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Open Access 01-12-2021 | Influenza Vaccination | Research article

Determinants of influenza vaccine uptake and willingness to be vaccinated by pharmacists among the active adult population in Hungary: a cross-sectional exploratory study

Authors: Githa Fungie Galistiani, Mária Matuz, Nikolett Matuszka, Péter Doró, Krisztina Schváb, Zsófia Engi, Ria Benkő

Published in: BMC Public Health | Issue 1/2021

Abstract

Background

Many studies have addressed influenza vaccine uptake in risk-group populations (e.g. the elderly). However, it is also necessary to assess influenza vaccine uptake in the active adult population, since they are considered to be a high-transmitter group. In several countries pharmacists are involved in adult vaccination in order to increase uptake. This study therefore aimed to investigate the determinants of influenza vaccination uptake and examine the willingness to be vaccinated by pharmacists.

Methods

A cross-sectional study was conducted among Hungarian adults using a self-administered online questionnaire distributed via social media (Facebook). The questionnaire included five domains: demographics, vaccine uptake, factors that motivated or discouraged vaccination, knowledge and willingness of participants to accept pharmacists as influenza vaccine administrators. Descriptive statistics were applied and logistic regression was conducted to assess the possible determinants of vaccination uptake.

Results

Data from 1631 participants who completed the questionnaires were analysed. Almost 58% of respondents (944/1631) had occupational and/or health risk factors for influenza. Just over one-tenth (12.3%;200/1631) of participants were vaccinated during the 2017/18 influenza season, 15.4% (145/944) of whom had a risk factor for influenza. Approximately half of the participants (47.4%) believed that influenza vaccination can cause flu, and just over half of them (51.6%), were not knowledgeable about the safety of influenza vaccine ingredients. Logistic regression found that age, sex, health risk factor and knowledge on influenza/influenza vaccination were associated with influenza vaccination uptake (p < 0.05). The most frequently cited reason for having an influenza vaccination was self-protection (95.0%). The most common reason given for refusing the influenza vaccine was that the respondent stated they rarely had an infectious disease (67.7%). The number of participants who were willing to be vaccinated by pharmacists was two-times higher than the number of participants who were actually vaccinated during the 2017/18 influenza season.

Conclusion

Influenza vaccine uptake in the active adult population is low in Hungary. Public awareness and knowledge about influenza vaccination and influenza disease should be increased. The results also suggest a need to extend the role played by pharmacists in Hungary.

World Health Organization (WHO). Influenza (Seasonal) 2019. http://www.who.int/mediacentre/factsheets/fs211/en/ (Accessed August 11, 2019).

European Centre for Disease Prevention and Control (ECDC). ECDC Technical Report: Seasonal influenza vaccination in Europe. In: Vaccination recommendations and coverage rates in the EU Member States for eight influenza seasons 2007–2008 to 2014–2015; 2017. https://doi.org/10.2900/153616.CrossRef

Cassini L, Colzani E, Pini A, Mangen M-JJ, Plass D, McDonald SA, et al. Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): results from the burden of communicable diseases in Europe study, European Union and European economic countries, 2009 to 2013. Eurosurveillance. 2018;23(16):17–454. https://doi.org/10.2807/1560-7917.ES.2018.23.16.17-00454.CrossRefPubMedCentral

European Centre for Disease Prevention and Control (ECDC). Key Facts about Influenza (Flu) & Flu Vaccine. Seas Influ 2019. http://www.cdc.gov/flu/keyfacts.htm (Accessed August 11, 2019).

