Awareness Of Influenza Research Articles

Consensus statements for influenza awareness, prevention, and vaccination in Pakistan.

Influenza is a serious underestimated viral infection in Pakistan and influenza vaccination and vaccination awareness are low. The current work aimed to develop consensus on influenza epidemiology, prevention, vaccination, and awareness in Pakistan. A systematic literature search was conducted to develop recommendations on influenza vaccines in Pakistan. Experts' feedback was incorporated using the modified Delphi method. A three-step process was used, with 18 experts from different specialties from Pakistan who participated in voting rounds to achieve a minimum 75% agreement level. Pakistan has a low-immunization-rate and is susceptible to serious influenza outbreaks and influenza-related complications. Influenza circulates year-round in Pakistan but peaks during January and February. The subtype A/H1N1 is predominant. The experts urged vaccination in all individuals ≥ 6 months of age and with no contraindications. They highlighted special considerations for those with comorbidities and specific conditions. The experts agreed that the inactivated influenza vaccine is safe and efficient in pregnant women, immunocompromised, and comorbid respiratory and cardiovascular patients. Finally, the experts recommended conducting promotional and educational programs to raise awareness on influenza and vaccination. This is the first regional consensus on influenza and influenza vaccination in Pakistan with experts' recommendations to increase influenza vaccination and decrease influenza cases and its associated detrimental effects.

The Attitude Regarding the Uptake of Influenza Vaccine in the COVID-19 Era in Jeddah City, Saudi Arabia

The onset of COVID-19 has had a profound impact on the world, leading to significant adjustments in human behavior. A plethora of behavioral modifications have been embraced by individuals. As COVID-19 symptoms are similar to influenza symptoms, this study aimed to measure attitudes regarding the uptake of influenza vaccination in the COVID-19 era. This cross-sectional study used a self-administered questionnaire. A total of 311 participants were conveniently selected from two of the most popular shopping malls in Jeddah City, Saudi Arabia, during a three-day influenza awareness campaign conducted between 11 November 2020 to 14 November 2020. Demographic items and all scales (summed and examined for internal reliability using Cronbach’s alpha) were analyzed using univariate analysis, including measures of central tendencies and frequencies. This study indicates that the COVID-19 pandemic has not significantly affected vaccination adoption rates. Only 9.3% of the individuals who received the vaccine expressed fear or a desire for protection against COVID-19.

Pneumococcal and influenza vaccine awareness in individuals over 65 years

Aims: Vaccination is of great importance due to the increased risk of infection as a result of changes in the immune system with aging and the weak immune response against these infections. In this study, it was aimed to determine the pneumococcal and influenza vaccination awareness and vaccination rates of individuals aged 65 years and over, to direct the unvaccinated individuals to be vaccinated and to protect them from possible infections and complications.
 Methods: A questionnaire form was filled in by asking demographic information, awareness of influenza and pneumococcal vaccines and the status of vaccination of individuals aged 65 years and over who applied to the clinic between June and September 2020. Unvaccinated individuals were referred to the vaccination unit.
 Results: A total of 553 elderly individuals aged 65 years and over, 338 women and 215 men, were included in the study. Among the study participants, the rate of patients with awareness of influenza/pneumococcal vaccine was 48.5%. Although the vaccination awareness rate was higher in males, non-smokers, those with higher education level, those with at least one of the comorbidities such as hypertension, coronary artery disease, hyperlipidemia, chronic renal failure, vaccination rates were lower in patients with these comorbidities and additionally diabetes mellitus. The majority of individuals with awareness were informed by healthcare workers. The rate of vaccination among the individuals participating in the study was 18.4%. Vaccination was higher in individuals with awareness. While 5.3% of those who were not vaccinated were hospitalized for pneumonia, those who were vaccinated did not have pneumonia severe enough to require hospitalization.
 Conclusion: In order to fight with the increasing vaccine hesitancy in our society, healthcare workers should be educated, the media should be supported, and vaccination should be encouraged in every clinic application.

Factors Affecting Influenza Vaccination Uptake and Attitudes among Lebanese University Students: The Impact of Vaccination Promotional Programs and COVID-19 Pandemic.

