Previous Influenza Vaccination Research Articles

The effect of influenza vaccination on the rate of dementia amongst older adults.

Previous studies have reported conflicting results regarding the association between influenza vaccination and dementia. This association was investigated in a nationwide register-based cohort study. Using nationwide registries, dementia-free adults aged ≥65 years in Denmark from 2002 to 2018 without previous influenza vaccinations were included. Poisson regression facilitated confounder-adjusted comparisons of dementia rates for ever versus never vaccinated, number of vaccinationsand within/after 5 years from first vaccination. Sensitivity analyses included stratification on age and sex. Vaccination during follow-up was associated with a slightly higher rate of dementia when adjusted for sociodemographic factors and comorbidities, both within and after the first 5 years from first vaccination (incidence rate ratio [IRR] 1.04; 95% confidence interval [CI] 1.03-1.05). The rate of dementia decreased with increasing number of vaccinations. The highest rate was amongst those with only one vaccination (IRR 1.14; 95% CI 1.12-1.17) and the rate of dementia was only decreased amongst those with six or more vaccinations (IRR 0.95; 95% CI 0.93-0.97). Applying the same models to control outcomes of hip fracture and cancer resulted in higher rates amongst vaccinated people of 6% and 7%, respectively. Vaccinated people also had a 10% higher mortality rate. Our results do not support the case for a preventive effect of influenza vaccination on the risk of dementia in the general population, as reported by some previous studies. However, the higher dementia rate amongst vaccinated people found in this study is probably due to residual confounding, indicated by a higher rate for control outcomes and mortality.

University Students' Vaccination Intention after the Fifth Wave of the COVID-19 Outbreak in Hong Kong: Inspiration from a Health Belief Model.

The fifth wave of COVID-19, driven by the Omicron variant, started to surge in Hong Kong in December 2021. Previous studies have shown that younger adults, compared to older adults, are vulnerable to increased risks of side effects after vaccination. However, little is known about the COVID-19 vaccination behavior among younger adults, especially university students, in Hong Kong. Therefore, the present online survey study aimed to investigate the predictors of COVID-19 vaccination intention among university students in Hong Kong using the Health Belief Model (HBM) as a framework. Two other potential predictors, the previous influenza vaccine uptake frequency and the Hong Kong SAR government vaccination lottery program, were also examined. The intention to receive another dose of the COVID-19 vaccine was low (36.4%). Multivariate binomial logistic regression analysis showed that, after controlling for demographic and baseline characteristics, the perceived susceptibility (OR = 2.98, CI = 1.18-7.53) and previous influenza vaccine uptake frequency (OR = 1.54, CI = 1.08-2.19) significantly and positively predicted the COVID-19 vaccination intention. However, the government vaccination lottery program (i.e., wining prizes for being vaccinated) (OR = 0.87, CI = 0.34-2.26) was not a significant motivator of COVID-19 vaccination. Future public health campaigns should focus on the individual susceptibility to COVID-19 and past influenza vaccination history to promote increased vaccination uptake among university students.

Factors Influencing Childhood Influenza Vaccination: A Systematic Review.

Childhood influenza vaccination coverage remains low in lower/middle-income countries. This systematic review aims to identify influencing factors around childhood influenza vaccination. A systematic literature review was conducted and included empirical studies with original data that investigated factors influencing childhood influenza vaccination. We searched MEDLINE, Web of Science, EMBASE, CINAHL Plus, Global Health, PsycINFO, and two Chinese databases, China Knowledge Resource Integrated Database and Chongqing VIP, using a combination of the key terms 'childhood', 'influenza', 'vaccination', and related syntax for all peer-reviewed publications published before December 2019. Thirty studies were included in the analysis. Childhood influenza vaccination was positively associated with caregivers' knowledge of influenza vaccine, positive vaccine attitudes, self-efficacy, perceived susceptibility and severity of influenza, believing in the efficacy of influenza vaccine, the worry of getting sick, healthcare workers' recommendations, and previous influenza vaccination experiences. Barriers included the fear of safety and side effects of the vaccine, as well as poor access to vaccination service. To improve childhood influenza vaccine uptake, health education is necessary to address caregivers' lack of confidence on vaccine safety. Future studies are needed to investigate influencing factors around healthcare workers' vaccination recommendation behaviors and the impact of contextual factors on public vaccination behaviors.

