward group in primary care clinics from a rural site (Yangshan), a suburban site (Zengcheng), and an urban site (Tianhe). Participants were introduced to the influenza vaccine by project staff using a pamphlet about influenza vaccination and were either asked to pay out-of-pocket at the standard market price (US$8·5–23·2; standard-of-care group) or to donate any amount anonymously (pay-it-forward group). Participants had to be eligible to receive an influenza vaccine and to have not received an influenza vaccine in the past year. The primary outcome was vaccine uptake. Secondary outcomes were vaccine confidence and costs (from the health-care provider perspective). Regression methods compared influenza vaccine uptake and vaccine confidence between the two groups. This trial is registered with ChiCTR, ChiCTR2000040048.FindingsFrom Sept 21, 2020, to March 3, 2021, 300 enrolees were recruited from patients visiting three primary care clinics. 55 (37%) of 150 people in the standard-of-care group (40 [53%] of 75 children and 15 [20%] of 75 older adults) and 111 (74%) of 150 in the pay-it-forward group (66 [88%] of 75 children and 45 [60%] of 75 older adults) received an influenza vaccine. People in the pay-it-forward group were more likely to receive an influenza vaccine compared with those in the standard-of-care group (adjusted odds ratio [aOR] 6·7 [95% CI 2·7–16·6] among children and 5·0 [2·3–10·8] among older adults). People in the pay-it-forward group had greater confidence in vaccine safety (aOR 2·2 [95% CI 1·2–3·9]), importance (3·1 [1·6–5·9]), and effectiveness (3·1 [1·7–5·7]). In the pay-it-forward group, 107 (96%) of 111 participants donated money for subsequent vaccinations. The pay-it-forward group had a lower economic cost (calculated as the cost without subtraction of donations) per person vaccinated (US$45·60) than did the standard-of-care group ($64·67).InterpretationThe pay-it-forward intervention seemed to be effective in improving influenza vaccine uptake and community engagement. Our data have implications for prosocial interventions to enhance influenza vaccine uptake in countries where influenza vaccines are available for a fee.FundingBill & Melinda Gates Foundation and the UK National Institute for Health Research.

Disparities in co-payments for influenza vaccine among the elderly, during the COVID-19 pandemic in Japan

IntroductionSeasonal influenza vaccination for the elderly is highly recommended during the COVID-19 pandemic. In Japan, the amount of subsidy for influenza differs among municipalities. Thus, we investigated the amount of and variation in subsidy for influenza vaccination for the elderly in 2020. MethodsThis was an ecological study of 1,922 municipalities in Japan. The amount of subsidy for influenza vaccines for the elderly in each municipality was surveyed through websites or via telephone. Geographic and financial data for municipalities and prefectures were obtained from the open data. The amount of co-payment for the influenza vaccine and the geographical and financial status of each municipality were compared, according to the aging rate. Univariate logistic regression analysis was performed to explore factors related to the free influenza vaccine. ResultsMunicipalities with higher aging rates tended to have higher median co-payments for vaccines in 2020. (0 yen vs 1000 yen, p < 0.001) In addition, they tended to have worse financial conditions and lower per capita incomes. A similar trend was observed in the analysis by prefecture, i.e., a higher influenza mortality rate in prefectures with a higher aging rate. Despite having lower incomes, municipalities and prefectures with higher aging populations had higher mortality rates from influenza and higher co-payments for influenza vaccination. ConclusionsIn Japan, there is a disparity among elderly people; areas with an aging population have higher co-payments for influenza vaccines despite lower incomes, suggesting that the government needs to implement corrective measures to reduce this disparity.

Development and evaluation of an interprofessional student-led influenza vaccination clinic for medical, nursing and pharmacy students.