Vaccination is the most effective preventative strategy against influenza, yet university students' influenza vaccination uptake remains low. This study aimed firstly to determine the percentage of university students who were vaccinated for the 2015-2016 influenza season and to identify reasons for non-vaccination, and secondly to examine the impact of external factors (on-campus/online influenza awareness campaigns and COVID-19 pandemic) on their influenza vaccination uptake and attitudes for the 2017-2018 and 2021-2022 influenza seasons. A descriptive study was conducted over three phases for three influenza seasons at a Lebanese university in the Bekaa Region. Based on data collected in 2015-2016, promotional activities were developed and implemented for the other influenza seasons. This study was conducted using an anonymous, self-administered questionnaire by students. The majority of the respondents in the three studies did not receive the influenza vaccine (89.2% in the 2015-2016 study, 87.3% in the 2017-2018 study, and 84.7% in the 2021-2022 study). Among the unvaccinated respondents, the main reason for non-vaccination was that they thought that they did not need it. The primary reason for vaccination among those who were vaccinated was that they believed they were at risk of catching influenza in a 2017-2018 study and due to the COVID-19 pandemic in the 2021-2022 study. As for attitudes towards influenza vaccination post-COVID-19, significant differences were shown among the vaccinated and unvaccinated respondents. The vaccination rates among university students remained low despite of the awareness campaigns and COVID-19 pandemic.

Knowledge, attitudes, perceptions, and practice toward seasonal influenza and its vaccine: A cross-sectional study from a country of conflict.

The seasonal influenza vaccine is an important preventive measure against influenza and its associated complications. In Yemen, there is no seasonal influenza vaccination policy, and the influenza vaccine is excluded from the national immunization program. Data on vaccination coverage remain scarce with no previous surveillance programs or awareness campaigns implemented in the country. The current study aims to assess the awareness, knowledge, and attitudes of the public in Yemen toward seasonal influenza and their motivators and perceived barriers to receiving its vaccine. A cross-sectional survey was carried out using a self-administered questionnaire that was distributed to eligible participants using convenience sampling. A total of 1,396 participants completed the questionnaire. The respondents showed a median knowledge score of influenza of 11.0/15.0, and most of them (70%) were able to recognize its modes of transmission. However, only 11.3% of the participants reported receiving the seasonal influenza vaccine. Physicians were the respondents' most preferred information source for influenza (35.2%), and their recommendation (44.3%) was the most cited reason for taking its vaccine. On the contrary, not knowing about the vaccine's availability (50.1%), concerns regarding the safety of the vaccine (17%), and not considering influenza as a threat (15.9%) were the main reported barriers to getting vaccinated. The current study showed a low uptake of influenza vaccines in Yemen. The physician's role in promoting influenza vaccination seems to be essential. Extensive and sustained awareness campaigns would likely increase the awareness of influenza and remove misconceptions and negative attitudes toward its vaccine. Equitable access to the vaccine can be promoted by providing it free of charge to the public.

Http://www.mejfm.com/February%202023/Seasonal%20influenza.htm

Background: Increasing vaccination rates and reducing the spread of influenza are both greatly improved by raising public knowledge about seasonal influenza. To promote acceptance and create awareness it is necessary to identify any potential barriers to vaccination. This study aimed to assess seasonal influenza awareness, knowledge, vaccination uptake, and barriers. Methods: A cross-sectional study was conducted as an online survey of 355 medical and non-medical students of Umm Al-Qura University. Results: Out of the total 355 participants, 175(49.3%) were medical students and 180 (50.7) were non-medical students. There was an almost equal distribution of males (178 (50.1%) and females 177 (49.9%) in both groups. Most of the students 208 (58.6%) were aged 21-24 and most of them were single 346 (97.5%). Awareness of seasonal influenza was 172 (98.3%) among medical students and 157 (87.2%) among non-medical students. The mean knowledge score was 7.75 ± 2.9, with a statistical difference between the two groups (P < 0.001). Vaccination uptake was low in both groups 29 (16.6%) vs 46 (25.6%) in medical and non-medical respectively. The most prominent barriers to vaccination were the negative perceptions of the vaccine’s efficacy (53%) followed by accessibility (20%) and vaccine safety concerns (17%). More than one-third (37.7%) of the medical students and (8.9%) of non-medical students had good knowledge levels of seasonal influenza. Surprisingly, 145 (40.8%) had a poor knowledge level of seasonal influenza with a significant difference between the medical and non-medical groups (p < 0.001). Conclusions: Despite the high level of awareness, the knowledge level and vaccine uptake were unsatisfactory. Negative perceptions of the vaccine’s efficacy, and accessibility were the most significant barriers to vaccination. Campaigns and health education programmes should be considered to encourage others to get vaccinated to reduce the burden of seasonal influenza. Keywords: Awareness, seasonal influenza, vaccine uptake, knowledge

