“三位一体”综合干预对老年慢性病患者流感疫苗接种的影响

探索“三位一体”综合干预模式在老年慢性病患者流感疫苗接种意愿干预中的有效性和可行性,为推广老年慢性病患者疫苗接种的综合干预模式提供理论依据。方法 2020年9月—2021年6月,采用分层随机抽样方法,随机抽取900名慢性病患者作为研究对象,对其开展为期6个月的“三位一体”综合干预,采用问卷调查评估干预前后研究对象的流感疫苗接种意愿、知识知晓率和接种率,并对所得数据进行统计分析。结果 干预前,研究对象愿意接种流感疫苗的人数比例、流感疫苗知识知晓率及流感疫苗接种率分别为53.09%、53.00%及8.10%;干预后,研究对象愿意接种流感疫苗的人数比例、流感疫苗知识知晓率及流感疫苗接种率分别为61.40%、93.10%及31.26%,干预前后比较,差异均有统计学意义（均P<0.05）。风险估计结果显示：“三位一体”综合干预对不同病种、性别及年龄段研究对象的流感疫苗接种意愿、知识知晓率和接种率均为保护性因素（均OR<1）。此外,均一性检验及独立性检验结果显示：性别、年龄因素在本研究中的混杂作用不明显,病种因素在“三位一体”综合干预与研究对象疫苗知识知晓率的关系中存在效应修饰作用。结论 “三位一体”综合干预可有效提高老年慢性病患者流感疫苗接种意愿、知识知晓率和接种率。     

提高冠心病患者流行性感冒认知及疫苗接种率的研究

  目的  了解冠心病患者对流行性感冒（简称为流感）及疫苗的认知情况，并对社区健康干预措施在提高此类人群流感认知及疫苗接种率中的效果进行评价。  方法  采用随机整群抽样的方式，将徐州市鼓楼区7家社区卫生服务中心在管冠心病患者随机分为干预组与对照组，干预组给予多频次社区健康干预，对照组不作任何处理。比较干预前后对流感知晓率及干预、对照两组疫苗接种率的异同。  结果  干预组1 711例、对照组1 805例参与了此次研究；干预后，干预组对流感及其疫苗的认知程度普遍有所提升（均有P < 0.05），总知晓率由15.84%上升至53.59%（χ2=518.734，P < 0.001）；干预组与对照组流感疫苗接种率基线数据分别4.32%、4.76%，两者差异无统计学意义（χ2=0.391，P=0.532）；经干预后，干预组流感疫苗接种率为7.89%，高于本组基线数据（χ2=43.373，P < 0.001），也高于对照组在项目结束时接种率（1.88%，χ2=69.258，P < 0.001）；对照组在项目结束时流感疫苗接种率为1.88%，较本组基线（χ2=36.125，P < 0.001）与干预组基线接种率均低（χ2=17.583，P < 0.001）。  结论  徐州市鼓楼区冠心病患者流感疫苗的接种率不高，后期应针对冠心病患者进一步加大流感相关知识的宣教，社区健康干预不失为提高冠心病患者流感知晓率与疫苗接种率的有效手段。     

我国两个地区儿童流感疫苗与肺炎疫苗接种现状与影响因素分析

目的 了解儿童流感疫苗和肺炎疫苗的接种行为与影响因素。方法 采用两阶段整群抽样,在北京市通州区和甘肃省白银市对适龄儿童家长开展横断面问卷调查,分析儿童流感疫苗和肺炎疫苗接种率及影响因素。结果 共纳入2 377名儿童,儿童流感疫苗接种率为35.93%,肺炎疫苗接种率为16.58%,两种疫苗均接种率为11.65%。接种两种疫苗的理由占比前三位分别为认为疾病严重（流感疫苗：36.02%;肺炎疫苗：49.61%）、学校、单位要求接种（流感疫苗：28.76%;肺炎疫苗：25.45%）和认为疾病易感（流感疫苗：26.41%;肺炎疫苗：13.88%）;未接种疫苗的理由前三位分别为个人方面、疫苗本身和疫苗供应。家庭居住地为农村是影响两类疫苗接种的重要因素。子女数量>1个的家庭、家庭居住地为农村和家庭人均年收入较低与两类疫苗的接种呈负相关。结论 调查地区儿童流感疫苗和肺炎疫苗接种率较低,农村家庭、多子女家庭是扩大疫苗接种的重点关注人群。加强疫苗相关知识宣教,引导家长正确认知疫苗安全性问题,协调疫苗供应与降低疫苗价格对提高流感疫苗和肺炎疫苗接种率具有促进作用。     