Background:Students in their final years of medicine, nursing and pharmacy degrees were invited to participate in an interprofessional influenza vaccination training course and clinic. Twenty-four students (8 from each discipline) were selected to participate. After vaccination training these students administered free influenza vaccines under supervision in two student-led clinics to 546 students in health and allied health programs prior to their clinical placements.Objective:To evaluate the students’ experience of the interprofessional vaccination training and clinic, and to evaluate the experiences of students who received their vaccination in the student-led clinic.Methods:Before and after participating, students completed a questionnaire evaluating their perceived knowledge of influenza vaccinations, and their skills and confidence in administering vaccinations and the Readiness for Interprofessional Learning Scale (RIPLS). Eighteen students completed both the pre- and post-questionnaires. All students who received their flu vaccination were also asked to complete a short patient evaluation survey.Results:The course resulted in significant increases in the students’ perceived knowledge of influenza vaccinations (27.5% increase, p<0.001), skills in managing patients receiving influenza vaccines (23.9% increase, p<0.001) and confidence level to administer influenza vaccines (46.0% increase, p<0.001). While there was no significant change in any subscales of the RIPLS, open-ended responses indicated that the students enjoyed and could see the benefits of meeting and learning with and from students from other health disciplines. Of the students who received their influenza vaccination, 97.7% were very likely or somewhat likely to recommend the clinic to fellow students.Conclusion:The interprofessional vaccination training and influenza vaccination clinic provided effective interprofessional vaccination training and afforded an authentic interprofessional experiential opportunity.

The impact of free vaccination policies under the Korean Influenza National Immunization Program: Trends in influenza vaccination rates in South Korea from 2010 to 2019

BackgroundAnnual vaccination for influenza is recommended for high-risk populations for its high morbidity and mortality. South Korea provides free influenza vaccination to some target groups under the National Immunization Program (NIP), and discrepantly high vaccination rates are observed in such populations. In this study, we analyzed the trends in influenza vaccination rates and evaluated the impact of the recent expansion of financial coverage to children ≤12 years and pregnant women.MethodsWe conducted a cross-sectional study with nationwide survey data from Korea National Health and Nutrition Examination Survey (KNHANES). From 2010 to 2019, we evaluated the trends in influenza vaccination rates of the following four target groups: children ≤12 years, adults ≥65 years, pregnant women, and people with chronic diseases.ResultsIn total, 80,861 individuals were analyzed. From 2017 to 2019, the vaccination coverage of children ≤12 years increased from 66.2% to 83.1%; pregnant women from 44.1% to 68.5% (comparing the mean of 2010–2017 and 2018–2019, P <0.001 for both). The elderly ≥65 years showed the highest rates (85.8% in 2019), while people with chronic diseases marked the lowest (41.9% in 2019). People with liver diseases showed the lowest vaccination rate of 27.8%, while that of other common diseases ranged between 31.7–44.1%.ConclusionThe discrepancy between target groups corresponds to their financial coverage under NIP. The recent expansion of financial aids to children ≤12 years and pregnant women was followed by significant increases in vaccination rates in both groups. We suggest that free vaccination policy is one of the most effective strategies to enhance vaccination coverage, and we call for its expansion to other under-vaccinated target groups, especially people with chronic diseases.

Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in Beijing: A modeling analysis

BackgroundSince 2007, Beijing has offered a free trivalent influenza vaccine (TIV) for residents aged ≥ 60 years and school students. The quadrivalent influenza vaccine (QIV) was administered to school children in 2018 and will be administered to elderly adults in the future. In addition, health care workers (HCWs) who are involved in the prevention and control of COVID-19 were included in the program in 2020. This study aimed to analyze the cost-effectiveness of a comprehensive list of combined strategies of TIV and QIV for school children, elderly adults, and HCWs to identify the most cost-effective strategy. MethodsA decision tree was developed to compare 1-year outcomes of TIV vs. QIV in three risk groups: school children, elderly adults, and HCWs. The outcome was incremental cost per quality-adjusted life-year (QALY). Probabilistic sensitivity analyses and scenario analyses were developed to assess the robustness of the results. ResultsFrom the perspective of society, this study found that the introduction of QIVs can be cost-effective for any and all targeted groups with a willingness-to-pay threshold of 3-fold GDP per capita. Among all programs, program H (all school children, elderly adults, and HCWs received the QIV) showed a 79% probability of being cost-effective with an incremental cost-effectiveness ratio (ICER) of 13,580 (95% CI: 13,294, 13,867) US$/QALY and was the preferred option in the base case scenario. ConclusionThe introduction of QIVs to school children, elderly adults, or HCWs is likely to be cost-effective, either separately or collectively. The introduction of QIV to school children, elderly adults, and health care workers simultaneously showed the highest probability of being cost-effective and was the preferred option.