Predictors of influenza severity among hospitalized adults with laboratory confirmed influenza: Analysis of nine influenza seasons from the Valencia region, Spain.

PurposeInfluenza hospitalizations contribute substantially to healthcare disruption. We explored the impact of ageing, comorbidities and other risk factors to better understand associations with severe clinical outcomes in adults hospitalized with influenza.MethodsWe analysed multi‐season data from adults ≥18 years, hospitalized with laboratory‐confirmed influenza in Valencia, Spain. Severity was defined as intensive care unit (ICU) admission, assisted ventilation and/or death. Generalized estimating equations were used to estimate associations between risk factors and severity. Rate of hospital discharge was analysed with a cumulative incidence function.ResultsOnly 26% of influenza patients had their primary discharge diagnosis coded as influenza. Comorbidities were associated with severity among adults aged 50–79 years, with the highest odds ratio (OR) in patients with ≥3 comorbidities aged 50–64 years (OR = 6.7; 95% CI: 1.0–44.6). Morbid obesity and functional dependencies were also identified risk factors (ORs varying from 3 to 5 depending on age). The presence of increasing numbers of comorbidities was associated with prolonged hospital stay.ConclusionsInfluenza clinical outcomes are aggravated by the presence of comorbidities and ageing. Increased awareness of influenza among hospitalized patients could prompt clinical and public health interventions to reduce associated burden.

Front-Line Emergency Department Clinician Acceptability and Use of a Prototype Real-Time Cloud-Based Influenza Surveillance System.

Objectives: To assess emergency department (ED) clinicians' perceptions of a novel real-time influenza surveillance system using a pre- and post-implementation structured survey.Methods: We created and implemented a laboratory-based real-time influenza surveillance system at two EDs at the beginning of the 2013-2014 influenza season. Patients with acute respiratory illness were tested for influenza using rapid PCR-based Cepheid Xpert Flu assay. Results were instantaneously uploaded to a cloud-based data aggregation system made available to clinicians via a web-based dashboard. Clinicians received bimonthly email updates summating year-to-date results. Clinicians were surveyed prior to, and after the influenza season, to assess their views regarding acceptability and utility of the surveillance system data which were shared via dashboard and email updates.Results: The pre-implementation survey revealed that the majority (82%) of the 151 ED clinicians responded that they “sporadically” or “don't,” actively seek influenza-related information during the season. However, most (75%) reported that they would find additional information regarding influenza prevalence useful. Following implementation, there was an overall increase in the frequency of clinician self-reporting increased access to surveillance information from 50 to 63%, with the majority (75%) indicating that the surveillance emails impacted their general awareness of influenza. Clinicians reported that the additional real-time surveillance data impacted their testing (65%) and treatment (51%) practices.Conclusions: The majority of ED clinicians found surveillance data useful and indicated the additional information impacted their clinical practice. Accurate and timely surveillance information, distributed in a provider-friendly format could impact ED clinician management of patients with suspected influenza.

Impact of a community-based health education intervention on awareness of influenza, pneumonia, and vaccination intention in chronic patients

ABSTRACT The study aimed to examine the impact of a community-based health education intervention on the awareness and attitude of influenza and Streptococcus pneumoniae vaccination in patients with chronic diseases. We selected study participants from two counties in Jiaxing City, Zhejiang Province. We conducted a household baseline survey with quarterly follow-up and health education for all chronic disease patients in the area. A total of 720 patients with chronic diseases were included in two rounds of questionnaire surveys before and after a year-long health education related to the influenza and Streptococcus pneumoniae vaccination. Before the community education, 59.9% and 59.6% of study participants self-report the awareness of the hazards of influenza and pneumonia, respectively; while only 17.7% and 6.0% study participants self-reported awareness of the influenza or pneumonia vaccination, respectively; the self-reported vaccination rates were 1.3% and 0% for influenza and pneumonia, respectively. One year after the intervention, all rates were increased significantly, but the influenza vaccination rate was still far below the WHO minimum target level (75%). The main reason for not getting vaccinated reported by study participants was that participants thought they were in good health and would not become sick easily. There was no statistically significant difference between the impacts of health care practitioners’ and general practitioners’ recommendations for vaccination. Continued and pertinent health education has a significant impact on influenza and pneumonia vaccination in patients with chronic diseases.