Influenza vaccination as a prognostic factor of humoral IgA responses to SARS-CoV-2 infection.

There is evidence that influenza vaccination may provide additional benefits by inducing training of innate immunity and increasing humoral responses to heterologous challenges. Immunoglobulin A (IgA) antibodies dominate the early phase of the adaptive response to SARS-CoV-2 infection, but whether their production may be associated with previous influenza vaccination has not been a subject of any study. This study compared serum SARS-CoV-2-specific IgA responses, measured with Microblot-Array assay, in individuals who experienced COVID-19 (N = 1318) and differed in the status of the seasonal influenza vaccine, age, sex, and disease severity. Influenza-vaccinated individuals had a higher seroprevalence of IgA antibodies against nucleocapsid (anti-NP; by 10.1%), receptor-binding domain of spike protein (anti-RBD; by 11.8%) and the S2 subunit of spike protein (anti-S2; by 6.8%). Multivariate analysis, including age, sex, and COVID-19 severity, confirmed that receiving the influenza vaccine was associated with higher odds of being seropositive for anti-NP (OR, 95% CI = 1.57, 1.2-2.0), anti-RBD (OR, 95% CI = 1.6, 1.3-2.0), and anti-S2 (OR, 95% CI = 1.9, 1.4-2.7), as well as being seropositive for at least one anti-SARS-CoV-2 IgA antibody (OR, 95% CI = 1.7, 1.3-2.1) and all three of them (OR, 95% CI = 2.6, 1.7-4.0). Age ≥ 50 years was an additional factor predicting better IgA responses. However, the concentration of particular antibodies in seropositive subjects did not differ in relation to the influenza vaccination status. The study evidenced that influenza vaccination was associated with improved serum IgA levels produced in response to SARS-CoV-2 infection. Further studies are necessary to assess whether trained immunity is involved in the observed phenomenon.

Prevention of influenza complications in patients with liver disease: a retrospective cohort study.

Patients with chronic liver disease are highly prone to acquiring influenza infection diseases and experiencing associated complications. National and international guidelines recommend the influenza vaccine for patients with liver disorders to reduce the risk of influenza complications. Our study aims to evaluate the risk of flu complications faced by patients with liver disease and assess influenza vaccination coverage. The archive of hospital discharge forms was used to define the list of Apulian patients with liver disease, considering data from 2017 through 2022. The vaccination status of these patients was assessed via data collected from the Regional Immunization Database. We focused on influenza vaccine shots administered during the 2020/21, 2021/22, and 2022/23 flu seasons. A declining trend across the flu seasons was observed, with a VC of 49.5% in the 2020/21 flu season, 48.1% in the 2021/22 season, and 45.0% in the 2022/23 season. Subjects with multiple comorbidities have higher vaccination rates. Additionally, the multivariate models demonstrate that vaccination compliance increases with age and is strongly associated with having received a previous influenza vaccine shot. The VC rates reported in our study are unsatisfactory and did not reach the minimum achievable goal (75%) the Italian Ministry of Health set. A multifactorial approach is required to raise the immunization rates and therefore protect the patients from the influenza-associated risk of collateral liver damage; the role of gastroenterologists and hepatologists is crucial, as their responsibilities should extend beyond patient care to the prevention of complications after infectious diseases.

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

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

Opinions, Attitudes and Factors Related to SARS-CoV-2 Vaccine Uptake in Eight South American Countries.