深圳市学龄儿童接种流感疫苗对缺课预防效果的实证研究

目的 评估深圳市采用入校接种方式以及学龄儿童流感疫苗接种率高低对缺课的影响。方法 以深圳市小学学龄儿童为研究对象,利用2017年12月至2020年6月深圳市286所小学缺课数据以及学龄儿童流感疫苗接种政策实施后深圳市9个区疫苗接种率和组织方式（入校接种与非入校接种）数据,以缺课人数作为被解释变量,分别以组织方式和区接种率作为分组变量,构建双重差分模型,采用泊松回归进行分析,并对回归结果进行稳健性检验。结果 相比于非入校接种和低接种率,入校接种和高接种率可有效降低缺课的发生风险,对缺课的预防效果分别为32.6%（95%CI： 17.0%~45.3%,P<0.01）和53.0%（95%CI：42.1%~61.8%,P<0.01）。结论 深圳市实施学龄儿童流感疫苗免费接种政策并优先采用入校接种的方式,可有效降低学生缺课的发生风险。     

陕西省护士流感认知、罹患及疫苗接种情况调查

目的了解陕西省在册护士流感认知、罹患及流感疫苗接种情况,并分析其影响因素。方法通过方便抽样、定向投放调查问卷的方式,对在护联网注册的现住址为陕西省的护士开展网络问卷调查,采用卡方检验和logistic回归分析进行单因素和多因分析。结果本次调查回收516份有效调查问卷,调查对象流感相关知识的知晓率较高(均89.0%),50.4%的调查对象在2017年10月至2018年3-4月间曾出现过流感样症状,且如果出现流感样症状后相关健康行为较高,分别是"戴口罩"89.2%、"频繁洗手"83.4%和"自我隔离"79.6%。但调查对象过去1年流感疫苗接种率仅为3.1%,且仅有15.5%(80/516)的护士曾向护理对象推荐接种流感疫苗。"工作太忙"(25.9%)为未接种过流感疫苗的首要原因。多因素分析表明,曾经接种过流感疫苗的护士向护理对象推荐接种流感疫苗的比例远高于未接种过流感疫苗的护士(OR=14.842,95%CI=4.854～45.381)。结论陕西省护士流感相关知识的知晓率较高,但疫苗接种率低,有必要进一步开展健康教育,提高流感疫苗相关知识,探索制定医务人员疫苗免费接种政策,改进预防接种服务措施,提高流感疫苗可及性及医护人员流感疫苗接种情况,从而提高医护人员向服务对象推荐率。     

中国东北5个城市男男性行为人群猴痘认知、风险感知和猴痘疫苗接种意愿调查

目的 了解我国东北5个城市MSM对猴痘认知、风险感知和猴痘疫苗接种意愿。方法 采用电子问卷，于2023年6月28日至7月8日在东北5个城市（沈阳市、盘锦市、长春市、哈尔滨市和佳木斯市）通过方便抽样开展横断面调查。调查对象由当地CDC和MSM社会组织的工作人员招募。估计样本量为220人。收集信息包括调查对象的人口学特征、猴痘相关知识知晓、对猴痘疫情关注程度猴痘感染风险感知和猴痘疫苗接种意愿。采用logistic回归模型分析调查对象猴痘疫苗接种意愿的相关因素。结果 MSM调查对象共355人，对猴痘疫苗有接种意愿的比例为63.9%（227/355），猴痘知识得分为（3.7±1.5）分、猴痘知识知晓率为55.5%（197/355）。高中及以上文化程度（aOR=1.93，95%CI：1.01~3.69）、猴痘知识得分较高（aOR=1.19，95%CI：1.02~1.40）、担心自身感染猴痘病毒（aOR=1.82，95%CI：1.15~2.88）的调查对象对猴痘疫苗的接种意愿更高。调查对象有猴痘疫苗接种意愿的主要原因包括有效预防猴痘感染（86.3%，196/227）和避免感染后影响容貌（62.1%，141/227）；无猴痘疫苗接种意愿的主要原因包括担心猴痘疫苗不安全（53.1%，68/128）、担心接种疫苗对艾滋病疾病进展（46.1%，59/128）和艾滋病抗病毒治疗效果（44.5%，57/128）有影响。结论 东北5个城市MSM的猴痘知识知晓率和疫苗接种意愿仍有待提高。有必要持续加强MSM对猴痘认知和疫情防范意识，强调MSM保持安全性行为，提高对猴痘感染的自我评估和风险感知能力，减少疫苗犹豫，提高猴痘疫苗接种意愿。     