Awareness of influenza and pneumococcal vaccines in diabetic patients.

PurposeIn our study, it was aimed to evaluate the awareness of diabetic patients about vaccination status and vaccines.MethodsThis cross-sectional study was conducted between January 2019 and February 2019. A survey questioning the level of knowledge about and vaccination status for influenza and pneumonia vaccines was applied by face-to-face interviews with patients with diabetes mellitus who admitted to the diabetes outpatient clinic. All results were evaluated with SPSS-20.0.ResultsA total of 202 patients [66 male (32.7%) and 136 female (67.3%) patients; with a mean age of 57.7 ± 11.3 years and mean duration of diabetes 10.7 ± 7.9 years] were recruited in the study. Majority of the patients (92.6%) were type 2 DM patients. 59.4% of the patients had never been vaccinated. The rate of those who had pneumonia vaccine was very low, only 14.7%. The vast majority of the patients had knowledge about vaccines and their most common source of information was nurses. 53% of patients believed that diabetic patients should be vaccinated regularly. 16.8% of the patients were reluctant to have the recommended vaccine. The factor with greatest impact on this was that they did not consider the vaccine necessary. 52.5% of the patients recommended to be vaccinated had the recommended vaccine. 26.4% of the patients who were not enthusiastic about the recommended vaccine had pneumococcal vaccine after being informed about the vaccine.ConclusionIt was observed that the information given about vaccines positively affected the vaccination rate. The main barrier to vaccination was the lack of information about the need for influenza vaccination. Designing strategies and training programs for healthcare professionals and patients should be the main goal to improve vaccination coverage and vaccination rates.

Seasonal influenza vaccine hesitancy profiles and determinants among Chinese children’s guardians and the elderly

ABSTRACT Objectives Seasonal influenza vaccine coverage remains low in China due to possible influenza vaccine hesitancy (IVH) and practical issues. We sought to investigate IVH and its determinants among children’s guardians and the elderly for a better understanding of the situation and for future intervention. Methods We performed two cross-sectional studies to identify the profiles and determinants of IVH using stratified cluster random sampling in an eastern China province in 2019. Results Of the 1564 guardians and 522 elders, 43.2% (95%CI: 40.4–46.0%) of guardians and 33.5% of elders (95%CI: 29.5–37.6%) had IVH. ‘From rural area’ (odds ratio: 1.36), ‘don’t know government recommendation for flu vaccination’ (1.39), ‘don’t know flu vaccine is vaccinated annually’ (1.93), and ‘family members (0.22), friends and neighbors had positive attitude toward flu vaccine’ (0.58) were related factors of the guardians’ IVH. ‘Aged 70–79 years’ (0.46), ‘had flu before’ (0.35) and ‘once had been vaccinated’ (0.42) were related to the elderly’s IVH. Conclusion Poor awareness of influenza and vaccination, relatives’ negative/positive attitude, lack of government recommendations, anxiety about vaccine quality, and practical issues such as short supply are related to IVH in China. Precision education aimed at hesitancy in wider groups is anticipated to increase vaccine confidence and coverage in influenza-vulnerable groups.

Influenza Awareness in the Workplace

The United States has been actively researching Western medicine and disease prevention. Influenza is a common viral infection that it is widely known can be fatal. Nonetheless, complacency has become common. Not all workplaces and community training centers outside medical facilities properly train employees on the hazards associated with contracting influenza. However, standard training procedures and a wide variety of resources are used to disseminate awareness of seasonal influenza (flu). The United States Centers for Disease Control (CDC) publish morbidity and mortality rates and alert the public to any pandemics. Its estimates of influenza cases are delivered in three age categories: <19 years, 19–64 years, and ≥65 years (CDC, 2010). This study aims to incorporate prevention methods that have not been used to help protect American workers.