Effectiveness of influenza vaccination for school-age children in preventing school absenteeism in Shenzhen: an empirical study

Objective: To assess the impact of vaccination at school and influenza vaccination rates among school-age children on school absenteeism in Shenzhen. Methods: The study subjects were primary school students in Shenzhen. School absenteeism panel database from December 2017 to June 2020 of 286 primary schools in Shenzhen was merged with vaccination rates and organizational patterns (i.e., vaccination at school vs. non-school) data of 9 districts in Shenzhen after influenza vaccination for children. The outcome was the number of school absenteeism. The treatment and control groups were distinguished by organizational patterns and district vaccination rates. Difference-in-Difference (DiD) Poisson regressions were used to analyze the effectiveness of vaccination at school and higher vaccination rates. Besides, a robustness test was performed on the regression results. Results: Poisson regression analysis and robustness test of regression results showed that vaccination at school and higher vaccination rates effectively reduced the risk of school absenteeism, with effectiveness against absenteeism of 32.6% (95%CI: 17.0%-45.3%, P<0.01) and 53.0% (95%CI: 42.1%-61.8%, P<0.01), respectively. Conclusion: A free influenza vaccination program for school-age children in Shenzhen and prioritizing school-based vaccination may be an effective measure to reduce the risk of school absenteeism.

Influenza vaccination during pregnancy and influencing factors in Korea: A multicenter questionnaire study of pregnant women and obstetrics and gynecology doctors

BackgroundAlthough the World Health Organization and health authorities in most countries recommend that pregnant women receive inactivated influenza virus vaccines, coverage remains low. This study aimed to investigate (1) the proportion of pregnant women who received an influenza vaccination and influencing factors and (2) the proportion of obstetrics and gynecology (OBGYN) doctors who routinely recommend influenza vaccination to pregnant women and influencing factors.MethodsTwo separate, anonymized questionnaires were developed for physicians and pregnant and postpartum women and were distributed to multicenters and clinics in South Korea. The proportions of women who received influenza vaccination during pregnancy and OBGYN doctors who routinely recommend the influenza vaccine to pregnant women were analyzed. Independent influencing factors for both maternal influenza vaccination and OBGYN doctors’ routine recommendations to pregnant women were analyzed using log-binomial regression analysis.ResultsThe proportion of self-reported influenza vaccination during pregnancy among 522 women was 63.2%. Pregnancy-related independent factors influencing maternal influenza vaccination were “(ever) received information about influenza vaccination during pregnancy” (OR 8.9, 95% CI 4.17–19.01), “received vaccine information about from OBGYN doctors” (OR 11.44, 95% CI 5.46–24.00), “information obtained from other sources” (OR 4.38, 95% CI 2.01–9.55), and “second/third trimester” (OR 2.41, 95% CI 1.21–4.82)..Among 372 OBGYN doctors, 76.9% routinely recommended vaccination for pregnant women. Independent factors effecting routine recommendation were “working at a private clinic or hospital” (OR 5.33, 95% CI 2.44–11.65), “awareness of KCDC guidelines” (OR 3.11, 95% CI 1.11–8.73), and “awareness of the 2019 national free influenza vaccination program for pregnant women” (OR 4.88, 95% CI 2.34–10.17). OBGYN doctors most commonly chose ‘guidelines proposed by the government or public health (108, 46%) and academic committees (59, 25%), as a factor which expect to affect the future recommendationConclusionThis study showed that providing information about maternal influenza vaccination, especially by OBGYN doctors, is crucial for increasing vaccination coverage in pregnant women. Closer cooperation between the government and OBGYN academic societies to educate OBGYN doctors might enhance routine recommendations.

Intention to have the seasonal influenza vaccination during the COVID-19 pandemic among eligible adults in the UK: a cross-sectional survey

ObjectiveTo investigate the likelihood of having the seasonal influenza vaccination during the COVID-19 pandemic in individuals who were eligible to receive it.DesignWe conducted a cross-sectional online survey in July 2020....

Influenza Vaccination Coverage and Intention to Receive Hypothetical Ebola and COVID-19 Vaccines among Medical Students.