This article presents attitudes and practices regarding COVID-19 vaccination in the South American population. The study collected data from a self-administered survey distributed through social media platforms between February and April 2022 (N = 6555). The survey included questions related to participants' sociodemographic background, flu vaccination practices, sources of information about COVID-19, and opinions regarding pandemic management and vaccination against SARS-CoV-2. The respondents agreed with the statement that COVID-19 vaccines were necessary (86.4%), effective (79.8%), safe (79.1%), and should be mandatory (64%). Overall, 83.4% accepted vaccination and 12.3% refused it completely. Main rejection reasons were safety (65.8%) and efficacy (54.9%) issues, and rushed development and approvals (49.1%). Vaccine uptake was associated with being ≥60 years, being a healthcare worker, previous influenza vaccine uptake, adherence to preventive measures, the death of ≥1 close people from COVID-19, and being informed through mass media or health authorities' channels. Vaccine uptake inversely correlated with male gender, low educational level, and use of closed social networks for COVID-19 information purposes. This study provides valuable insights into COVID-19 vaccination attitudes and practices in South America that may be used to promote vaccine uptake in the region. Higher COVID-19 vaccination acceptance among people with previously acquired prevention habits reinforces the importance of routine health promotion strategies.

Technical guidelines for seasonal influenza vaccination in China (2023-2024)

Technical guidelines for seasonal influenza vaccination in China (2023-2024)

COVID-19 vaccine confidence, concerns, and uptake in children aged 5 and older in Calgary, Alberta: a longitudinal cohort study.

Beginning early in the pandemic, there was a worldwide effort to develop effective vaccines against the SARS-CoV-2 virus. Before and after the approval and implementation of vaccines, there were concerns about their need as well as their safety and rapid development. We explored child demographic characteristics and parental concerns to identify factors associated with the decision to vaccinate. A cohort of 1035 children from Calgary was assembled in 2020 to participate in 5 visits every 6 months for survey completion and blood sampling for SARS-CoV-2 antibodies. Visits 1 to 2 occurred before approval of vaccines for children; Visits 3 to 5 occurred after vaccine approval for different age groups. We described vaccine concerns and utilized logistic regression to examine factors associated with the decision to vaccinate in children ≥5 years of age. Children ≥12 years of age, of non-white or non-black ethnicity, and who had received previous influenza vaccines had higher odds of being vaccinated against SARS-CoV-2. Children with previous SARS-CoV-2 infection had lower odds of being vaccinated. The most common concerns in early 2021 were about vaccine safety. By summer 2022, the most common concern was a belief that vaccines were not necessary. Through the study 88% of children were vaccinated. Age, ethnicity, previous infections, and vaccine attitudes were associated with parental decision to vaccinate against SARS-CoV-2. For children who remained unvaccinated, parents continued to have safety concerns and questioned the necessity of the vaccine. Complacency about the need for vaccination may be more challenging to address and overcome than concerns about safety alone.

Factors associated with COVID-19 vaccine uptake in a US/Mexico border community: demographics, previous influenza vaccination, and trusted sources of health information.

COVID-19 vaccine uptake has been uneven, particularly across racial/ethnic and age groups. This study seeks to understand factors associated with COVID-19 vaccine uptake in a large cross-sectional sample of predominantly Latinos/Latinas individuals living near the US/Mexico border. Data are extracted from a 176-item survey conducted as part of a parent study focused on the co-creation of a COVID-19 testing program for underserved communities developed through a partnership between an academic institution and a Federally Qualified Health Center. The following participant variables were examined: health history, COVID-19 symptoms, COVID-19 testing and vaccine experiences, and perceptions of sources of health information. Participant characteristics were compared using chi-square tests. Multivariate logistic regressions were used for the final statistical model. From 1 May 2021 to 30 April 2022, 4,964 adults, 66% of whom were identified as women, completed the survey. Approximately 80% of participants reported having received at least one COVID-19 vaccine. Female sex, older age, Hispanic/Latino(a) ethnicity, previous influenza vaccination, advanced education, and perceived elevated risk of COVID-19 were significantly (p < 0.05) associated with having received a COVID-19 vaccine. Regarding sources of health information, individuals who indicated they trust their doctor, healthcare provider, or the US government "a great deal" were more likely to have received a COVID-19 vaccine compared to individuals who indicated that they trusted these sources "not at all." In contrast, those who reported having "a great deal" of trust in their faith leader or their social media contacts were significantly less likely to have received a COVID-19 vaccine than those who reported that they trusted these sources "not at all." Sex, education, past influenza vaccination, perceived risk of COVID-19 infection, and trust in specific sources of information were correlated with the uptake of COVID-19 vaccination. Additional research is needed to better understand why this confluence of factors, particularly the unique findings about trusted sources of information, are associated with vaccine uptake. Understanding these associations, specifically within underserved, Latino/Hispanic communities, is an important first step to inform efforts aimed at increasing and sustaining COVID-19 vaccine uptake and adoption of other public health interventions.