Seasonal Influenza Vaccine Hesitancy Profiles and Determinants Among Chinese Children's Guardians and the Elderly

Background: Seasonal influenza imposes a significant clinical and economic burden, yet vaccine coverage remains low in China due to possible influenza vaccine hesitancy (IVH) and practical issues. We sought to investigate IVH and its determinants among children’s guardians and the elderly for better understanding of the situation and for future intervention. Methods: We performed two cross-sectional studies to identify the profiles and determinants of IVH using stratified cluster random sampling in an eastern China province in 2019. Results: Of the 1,564 guardians and 522 elders, 43·2% (95%CI: 40·4–46·0%) of guardians and 33·5% of elders (95%CI: 29·5–37·6%) had IVH, whereas 31·3% of the guardians and 5·5% of the elderly had Influenza vaccine demand. ‘From rural area’ (Odds ratio: 1·36), ‘don’t know government recommendation for flu vaccination’ (1·39), ‘don’t know flu vaccine is vaccinated annually’ (1·93), ‘family members (0·22), friends and neighbors had positive attitude toward flu vaccine’(0·58) were related factors of the guardians’ IVH. ‘Aged 70–79 years’ (0·46), ‘had flu before’ (0·35), and ‘once had been vaccinated’ (0·42) were related to the elderly’s IVH. Interpretation: Poor awareness of influenza and vaccination, relatives’ negative/positive attitude, lack of government recommendations, anxiety about vaccine quality, and practical issues such as short supply are related to IVH in China. Precision education aiming hesitancy in wider groups are anticipated to increase vaccine confidence and coverage in influenza-vulnerable groups. Funding Statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Zhejiang Chinese Medical University Ethnics Committee reviewed and approved this protocol and informed consent was obtained from each subject.

Socioeconomic bias in influenza surveillance.

Individuals in low socioeconomic brackets are considered at-risk for developing influenza-related complications and often exhibit higher than average influenza-related hospitalization rates. This disparity has been attributed to various factors, including restricted access to preventative and therapeutic health care, limited sick leave, and household structure. Adequate influenza surveillance in these at-risk populations is a critical precursor to accurate risk assessments and effective intervention. However, the United States of America’s primary national influenza surveillance system (ILINet) monitors outpatient healthcare providers, which may be largely inaccessible to lower socioeconomic populations. Recent initiatives to incorporate Internet-source and hospital electronic medical records data into surveillance systems seek to improve the timeliness, coverage, and accuracy of outbreak detection and situational awareness. Here, we use a flexible statistical framework for integrating multiple surveillance data sources to evaluate the adequacy of traditional (ILINet) and next generation (BioSense 2.0 and Google Flu Trends) data for situational awareness of influenza across poverty levels. We find that ZIP Codes in the highest poverty quartile are a critical vulnerability for ILINet that the integration of next generation data fails to ameliorate.

Future Pandemic Influenza Virus Detection Relies on the Existing Influenza Surveillance Systems: A Perspective from Australia and New Zealand

The anniversary of the 1918–1919 influenza pandemic has allowed a refocusing on the global burden of influenza and the importance of co-ordinated international surveillance for both seasonal influenza and the identification of control strategies for future pandemics. Since the introduction of the International Health Regulations (IHR), progress had been slow, until the emergence of the novel influenza A(H1N1)2009 virus and its global spread, which has led to the World Health Organization (WHO) developing a series of guidance documents on global influenza surveillance procedures, severity and risk assessments, and essential measurements for the determination of national pandemic responses. However, the greatest burden of disease from influenza occurs between pandemics during seasonal influenza outbreaks and epidemics. Both Australia and New Zealand utilise seasonal influenza surveillance to support national influenza awareness programs focused on seasonal influenza vaccination education and promotion. These programs also serve to promote the importance of pandemic preparedness.