2014-2015年中国40岁及以上慢性阻塞性肺疾病患者肺炎疫苗接种状况

目的 了解我国≥40岁慢性阻塞性肺疾病（慢阻肺）患者的肺炎疫苗接种状况,为慢阻肺的防控提供科学依据。方法 将2014-2015年中国居民慢性阻塞性肺疾病监测中支气管舒张试验后测试FEV₁/FVC<70%的调查对象作为慢阻肺患者,其中9 067名通过询问调查明确肺炎疫苗接种情况的患者被纳入本研究分析。应用复杂抽样调整方法,估计慢阻肺患者中的肺炎疫苗接种率及其95% CI,并对其影响因素进行分析。结果 我国≥40岁慢阻肺患者的5年内肺炎疫苗接种率是0.8%（95% CI：0.3%～1.4%）。40～岁组患者的肺炎疫苗接种率是0.3%（95% CI：0.2%～0.5%）,≥60岁组患者的接种率为1.2%（95% CI：0.3%～2.1%）（P<0.05）;城镇患者的接种率（1.5%）高于乡村患者（0.4%）（P<0.05）;慢阻肺患者的气流受限程度越严重,其肺炎疫苗接种率越高（P<0.05）;合并其他慢性肺部疾病或糖尿病的患者接种率为1.7%、2.1%,高于未合并的患者（P<0.05）;曾经吸烟的慢阻肺患者肺炎疫苗接种率为1.4%,现在吸烟的患者接种率为0.6%。慢阻肺患者的肺炎疫苗接种与年龄、文化程度、职业、气流受限严重程度分级、流感疫苗接种史有关。结论 我国≥40岁慢阻肺患者的肺炎疫苗接种率非常低,需要采取多种措施加强对慢阻肺患者的健康教育与肺炎疫苗接种推荐。     

青海省西宁市医院临床医护人员2016－2017年度流感疫苗接种情况及影响因素分析

目的 了解青海省西宁市临床医护人员2016-2017年度流感疫苗的接种情况及影响因素,初步探索推动西宁市临床医护人员流感疫苗接种措施。方法 随机抽取西宁市4家三级医院,在知情同意的原则下自愿参与完成自填式问卷调查,并访谈医院相关负责人。结果 西宁市三级医院临床医护人员2016-2017年度流感疫苗接种率为5.14%（95%CI：4.80%~5.49%）,多因素分析显示,流感疫苗优先推荐接种人群、接种频次,接种效果的知晓以及职称是主要影响因素。接种组向他人推荐流感疫苗的意愿高于未接种组（χ²=99.57,P<0.001）。结论 西宁市医院临床医护人员流感疫苗接种率低,主要与流感疫苗的认知不足有关。应开展宣传教育,充分发挥示范和影响作用。     

北京市通州区18岁以上居民流感知识知晓率及疫苗接种状况分析

目的了解北京市通州区居民对流感知识知晓情况及流感疫苗接种情况。方法采用多阶段系统抽样的方法,在该区25个村/居委会中各抽取86人作为调查对象,采用自填和询问相结合的方式进行调查。对回收的问卷应用EpiData数据库进行双录入,对调查对象的基本人口学资料、各项流感知晓的知晓率、流感疫苗接种情况及其影响因素进行应用SPSS 13.0进行分析。结果共回收有效问卷2 341份,通州区居民对流感相关知识的正确知晓率分别为89.83%、64.63%、79.92%、50.23%和82.44%。不同性别调查对象流感知识知晓情况进行χ2检验,差异均无统计学意义;不同年龄、不同受教育程度调查对象的流感知识知晓率差异均有统计学意义。2007~2010年通州区流感疫苗接种率分别为9%、14%、19%和15%,43%的人从未接种过流感疫苗。影响疫苗接种的原因主要包括:觉得身体好,没必要注射(占34.36%)、没时间(占14.34%)、价钱太贵(占12.51%)、觉得会对身体产生不良影响(占10.73%)、不相信注射后能达到预防流感的效果(10.62%)。结论通州区居民流感相关知识知晓率较高,但不同年龄、不同受教育程度人群间差异较大。2007~2010年流感疫苗接种情况及其影响因素与北京市总体情况基本一致。     