The study aimed to determine influenza vaccine uptake among medical students and their intention to receive a hypothetical Ebola or COVID-19 vaccine. This cross-sectional questionnaire-based study was performed in 2015 and 2020 on 675 medical students at the Medical University of Warsaw, Poland. In 2020, the influenza vaccination coverage was 36.5%, and students were almost five times more likely to be vaccinated than in 2015 (OR = 4.8; 95% CI: 3.1–7.5). In 2020, the survey was conducted during the first university campaign targeted at free influenza vaccinations for all students, as well as during the first lockdown in Poland due to the COVID-19 pandemic. In 2020, clinical students (4th–6th study year) were significantly more often vaccinated than preclinical students (p < 0.001), in contrast to 2015. A majority—67.0% and 94.6%—of students expressed their intention to receive a hypothetical Ebola or COVID-19 vaccine, respectively. Among the medical students, influenza vaccination status was a predictor of the intention to receive a COVID-19 vaccine. Influenza vaccine uptake among medical students has increased significantly, but it is still not optimal; thus, further educational efforts are needed to convince those who are hesitant regarding vaccines. A high number of students reported their intention to receive a COVID-19 vaccine, and it is crucial to support their positive attitude about it.

Impact of the coronavirus disease 2019 epidemic and a free influenza vaccine strategy on the willingness of residents to receive influenza vaccines in Shanghai, China

ABSTRACT The influenza vaccine is not included in China’s national immunization program. Here, we assessed influenza vaccine coverage among Shanghai residents and estimated the impacts of the coronavirus disease 2019 (COVID-19) epidemic and a hypothetical free vaccine strategy on the willingness of participants to receive influenza vaccines. The coverage of influenza vaccines among Shanghai residents from 2015 to 2019 was 1.4% (range: 1%–2.4%). A total of 792 adult participants (aged 19–59 years) along with 821 children and 445 older individuals were included in the analysis. The willingness of participants to receive influenza vaccines reached 68.4% following the COVID-19 epidemic. Furthermore, if the vaccine was made available at no cost, 85.9% of participants were willing to be vaccinated. Our data indicated that influenza vaccine coverage is extremely low in Shanghai but that more than two-thirds of participants were willing to receive influenza vaccines following the COVID-19 epidemic. Making influenza vaccines available for free could further increase coverage.

Parental Attitude to Influenza Infection: Willingness for Childhood Vaccination

Introduction: As the 2020- 2021 flu season coincides with the currently circulating Coronavirus disease 2019 (COVID-19), Ireland is introducing free influenza vaccines to children ages 2- 12 this year. This is to minimise the disease and economic burden of influenza to an already- strained hospital system due to the ongoing pandemic. Therefore, it is important to identify factors that may affect vaccine uptake. Objective: To explore parental knowledge and attitudes towards influenza infection and potential factors affecting willingness to routinely vaccinate their child (ren). Methods: This descriptive study involved interviewing parents (n= 300) attending the paediatric outpatient department (OPD) at University Hospital Galway. A pilot study assisted with standardizing the questionnaire and in optimizing the clinical catchment area (Emergency Department vs. postnatal ward vs. OPD clinics). Galway Clinical Research Ethics Committee granted the ethical approval and data was analyzed using SPSS. Results: The majority of respondents were Irish (251, 83.7%), 236 (78.7%) with private health insurance. The commonest age range was 31-40 years (163, 54.3%). Less than 40% had a Bachelor’s degree (113, 37.7%) as their highest education level. Most participants (226, 75.3%) agreed with annual influenza vaccine for their child if recommended. The following factors were shown to positively affect potential annual influenza vaccine uptake (p

Expert consensus on developing publicly-funded influenza vaccination project plan

The overall coverage rate of influenza vaccination in China has been only about 2% in recent years. At present, free influenza vaccination programs, also named the "Publicly-funded Influenza Vaccination Project", have been carried out for the specific groups (the elderly, school-age children, healthcare workers, etc.) through livelihood projects or policies to benefit the people in some areas of China, which has significantly increased the vaccine coverage in the target population. In order to promote the project to be launched in a scientific and orderly manner in more and more regions of China, we organized and compiled this consensus on implementation of publicly-funded influenza vaccination project, including the project's purpose, establishment, implementation, organization and management, which was based on the research of influenza vaccine application strategies in some European countries and the United States and combined with the relevant policies, technical guidelines and past experiences in China. Meanwhile, the evaluation indicators, such as vaccination rates, effectiveness, safety and cost-effectiveness, and relevant assessment methods were also comprehensively expounded, aiming to provide reference for regions that are willing to implement or have launched the project.