Medlock J, Galvani AP. Optimizing Influenza Vaccine Distribution. Science. 2009;325(5948):1705–9. https://doi.org/10.1126/science.1175570.CrossRefPubMed

Knipl DH, Röost G. Modelling the strategies for age Spesific vaccination scheduling during influenza pandemic outbreaks. Math Biosci Eng. 2011;8(1):123–39. https://doi.org/10.3934/mbe.2011.8.123.CrossRefPubMed

Aw D, Silva AB, Palmer DB. Immunosenescence: emerging challenges for an ageing population. Immunology. 2007;120(4):435–46. https://doi.org/10.1111/j.1365-2567.2007.02555.x.CrossRefPubMedPubMedCentral

Schmid P, Rauber D, Betsch C, Lidolt G, Denker L. Barriers of Influenza Vaccination Intention and Behavior – A Systematic Review of Influenza Vaccine Hesitancy , 2005–2016. PLoS One. 2017;12(1):2005–16. https://doi.org/10.1371/journal.pone.0170550.CrossRef

Yuen CYS, Tarrant M. Determinants of uptake of influenza vaccination among pregnant women – a systematic review. Vaccine. 2014;32(36):4602–13. https://doi.org/10.1016/j.vaccine.2014.06.067.CrossRefPubMed

10.

Endrich MM, Blank PR, Szucs TD. Influenza vaccination uptake and socioeconomic determinants in 11 European countries. Vaccine. 2009;27(30):4018–24. https://doi.org/10.1016/j.vaccine.2009.04.029.CrossRefPubMed

11.

Rizzo C, Rezza G, Ricciardi W. Strategies in recommending influenza vaccination in Europe and US. Hum Vaccin Immunother. 2018;14(3):693–8. https://doi.org/10.1080/21645515.2017.1367463.CrossRefPubMedPubMedCentral

12.

Atkins K, Van Hoek AJ, Watson C, Baguelin M, Choga L, Patel A, et al. Seasonal influenza vaccination delivery through community pharmacists in England: evaluation of the London pilot. BMJ Open. 2016;6(2):1–11. https://doi.org/10.1136/bmjopen-2015-009739.CrossRef

13.

The Pharmaceutical Group of the European Union (PGEU). European Union Communicable Diseases and Vaccination 2019. https://www.pgeu.eu/wp-content/uploads/2019/07/180403E-PGEU-Best-Practice-Paper-on-Communicable-Diseases-and-Vaccination.pdf (Accessed August 15, 2019).

14.

International Pharmaceutical Federation (FIP). An overview of pharmacy’s impact on immunisation coverage: a global survey. The Hague: International Pharmaceutical Federation; 2020.

15.

Isenor JE, Edwards NT, Alia TA, Slayter KL, MacDougall DM, McNeil SA, et al. Impact of pharmacists as immunizers on vaccination rates: a systematic review and meta-analysis. Vaccine. 2016;34(47):5708–23. https://doi.org/10.1016/j.vaccine.2016.08.085.CrossRefPubMed

16.

International Pharmaceutical Federation (FIP). Joint FIP/WHO guidelines on good pharmacy practice standards for quality of pharmacy services 2011.

17.

Forecast of Facebook user numbers in Hungary from 2017 to 2025 n.d. https://www.statista.com/statistics/568794/forecast-of-facebook-user-numbers-in-hungary/ (accessed January 15, 2018).

18.

Ogston SA, Lemeshow S, Hosmer DW, Klar J, Lwanga SK. Adequacy of sample size in health studies, vol. 47. West Sussex: Wiley; 1991. https://doi.org/10.2307/2532527.CrossRef

19.

Emberi Erőforrások Minisztériuma (EMMI). EMMI módszertani levele a 2018. évi védőoltásokról 2018:1–44. https://www.antsz.hu/data/cms84807/EMMI_VML2018_kozlony.pdf (accessed July 20, 2019).

20.

Güvenç IA, Parıldar H, Şahin MK, Erbek SS. Better knowledge and regular vaccination practices correlate well with higher seasonal influenza vaccine uptake in people at risk: promising survey results from a university outpatient clinic. Am J Infect Control. 2017;45(7):740–5. https://doi.org/10.1016/j.ajic.2017.02.041.CrossRef

21.

Alqahtani AS, Althobaity HM, Al Aboud D, Abdel-Moneim AS. Knowledge and attitudes of Saudi populations regarding seasonal influenza vaccination. J Infect Public Health. 2017;10(6):897–900. https://doi.org/10.1016/j.jiph.2017.03.011.CrossRefPubMed

22.