Veteran influenza vaccination acceptance rates after completion of the COVID-19 vaccination series among historical influenza vaccine refusers

BackgroundVaccine hesitancy remains an obstacle in disease prevention. The recent COVID-19 pandemic highlighted this issue and may influence acceptance of other recommended immunizations. The objective of this study was to determine the association between receiving the COVID-19 vaccination and the subsequent acceptance of the influenza vaccination in a Veteran population that historically declined influenza vaccination. MethodsInfluenza vaccination acceptance rates for the 2021–2022 influenza season were compared in patients who historically declined the influenza vaccine and either received or declined COVID-19 vaccinations. Logistic regression analysis was used to analyze factors associated with receiving influenza vaccination among vaccine hesitant individuals. ResultsA higher proportion of patients who had received the COVID-19 vaccination(s) subsequently accepted the influenza vaccination compared to the control group (37% vs. 11%, OR = 5.03; CI 3.15–8.26; p = 0.0001). ConclusionAmong previous influenza vaccine decliners, those who received COVID-19 vaccination had significantly higher odds of receiving subsequent influenza vaccination.

Dengue vaccine acceptability before and after the availability of COVID-19 vaccines in Puerto Rico.

Dengue is a growing public health threat, causing approximately 400 million infections annually. In June 2021, the Advisory Committee on Immunization Practices recommended the first dengue vaccine (CYD-TDV) for children aged 9-16years with a previous dengue infection, living in endemic areas, such as Puerto Rico (PR). As the COVID-19 pandemic affected vaccine intention worldwide, we assessed dengue vaccine intention before (pre-COVID) and after (post-COVID) COVID-19 vaccine availability among participants enrolled in the Communities Organized to Prevent Arboviruses (COPA) cohort to prepare for dengue vaccine implementation in PR. We used logistic regression models to evaluate changes in dengue vaccine intention by interview timing and participant characteristics. Among 2,513 participants pre-COVID, 2,512 answered the dengue vaccine intention question for themselves, and 1,564 answered relative to their children. Post-COVID, dengue vaccine intention in adults increased for themselves from 73.4% to 84.5% (adjusted odds ratio (aOR)=2.27, 95%CI:1.90-2.71) and relative to their children from 75.6% to 85.5% (aOR=2.21, 95%CI:1.75-2.78). Among all participants, groups with higher dengue vaccine intention included those who reported previous year influenza vaccine uptake and those who reported being frequently bitten by mosquitos, compared to those who did not. Adult males were also more likely to intend to vaccinate themselves than females. Respondents who were employed or in school were less likely to intend to vaccinate compared to those who were not working. The primary reasons for vaccine hesitancy were concerns with side effects and not believing in vaccines, which should be considered during educational strategies prior to dengue vaccine implementation. In general, dengue vaccine intention is high in PR and has increased after COVID-19 vaccine availability, potentially due to increased awareness of vaccine importance during the COVID-19 pandemic.