Influenza vaccination strategies for 2020-21 in the context of COVID-19.

BackgroundInfluenza vaccination prevents people from influenza-related diseases and thereby mitigates the burden on national health systems when COVID-19 circulates and public health measures controlling respiratory viral infections are relaxed. However, it is challenging to maintain influenza vaccine services as the COVID-19 pandemic has the potential to disrupt vaccination programmes in many countries during the 2020/21 winter. We summarise available recommendations and strategies on influenza vaccination, specifically the changes in the context of the COVID-19 pandemic.MethodsWe searched websites and databases of national and international public health agencies (focusing on Europe, North and South America, Australia, New Zealand, and South Africa). We also contacted key influenza immunization focal points and experts in respective countries and organizations including WHO and ECDC.ResultsAvailable global and regional guidance emphasises the control of COVID-19 infection in immunisation settings by implementing multiple measures, such as physical distancing, hand hygiene practice, appropriate use of personal protective equipment by health care workers and establishing separate vaccination sessions for medically vulnerable people. The guidance also emphasises using alternative models or settings (eg, outdoor areas and pharmacies) for vaccine delivery, communication strategies and developing registry and catch-up programmes to achieve high coverage. Several novel national strategies have been adopted, such as combining influenza vaccination with other medical visits and setting up outdoor and drive through vaccination clinics. Several Southern Hemisphere countries have increased influenza vaccine coverage substantially for the 2020 influenza season. Most of the countries included in our review have planned a universal or near universal influenza vaccination for health care workers, or have made influenza vaccination for health care workers mandatory. Australia has requested that all workers and visitors in long term care facilities receive influenza vaccine. The UK has planned to expand the influenza programme to provide free influenza vaccine for the first time to all adults 50-64 years of age, people on the shielded patient list and their household members and children in the first year of secondary school. South Africa has additionally prioritised people with hypertension for influenza vaccination.ConclusionsThis review of influenza vaccination guidance and strategies should support strategy development on influenza vaccination in the context of COVID-19.

Infection Prevention and Control Policies and Staffing: A National Survey of Home Health Agencies in the United States

Background: Infection prevention and control (IPC) is a national priority in all healthcare settings, and IPC staffing characteristics have been linked to patient safety outcomes. However, there is a lack of knowledge about IPC in home healthcare (HHC), the fastest growing healthcare sector. Our aim was to better understand the current state of IPC in HHC, as well as the HHC staff involved with IPC policy implementation. Methods: A national survey was conducted between October 2018 and November 2019. The participants included (1) agencies recruited from a national HHC conference and (2) a national random sample of 1,501 agencies stratified by census region, ownership status, and rural or urban location. Survey items included staff influenza vaccination policies, antibiotic stewardship, infection surveillance, and IPC staffing. Descriptive statistics were computed, and differences by ownership were calculated using 2 and Student t tests. Results: Of the 535 HHC agencies that responded to the survey (response rate, 33%), 64% were for-profit agencies. Overall, 30.8% of the agencies (17.9% for-profit, 57.6% nonprofit; P &lt; .01) required staff influenza vaccination. Most nonprofit agencies (84.1%) and about half of the for-profit agencies (48.1%) offered free influenza vaccinations to staff (P &lt; .01). During the past influenza season, 62.6% of agencies (81.5% nonprofit vs 51.6% for-profit; P &lt; .01) had 75% of their employees vaccinated for influenza, and 9.3% (2% nonprofit vs 13.5% for-profit; P &lt; .01) reported that they did not track this data. Only 17.9% of HHC agencies used antibiotic prescribing guidelines, and 33.3% reported that they reviewed cases to assess the appropriateness of antibiotic administration and/or indication. Most HHC agencies (86%) reported collecting and reviewing infection data to identify trends, which was often done quarterly or more frequently. Almost every responding agency reported that the staff member in charge of IPC had other responsibilities including administrative, education/training, or quality improvement, and 33.5% of those personnel had received no specific IPC training. Also, ~6% of agencies (12.5% of government-owned agencies) reported that they currently did not have a staff member in charge of IPC. Conclusions: This is the first national study of IPC in HHC, which can be used as a benchmark for quality improvement initiatives in the home care environment. Compared to other healthcare settings, HHC agencies have substantial challenges related to IPC. Most HHC agencies do not have a staff member exclusively dedicated to IPC, and staff training is inadequate. Furthermore, a significant number of agencies have no staff influenza vaccination or antibiotic stewardship policies in place. The situation is worse at for-profit agencies, which dominate the current US HHC industry.Funding: NoneDisclosures: None