Haridi HK, Salman KA, Basaif EA, Al-Skaibi DK. Influenza vaccine uptake, determinants, motivators, and barriers of the vaccine receipt among healthcare workers in a tertiary care hospital in Saudi Arabia. J Hosp Infect. 2017;96(3):268–75. https://doi.org/10.1016/j.jhin.2017.02.005.CrossRefPubMed

23.

Bof de Andrade F, Sayuri Sato AP, Moura RF, Ferreira Antunes JL. Correlates of influenza vaccine uptake among community-dwelling older adults in Brazil. Hum Vaccines Immunother. 2017;13(1):103–10. https://doi.org/10.1080/21645515.2016.1228501.CrossRef

24.

European Centre for Disease Prevention and Control (ECDC). Seasonal influenza vaccination and antiviral use in EU/EEA Member States. 2018.

25.

Tessier E, Warburton F, Tsang C, Rafeeq S, Boddington N, Sinnathamby M, Pebody R Population-level factors predicting variation in influenza vaccine uptake among adults and young children in England , 2015 / 16 and 2016 / 17. Vaccine 2019;36:3231–3238. https://doi.org/https://doi.org/10.1016/j.vaccine.2018.04.074, 23.

26.

Dyda A, Karki S, Hayen A, Macintyre CR, Menzies R, Banks E, et al. Influenza and pneumococcal vaccination in Australian adults : a systematic review of coverage and factors associated with uptake. BMC Infect Dis. 2016;16(1):1–15. https://doi.org/10.1186/s12879-016-1820-8.CrossRef

27.

Yeung S, Lam FLY, Coker R. Factors associated with the uptake of seasonal influenza vaccination in adults : a systematic review. J Public Health (Oxf). 2016;38:746–53. https://doi.org/10.1093/pubmed/fdv194.CrossRef

28.

Han YKJ, Michie S, Potts HWW, Rubin GJ. Predictors of influenza vaccine uptake during the 2009/10 influenza a H1N1v ('swine flu’) pandemic: results from five national surveys in the United Kingdom. Prev Med (Baltim). 2016;84:57–61. https://doi.org/10.1016/j.ypmed.2015.12.018.CrossRef

29.

Hoffmann K, Van Bijnen EM, George A, Kutalek R, Jirovsky E, Wojczewski S, et al. Associations between the prevalence of influenza vaccination and patient’s knowledge about antibiotics. BMC Public Health. 2015;15(1):1–9. https://doi.org/10.1186/s12889-015-2297-x.CrossRef

30.

Bödeker B, Remschmidt C, Schmich P, Wichmann O. Why are older adults and individuals with underlying chronic diseases in Germany not vaccinated against flu ? A population-based study. 2015;15(1):1–10. https://doi.org/10.1186/s12889-015-1970-4.CrossRef

31.

Eilers R, Krabbe PFM, De Melker HE. Motives of Dutch persons aged 50 years and older to accept vaccination: a qualitative study. BMC Public Health. 2015;15(1):1–10. https://doi.org/10.1186/s12889-015-1825-z.CrossRef

32.

Klett-Tammen CJ, Krause G, Seefeld L, Ott JJ. Determinants of tetanus, pneumococcal and influenza vaccination in the elderly: a representative cross-sectional study on knowledge, attitude and practice (KAP). BMC Public Health. 2016;16(1):121. https://doi.org/10.1186/s12889-016-2784-8.CrossRefPubMedPubMedCentral

33.

Larson HJ, Jarrett C, Eckersberger E, Smith DMD, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective : A systematic review of published literature, 2007–2012. Vaccine. 2014;32(19):2150–9. https://doi.org/10.1016/j.vaccine.2014.01.081.CrossRefPubMed

34.