Awareness among adults of vaccine-preventable diseases and recommended vaccinations, United States, 2015

BackgroundAdults are recommended to receive select vaccinations based on their age, underlying medical conditions, lifestyle, and other considerations. Factors associated with awareness of vaccine-preventable diseases and recommended vaccines among adults in the United States have not been explored. MethodsData from a 2015 internet panel survey of a nationally representative sample of U.S. adults aged ≥19years were analyzed to assess awareness of selected vaccine-preventable diseases and recommended vaccines for adults. A multivariable logistic regression model with a predictive marginal approach was used to identify factors independently associated with awareness of selected vaccine-preventable infections/diseases and corresponding vaccines. ResultsAmong the surveyed population, from 24.6 to 72.1% reported vaccination for recommended vaccines. Awareness of vaccine-preventable diseases among adults aged ≥19years ranged from 63.4% to 94.0% (63.4% reported awareness of HPV, 71.5% reported awareness of tetanus, 72.0% reported awareness of pertussis, 75.4% reported awareness of HZ, 75.8% reported awareness of hepatitis B, 83.1% reported awareness of pneumonia, and 94.0% reported awareness of influenza). Awareness of the corresponding vaccines among adults aged ≥19years ranged from 59.3% to 94.1% (59.3% HZ vaccine, 59.6% HPV vaccine, 64.3% hepatitis B vaccine, 66.2% pneumococcal vaccine, 86.3% tetanus vaccines, and 94.1% influenza vaccine). In multivariable analysis, being female and being a college graduate were significantly associated with a higher level of awareness for majority of vaccine-preventable diseases, and being female, being a college graduate, and working as a health care provider were significantly associated with a higher level of awareness for majority of corresponding vaccines. ConclusionsAlthough adults in this survey reported high levels of awareness for most vaccines recommended for adults, self-reported vaccination coverage was not optimal. Combining interventions known to increase uptake of recommended vaccines, such as patient reminder/recall systems and other healthcare system-based interventions, and ensuring patients’ vaccination needs are assessed, are needed to improve vaccination of adults.

High Prevalence of Humoral and Cellular Immunity to Influenza Viruses in Preschool Children Living in Addis Ababa, Ethiopia.

BackgroundInfluenza in children who reside in tropical and subtropical regions has until recently been regarded as insignificant. However, new evidence suggests that it significantly impacts hospitalization and promotes secondary bacterial coinfections. Ethiopia is situated in a subtropical area where influenza viruses are likely to circulate year round.MethodsClinical data were recorded in a cohort of 103 healthy preschool children recruited in Addis Ababa, Ethiopia. Humoral and cellular immune responses to influenza virus were determined by hemagglutination inhibition (HI) and interferon-γ enzyme-linked immunospot assays.ResultsNinety-six percent of the children (2–5 years old) had pre-existing HI antibody responses to 1 or more of the circulating influenza A subtypes, H1N1 (51%), H3N2 (86%), or influenza B (51%) strains. At the age of 4, all children had been infected with at least 1 strain, and 75% had been infected with 2–4 different viral strains. CD4+ and CD8+ T-cell responses against conserved viral antigens increased with repeated exposures, indicating boosting of cross-reactive cellular immunity. Malnutrition did not seem to affect these immune responses to influenza.ConclusionsInfluenza is highly prevalent among children in this area of Ethiopia. Due to the risk of secondary bacterial pneumonia, increased influenza awareness might benefit child health.

Awareness of Influenza and Attitude Toward Influenza Vaccination Among Medical Students.

In Poland, influenza vaccination coverage among both the general population and healthcare workers is low. The aim of the study was to evaluate attitudes towards influenza vaccination among final-year medical students compared with first-year students at medical schools in Poland. Students were asked about the last season's influenza vaccination and what the reasons were for having, or not having, the vaccination. The knowledge of influenza was assessed using a 10-point visual analog scale. The study group consisted of 712 medical students, 404 in the first year and 308 in the final year (35 % and 31 % of all students in those years, respectively). Final-year students believed they had a better knowledge of influenza (OR = 3.33; CI95%: 2.54-4.39). They answered questions about influenza immunizations (OR = 0.59; CI95%: 0.44-0.78) and vaccination recommendations in pregnant women correctly more frequently (OR = 0.21; CI95%: 0.16-0.28). The influenza vaccination rate among students in the 2014/2015 season was similar (17.1 % in the first vs. 15.9 % in the final year, NS). Among the final-year students, the reason for not having the vaccination was mainly financial and not any other. We conclude that although medical students' knowledge about influenza increases in the course of study, it did not much affect their unwilling attitude toward vaccination.