Impacts of expanding provider choice for free flu vaccination among the elderly in Korea

The Korean government, to increase the vaccination rates, implemented the policy expanding provider choice for free seasonal influenza vaccine for the elderly through contracting the provision of immunization to the private sector in 2015. Using the annual nationally representative individual between 2014–2017, this study explores the impacts of the policy change by using a difference-in-differences approach. Results show that influenza vaccine uptake at private clinics increases by 12 percentage points after the policy change. However, this effect is offset by a reduction in uptake at public health centers by 13 percentage points. As a result, we find no evidence that the policy increases overall vaccination coverage among the elderly. These results indicate that policymakers need to explore the reasons for vaccine hesitancy before delivering interventions.

Why is influenza vaccine uptake so low among Aboriginal adults?

Objectives:Determine major barriers to, and facilitators of, influenza vaccination of Aboriginal adults, in order to improve coverage from the current level of 30%. Methods:i) A focus group with 13 Aboriginal Immunisation Healthcare Workers; and ii) a cross‐sectional survey of Aboriginal people aged ≥18 years at the 2017 New South Wales Koori Knockout (29 September–2 October). Results:The focus group nominated poor identification of Aboriginality in general practice. Of 273 survey respondents, a substantial minority (30%) were unaware of their eligibility for free influenza vaccination. More than half (52%) believed the vaccine could cause influenza, 40% reported there were better ways than vaccination for avoiding infection and 30% said they would not have the vaccine if it was offered to them. Regarding health service access, few reported experiencing difficulty (17%), feeling uncomfortable (15%) or being discriminated against (8%), but 53% reported not receiving a reminder from a health professional. Conclusions:Misconceptions about influenza disease and vaccine among Aboriginal people and inadequate identification of Aboriginality in general practice appear to be the greatest barriers to vaccination, rather than health service access in general. Implications for public health:More active communication to and targeting of Aboriginal adults is required; this is even more urgent following the arrival of COVID‐19.

State of Infection Prevention and Control in Home Healthcare Agencies

<h3>Background</h3> Home healthcare (HHC) is becoming a leading source of post-acute services. Currently, most HHC patients have multiple chronic conditions, thereby increasing their risk of infections and rehospitalizations. With a nationally-representative survey, we aimed to better understand the current state of infection prevention and control (IPC) at HHC agencies. <h3>Methods</h3> A national survey, directed at administrators and clinical managers, was conducted from October 2018 to November 2019. Agencies were recruited from a national HHC conference, and a national random sample of 1,505 agencies stratified by census region, ownership status and rural/urban location. Questions were asked about IPC staffing, IPC compliance and training, and current IPC policies and procedures. Descriptive statistics were computed using Stata 13. <h3>Results</h3> 575 HHC agencies (35% response rate) responded; 63% had for-profit ownership. At responding agencies, 35.4 % of staff members in charge of IPC had received no specific IPC training, and 5.6% reported that they currently did not have a staff member in charge of IPC. Over 60% of agencies provided staff training on IPC topics either annually or at new employee orientation. 82.3% reported measuring adherence to hand hygiene policies; policy adherence was measured by shadowing (84.9%) and knowledge assessments (71.8%). Most HHC agencies (87.6%) reported collecting and reviewing infection data to identify trends. Overall, only 31% of agencies required staff influenza vaccination; however, a majority (61.4%) offered free influenza vaccinations to their staff. During the past influenza season, 62.7% of agencies had 75% or more of their employees vaccinated for influenza, and 9% reported not tracking that data. <h3>Conclusions</h3> This national study examining the current state of IPC in HHC can be used as a benchmark for quality improvement initiatives. Particularly, we learned that staff training around IPC and policies and procedures related to staff vaccination are currently inadequate.