Lorenc T, Marshall D, Wright K, Sutcliffe K, Sowden A. Seasonal influenza vaccination of healthcare workers: systematic review of qualitative evidence. BMC Health Serv Res. 2017;17(1):1–8. https://doi.org/10.1186/s12913-017-2703-4.CrossRef

35.

Bonfiglioli R, Vignoli M, Guglielmi D, Depolo M, Violante FS. Getting vaccinated or not getting vaccinated? Different reasons for getting vaccinated against seasonal or pandemic influenza. BMC Public Health. 2013;13(1):1221–8. https://doi.org/10.1186/1471-2458-13-1221.CrossRefPubMedPubMedCentral

36.

Thornley T, Alliance WB, Heights T, Weybridge B, Kt S. Benefits of pharmacist-led flu vaccination. Ann Pharm Fr. 2016;75(1):6–11. https://doi.org/10.1016/j.pharma.2016.08.005.CrossRef

37.

Anderson C, Thornley T, Anderson C. Who uses pharmacy for flu vaccinations ? Population profiling through a UK pharmacy chain. Int J Clin Pharm. 2016;38(2):218–22. https://doi.org/10.1007/s11096-016-0255-z.CrossRefPubMedPubMedCentral

38.

International Pharmaceutical Federation (FIP). An overview of current pharmacy impact on immunisation - A global report. The Hague: International Pharmaceutical Federation; 2016.

39.

Burt S, Hattingh L, Czarniak P. Evaluation of patient satisfaction and experience towards pharmacist - administered vaccination services in Western Australia. Int J Clin Pharm. 2018;40(6):1519–27. https://doi.org/10.1007/s11096-018-0738-1.CrossRefPubMed

40.

Isenor JE, Wagg AC, Bowles SK. Patient experiences with influenza immunizations administered by pharmacists. Hum Vaccines Immunother. 2018;14(3):706–11. https://doi.org/10.1080/21645515.2018.1423930.CrossRef

41.

Poulose S, Cheriyan E, Cheriyan R, Weeratunga D, Adham M. Pharmacist-administered influenza vaccine in a community pharmacy : a patient experience survey. Can Pharm J. 2015;148(2):64–7. https://doi.org/10.1177/1715163515569344.CrossRef

42.

Ahmed N, Quinn SC, Hancock GR, Freimuth VS, Jamison A. Social media use and influenza vaccine uptake among white and African American adults. Vaccine. 2018;36(49):7556–61. https://doi.org/10.1016/j.vaccine.2018.10.049.CrossRefPubMed

43.

Faasse K, Chatman CJ, Martin LR. A comparison of language use in pro- and anti-vaccination comments in response to a high profile Facebook post. Vaccine. 2016;34(47):5808–14. https://doi.org/10.1016/j.vaccine.2016.09.029.CrossRefPubMed

44.

Schmidt AL, Zollo F, Scala A, Betsch C, Quattrociocchi W. Polarization of the vaccination debate on Facebook. Vaccine. 2018;36(25):3606–12. https://doi.org/10.1016/j.vaccine.2018.05.040.CrossRefPubMed

45.

Smith N, Graham T. Mapping the anti-vaccination movement on Facebook. Inf Commun Soc. 2019;22(9):1310–27. https://doi.org/10.1080/1369118X.2017.1418406.CrossRef

46.

European Commission, World Health Organization. Global Vaccination Summit; 2019. p. 1–3. https://ec.europa.eu/health/sites/health/files/vaccination/docs/ev_20190912_mi_en.pdf (Accessed September 11, 2020)

Title: Determinants of influenza vaccine uptake and willingness to be vaccinated by pharmacists among the active adult population in Hungary: a cross-sectional exploratory study
Authors: Githa Fungie Galistiani
Mária Matuz
Nikolett Matuszka
Péter Doró
Krisztina Schváb
Zsófia Engi
Ria Benkő
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Influenza Vaccination
Vaccination
Influenza
Published in: BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-021-10572-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Determinants of influenza vaccine uptake and willingness to be vaccinated by pharmacists among the active adult population in Hungary: a cross-sectional exploratory study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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