Dangling Carrots and Twisting Arms: Incentivizing COVID-19 Vaccination for Community Benefit

Using the behavioral economics framework, the current study assessed the effectiveness of compliance gaining techniques and social normative influences to reduce vaccine hesitancy and increase vaccination behavior among college students. A total of 1,283 students responded to a cross-sectional survey assessing the influence of compliance gaining techniques and normative pressures upon vaccine attitudes and behavior. Findings suggest that being female, a person of color, and politically liberal were associated with increased likelihood of vaccination behavior. Likelihood of getting vaccinated was influenced by previous influenza vaccine behavior and parents’ vaccination status, suggesting the importance of parental social norms. Compliance gaining techniques may have strengthened attitudes for unvaccinated students but were less successful at motivating actual vaccine behavior.

Utilizing Multiple Linear Regression Models to Predict Intentions to Vaccinate for COVID-19

The purpose of this research is to develop a multiple linear regression model to predict the intention to vaccinate for COVID-19. An anonymous cross-sectional online survey utilizing Qualtrics software was conducted. Descriptive statistics and inter-correlations between predictors and criterion variables were presented. Multiple linear regression was used to analyze associations among predictors and criterion variables. Overall, results indicated that while 79% of participants reported their intentions to get vaccinated against COVID-19 when a vaccine becomes available, 21% reported not being likely to. Further, results showed that six socio-demographic, health-related, and belief factors had positive effects on intentions to vaccinate for COVID-19. Specifically, the predictive variables of the belief in the effectiveness of the COVID-19 vaccine, political party affiliation, previous influenza vaccinations, employment status, perceived knowledge of COVID-19 and the COVID-19 vaccine, as well as education level have crucial roles in predicting the dependent variable of the intention to vaccinate for COVID-19. This research contributes to our understanding of the various factors that influence the decision to vaccinate for COVID-19. Overall, the proposed regression model with the variables present in this study represents a strong effect and explains the proportion of the variability in the intention to vaccinate with over 70% accuracy. These results have important practical as well as theoretical implications for public health policymakers. With significant percentages of the population that are still hesitant to vaccinate, future studies should focus on finding this missing link and implementing any social/public health policies to level up individual intentions.

Summary of the National Advisory Committee on Immunization (NACI) Statement-Recommendation on Repeated Seasonal Influenza Vaccination.

Influenza vaccination is recommended annually; however, some studies have raised questions regarding whether repeated influenza vaccine administration may have unintended negative consequences for seasonal protection. The National Advisory Committee on Immunization (NACI) Influenza Working Group undertook an overview of systematic reviews on the effects of repeated influenza vaccination on vaccine effectiveness, efficacy, and immunogenicity. A systematic assessment of programmatic factors was conducted according to established NACI methods. The NACI evidence-based process was used to critically appraise the available evidence and to review recommendations. The evidence base consisted of four eligible systematic reviews/meta-analyses. Repeated vaccination, including the current season, was consistently more effective than no vaccination in the current season. The evidence showed no significant difference or predictable trend in vaccine efficacy or effectiveness between vaccinations in two consecutive seasons compared to vaccination in the current season only. Overall, NACI concluded that there is evidence to recommend annual influenza vaccination, irrespective of whether an individual received the seasonal influenza vaccine in previous seasons. It is neither currently feasible nor warranted to modify existing annual influenza vaccination programs to account for potential negative or positive interference. NACI continues to strongly recommend that seasonal influenza vaccine should be offered annually to everyone six months of age and older who does not have contraindications to the vaccine, irrespective of previous seasons' influenza vaccination status.

COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China

Objective: To examine COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China. Methods: An online cross-sectional study was conducted among parents of teenagers in Zhejiang, China from May 1 to 31, 2022. Data were interpreted via univariate and multivariate analyses using the statistical package for the social sciences (SPSS) program. Results: A total of 11115 (96.11%) participants and 11449 (99.00%) of their children in Zhejiang, China had been vaccinated against COVID-19. Children whose parents did not receive COVID-19 vaccination were 19 times (aOR 18.96, 95%CI 12.36-29.08) more likely to be unvaccinated than their counterparts. In addition, children with no previous influenza vaccination, those whose parents doubted the COVID-19 vaccine’s safety or effectiveness, were 6.11 times (aOR 6.11, 95%CI 2.80-13.34), 8.27 times (aOR 8.27, 95%CI 5.33-12.83), and 2.69 times (aOR 2.69, 95%CI 1.11-6.50) more likely to be unvaccinated than their counterparts, respectively. COVID-19 vaccine uptake varied between different sociodemographic groups. However, the odds of receiving the COVID-19 vaccine decreased as age and education level increased. The main refusal reasons claimed by participants were that they had medical conditions that may not qualify them for vaccination (53.78%), followed by safety concerns about the vaccine (13.56%), not knowing where to get vaccinated (6.44%), and concerns about fertility issues (5.56%). Conclusions: Despite a highly encouraging level of COVID-19 vaccine uptake in Zhejiang, China, the elderly and highly educated people had lower COVID-19 vaccine uptake. It is suggested that tailored health education strategies should be taken to increase the COVID-19 vaccine uptake in such groups. Furthermore, with vaccination rates at such a high level, the pandemic is still ongoing, and public confidence in vaccines may decline. Thus, sufficient evidence-based information regarding COVID-19 vaccines should be provided to the public.

Evaluation of a team-based quality improvement initiative for influenza vaccination in an underserved population.

Influenza vaccine is the most effective way to prevent influenza. However, low vaccination rates continue especially in underserved populations. To increase influenza vaccinations in an underserved population and to evaluate the impact of influenza vaccinations compared to previous year influenza vaccinations. Federally-Qualified Health care Center for the Homeless, Richmond, Virginia PRACTICE INNOVATION: Team-based quality improvement initiative led by a pharmacist champion. Before and after evaluation of the quality improvement initiative was conducted by comparing the total number of vaccines administered to those administered the previous year. Influenza vaccinations increased by 42% over the prior influenza vaccination season (1269 vs. 895), respectively. From a population perspective, 31% of patients received an influenza vaccine in 2019-20 and 48% in 2020-21. During the 2019-20 influenza vaccine season, the majority of patients vaccinated were female 56% versus 50.9% in 2020-21. The average age increased from 2019-20 to 2020-21, 37.62 years of age versus 42.71 years of age, respectively. A team-based quality improvement initiative was successful in improving our influenza vaccination program for adults and has served as a foundation for the delivery of other vaccines. Lessons learned were used to implement a COVID-19 vaccine program.

SG-APSIC1026: COVID-19 vaccine acceptance and hesitancy among primary healthcare workers in Singapore

Objectives: Factors affecting COVID-19 vaccine acceptance and hesitancy among primary-care healthcare workers (HCWs) remain poorly understood. We sought to identify factors associated with vaccine acceptance and hesitancy among HCWs. Methods: A multicenter online cross-sectional survey was performed across 6 primary-care clinics from May to June 2021, after completion of the vaccination rollout. The following data were collected: demographics, profession, years working in healthcare, residential status, presence of chronic medical conditions, self-perceived risk of acquiring COVID-19, and previous influenza vaccination. HCWs who accepted the vaccine were asked to rank their 5 best reasons for vaccine acceptance. HCWs who were vaccine hesitant completed the 5C scale on psychological antecedents of vaccination. Results: Of 1,182 eligible HCWs, 557 responded (response rate, 47.1%) and 29 were excluded due to contraindications. Among 557 respondents, the vaccine acceptance rate was 94.9% (n = 501) and 5.1% were hesitant (n = 27). COVID-19 vaccine acceptance was not associated with sex, age, ethnicity, profession, number of years in healthcare, living status, presence of chronic diseases, self-perceived risk, or previous influenza vaccination. The 3 most common reasons for COVID-19 vaccine acceptance as ranked by 501 HCWs were (1) to protect their family and friends, (2) protect themselves from COVID-19, and (3) the high risk of acquiring COVID-19 because of their jobs. The 15-item questionnaire from the 5C psychological antecedents of vaccination was completed by 27 vaccine hesitant HCWs. The mean scores for the components of the 5Cs were ‘confidence’ (3.96), ‘complacency’ (3.23), ‘constraint’ (2.85), ‘calculation’ (5.79) and ‘collective responsibility’ (4.12). Conclusions: COVID-19 vaccine hesitancy is a minute issue among primary-care HCWs in Singapore, where the acceptance rate is 95% with a 5% hesitancy rate. Future studies can focus on other settings with higher hesitancy rates and acceptance of booster vaccinations with the emergence of the SARS-CoV-2 δ (delta) variant. Trial Registration: This study was approved by the National Healthcare Group (NHG) Domain Specific Review Board (DSRB), Singapore on April 26, 2021 (Reg No. 2021/00213).