The intentions to get vaccinated against influenza and actual vaccine uptake among diabetic patients in Ningbo, China: identifying motivators and barriers

ABSTRACT Background: Health authorities recommend influenza vaccination to diabetic patients. Nevertheless, the vaccination coverage of adults was low in China. This study aimed to estimate influenza vaccination intentions and actual uptake among diabetic patients in China and identify the motivators and barriers associated with vaccination. Methods: During Nov 2016–Jan 2017, 1960 diabetic patients were invited to participate in the investigation about influenza vaccination based on health belief model (HBM). To link vaccination intention to behavior, a follow-up survey was conducted to collect vaccination records of the 2016–2017 season. Predictors of the motivation to obtain influenza vaccination were assessed using logistic regressions. Results: 1914 diabetic patients completed the survey. 46.13% participants reported intentions to be vaccinated against influenza and 7.84% actually received vaccination. In the multivariate models, while all the domains of HBM constructs were associated with intentions, age, increasing numbers of comorbidity, urban residents, perceived susceptibility, perceived benefits, free vaccination, and vaccination history displayed positive associations with vaccine uptake while increasing income and perceptions of barriers were negative predictors of vaccine uptake. Besides, interactions between perceived susceptibility and healthcare workers’ (HCW’s) recommendation, perceived severity and benefits, perceived severity and health-seeking behaviors, perceived benefits, and influence of family/friends had a significant positive effect modification on the vaccine uptake. Conclusion: To improve diabetic patients’ influenza vaccination and close the intention-behavior gap, multipronged strategies are required not only to increase vaccination intention by promoting HCW’s recommendation to improve perceptions about influenza vaccination but also facilitate a follow through on initial intentions by implementing free influenza vaccination program funded by the government.

An Immunological Algorithm to Defeat Covid-19

Countries like Italy, Spain or Germany etc. with very low prevalence of tuberculosis and discontinued BCG immunization since decades, are witnessing the worst form of this global pandemic of Corona virus. It has also been seen that Covid-19 affected more of those countries who have robust and free influenza vaccination programme.

The impact of new universal child influenza programs in Australia: Vaccine coverage, effectiveness and disease epidemiology in hospitalised children in 2018

BackgroundNew jurisdictionally-based vaccination programs were established providing free quadrivalent influenza vaccine (QIV) for preschool Australian children in 2018. This was in addition to the National Immunisation Program (NIP) funded QIV for Indigenous children and children with comorbid medical conditions. We assessed the impact of this policy change on influenza disease burden and vaccine coverage, as well as report on 2018 vaccine effectiveness in a hospital-based surveillance system. MethodsSubjects were recruited prospectively from twelve PAEDS-FluCAN sentinel hospital sites (April until October 2018). Children aged ≤16 years hospitalised with an acute respiratory illness (ARI) and laboratory-confirmed influenza were considered cases. Hospitalised children with ARI who tested negative for influenza were considered controls. VE estimates were calculated from the adjusted odds ratio of vaccination in cases and controls. ResultsA total of 458 children were hospitalised with influenza: 31.7% were <2 years, 5.0% were Indigenous, and 40.6% had medical comorbidities predisposing to severe influenza. Influenza A was detected in 90.6% of children (A/H1N1: 38.0%; A/H3N2: 3.1%; A/unsubtyped 48.6%). The median length of stay was 2 days (IQR: 1,3) and 8.1% were admitted to ICU. Oseltamivir use was infrequent (16.6%). Two in-hospital deaths occurred (0.45%). 12.0% of influenza cases were vaccinated compared with 36.0% of test-negative controls. Vaccine effectiveness of QIV for preventing influenza hospitalisation was estimated at 78.8% (95%CI: 66.9; 86.4). ConclusionsCompared with 2017 (n = 1268 cases), a significant reduction in severe influenza was observed in Australian children, possibly contributed to by improved vaccine coverage and high vaccine effectiveness. Despite introduction of jurisdictionally-funded preschool programs and NIP-funded vaccine for children with risk factors for severe disease, improved coverage is required to ensure adequate protection against paediatric influenza morbidity and mortality.