Strengthening the influenza vaccine virus selection and development process: Report of the 3rd WHO Informal Consultation for Improving Influenza Vaccine Virus Selection held at WHO headquarters, Geneva, Switzerland, 1–3 April 2014

Despite long-recognized challenges and constraints associated with their updating and manufacture, influenza vaccines remain at the heart of public health preparedness and response efforts against both seasonal and potentially pandemic influenza viruses.Globally coordinated virological and epidemiological surveillance is the foundation of the influenza vaccine virus selection and development process. Although national influenza surveillance and reporting capabilities are being strengthened and expanded, sustaining and building upon recent gains has become a major challenge.Strengthening the vaccine virus selection process additionally requires the continuation of initiatives to improve the timeliness and representativeness of influenza viruses shared by countries for detailed analysis by the WHO Global Influenza Surveillance and Response System (GISRS).Efforts are also continuing at the national, regional, and global levels to better understand the dynamics of influenza transmission in both temperate and tropical regions. Improved understanding of the degree of influenza seasonality in tropical countries of the world should allow for the strengthening of national vaccination policies and use of the most appropriate available vaccines.There remain a number of limitations and difficulties associated with the use of HAI assays for the antigenic characterization and selection of influenza vaccine viruses by WHOCCs. Current approaches to improving the situation include the more-optimal use of HAI and other assays; improved understanding of the data produced by neutralization assays; and increased standardization of serological testing methods.A number of new technologies and associated tools have the potential to revolutionize influenza surveillance and response activities. These include the increasingly routine use of whole genome next-generation sequencing and other high-throughput approaches. Such approaches could not only become key elements in outbreak investigations but could drive a new surveillance paradigm. However, despite the advances made, significant challenges will need to be addressed before next-generation technologies become routine, particularly in low-resource settings.Emerging approaches and techniques such as synthetic genomics, systems genetics, systems biology and mathematical modelling are capable of generating potentially huge volumes of highly complex and diverse datasets. Harnessing the currently theoretical benefits of such bioinformatics (“big data”) concepts for the influenza vaccine virus selection and development process will depend upon further advances in data generation, integration, analysis and dissemination.Over the last decade, growing awareness of influenza as an important global public health issue has been coupled to ever-increasing demands from the global community for more-equitable access to effective and affordable influenza vaccines. The current influenza vaccine landscape continues to be dominated by egg-based inactivated and live attenuated vaccines, with a small number of cell-based and recombinant vaccines. Successfully completing each step in the annual influenza vaccine manufacturing cycle will continue to rely upon timely and regular communication between the WHO GISRS, manufacturers and regulatory authorities.While the pipeline of influenza vaccines appears to be moving towards a variety of niche products in the near term, it is apparent that the ultimate aim remains the development of effective “universal” influenza vaccines that offer longer-lasting immunity against a broad range of influenza A subtypes.

Visualizing knowledge and attitude factors related to influenza vaccination of physicians

PurposeTo characterize groups of primary healthcare physicians according to sociodemographic data, years of professional experience and knowledge of and attitudes to influenza, and to evaluate differences between groups with respect to influenza vaccination in the 2011–2012 season. MethodsWe carried out an anonymous web survey of Spanish primary healthcare physicians in 2012. Information on vaccination, and knowledge of and attitudes to influenza was collected. Multiple correspondence analysis and cluster analysis were used to define groups of physicians. ResultsWe included 835 physicians and identified three types. Type B were physicians with low professional experience of influenza. Types A and C were physicians with high professional experience with influenza, type A also had a high awareness of influenza and seasonal vaccination. Types A and C were older and more often male than type B (p<0.0001). Knowledge of influenza was greatest in type A and lowest in type B. Awareness of influenza was greatest in type A and lowest in type C. In type A, 71.0% of physicians were vaccinated in the 2011–2012 season, compared with 48.1% and 33.6% from types B and C, respectively (p<0.001). ConclusionsAdditional efforts should be made to increase interest and concerns about preventing the transmission of influenza in physicians who do not believe influenza is a severe disease and are not concerned about its transmission.