Demographic and Clinical Predictors of Pharmacist-Administered Pediatric Influenza Immunization

Background: Pediatricians’ offices are primary locations for pediatric influenza vaccination; however, pharmacists are also well-positioned as immunizers. Considering the current COVID-19 pandemic and Public Readiness and Emergency Preparedness (PREP) Act, pharmacists’ authority to vaccinate children has been recently expanded. Methods: We used the de-identified Optum ClinformaticsTM Data Mart database to identify demographic and clinical predictors of pharmacist-administered pediatric influenza vaccination compared with influenza vaccination in pediatricians’ offices. Procedures codes for influenza vaccinations among children were captured for the 2016-2017 influenza season. Logistic regression was used to identify significant predictors. Results: We included 336 841 children receiving influenza vaccines by a pharmacist (5.2%) or in pediatricians’ offices (94.8%). The following significant predictors were identified: older pediatric age groups (13-17 years odds ratio [OR] 91.51, 5-12 years OR 35.41), states allowing pharmacist-administered influenza vaccination at younger ages (no age restrictions OR, 26.68, minimum age 2-4 years old OR, 33.76), influenza vaccination outside of pediatricians’ offices in the previous year (pharmacist-administered OR, 22.18, convenience care OR 4.15, emergency care OR 1.69), geographic region (South OR, 2.02, Midwest OR 1.60, and West OR 1.38), and routine health exam or follow-up in the prior 6-months (OR, 1.59). Conclusions: The strongest drivers of pharmacist-administered pediatric influenza vaccination were older pediatric age, more lenient minimum age restrictions, and previous influenza vaccination in a pharmacy. Due to the COVID-19 pandemic, the PREP Act, and forthcoming pediatric COVID-19 vaccines for children, pharmacists may play a greater role in pediatric vaccination resulting in sustained changes in pediatric vaccination practices.

Determinants of Acceptance of COVID-19 Vaccination in Healthcare and Public Health Professionals: A Review.

Vaccinations of healthcare workers (HCWs) aim to directly protect them from occupational diseases, and indirectly protect their patients and communities. However, studies increasingly highlight that HCWs can be vaccine hesitant. This review aims to analyze HCWs' and public health professionals' sentiments toward COVID-19 (Coronavirus Disease 2019) vaccination and determinants across different countries. A search strategy was conducted in PubMed using keywords such as "COVID-19", "sentiment/acceptance", "healthcare workers", "vaccine hesitancy", and "influenza". A total of 56 articles were selected for in-depth analyses. The highest COVID-19 vaccination uptake was found in an Italian study (98.9%), and the lowest in Cyprus (30%). Older age, male gender, the medical profession, higher education level, presence of comorbidities, and previous influenza vaccination were associated with vaccine acceptance. Factors for low acceptance were perceived side effects of the vaccine, perceived lack of effectiveness and efficacy, and lack of information and knowledge. Factors for acceptance were knowledge, confidence in the vaccine, government, and health authorities, and increased perception of fear and susceptibility. All studies focused on healthcare providers; no studies focusing on public health professionals' sentiments could be found, indicating a gap in research that needs to be addressed. Interventions must be implemented with vaccination campaigns to improve COVID-19 vaccine acceptance.