北京市职业学校学生流感预防认知状况调查

目的了解北京职业学校学生流感认知水平以及对北京市2007年流感疫苗接种优惠政策的知晓情况,为今后的流感预防工作提供参考依据。方法采用多阶段分层整群抽样方法,抽取北京市职业中学一、二年级学生742人,对其流感认知水平和2007年北京市流感疫苗接种政策的知晓情况进行问卷调查。结果北京市职业中学学生流感基本知识知晓率为59．1％,城区中学生的知晓率为66．9％,高于郊区学生的50．0％（P〈0．05）;学生流感疫苗接种率为36．4％,城区学生流感疫苗接种率为52．4％,高于郊区学生的17．6％（P〈0．01）;知道优惠政策的学生流感疫苗接种率为51．4％,高于不知道优惠政策学生的16．3％（P〈0．01）;知道流感疫苗可以预防流感的学生中,有39．4％的学生接种了流感疫苗,而不知道流感疫苗可以预防流感的学生中,只有17．8％的学生接种了流感疫苗,二者差异有统计学意义（P〈0．01）;学生获取流感相关信息的途径主要是居委会／单位／学校通知、电视和报纸。结论对中学生施行流感疫苗接种优惠政策,增强流感预防知识宣传,可以提高流感疫苗接种率和流感预防的效果。     

Willingness of future A/H7N9 influenza vaccine uptake: A cross-sectional study of Hong Kong community

We conducted a population telephone survey in Hong Kong during the second wave of influenza A/H7N9 outbreak in 2014. Among the respondents, 50.5% of the respondents would like to accept A/H7N9 vaccination in future. Respondents had poor knowledge of A/H7N9 influenza and vaccines. More than 60% of respondents mixed up seasonal influenza this year and A/H7N9 influenza. Results show that socio-demographic factors were all independent of the vaccine uptake willingness while anxiety level and vaccine history were the main affecting factors. Vaccine promotion strategies may focus on influenza knowledge, attitude and behavior.     

Reasons for low influenza vaccination coverage among adults in Puerto Rico,influenza season 2013–2014

BackgroundInfluenza vaccination is recommended annually for all persons 6 months and older. Reports of increased influenza-related morbidity and mortality during the 2013–2014 influenza season raised concerns about low adult influenza immunization rates in Puerto Rico. In order to inform public health actions to increase vaccination rates, we surveyed adults in Puerto Rico regarding influenza vaccination-related attitudes and barriers.MethodsA random-digit-dialing telephone survey (50% landline: 50% cellphone) regarding influenza vaccination, attitudes, practices and barriers was conducted November 19–25, 2013 among adults in Puerto Rico. Survey results were weighted to reflect sampling design and adjustments for non-response.ResultsAmong 439 surveyed, 229 completed the survey with a 52% response rate. Respondents’ median age was 55 years; 18% reported receiving 2013–2014 influenza vaccination. Among 180 unvaccinated respondents, 38% reported barriers associated with limited access to vaccination, 24% reported they did not want or need influenza vaccination, and 20% reported safety concerns. Vaccinated respondents were more likely to know if they were recommended for influenza vaccination, to report greater perceived risk of influenza illness, and to report being less concerned about influenza vaccine safety (p-value < 0.05). Of the 175 respondents who saw a healthcare provider (HCP) since July 1, 2013, 38% reported their HCP recommended influenza vaccination and 17% were offered vaccination. Vaccination rates were higher among adults who received a recommendation and/or offer of influenza vaccination (43% vs. 14%; p-value < 0.01).ConclusionsFailure of HCP to recommend and/or offer influenza vaccination and patient attitudes (low perceived risk of influenza virus infection) may have contributed to low vaccination rates during the 2013–2014 season. HCP and public health practitioners should strongly recommend influenza vaccination and provide vaccinations during clinical encounters or refer patients for vaccination.     

Cross-sectional study on factors associated with influenza vaccine uptake and pertussis vaccination status among pregnant women in Germany

Pregnant women and their newborns are at increased risk for influenza-related complications; the latter also have an increased risk for pertussis-related complications. In Germany, seasonal influenza vaccination is recommended for pregnant women since 2010. A dose of pertussis-containing vaccine has been recommended since 2004 for women of childbearing age if they have not been vaccinated within the past 10 years. We conducted a nationwide cross-sectional survey among pregnant women in February/March 2013 to assess knowledge, attitudes, and practices related to influenza vaccination during pregnancy and to identify factors associated with their pertussis vaccination status. In total, 1025 pregnant women participated and provided information through a self-administered questionnaire. Of these, 23.2% were vaccinated against seasonal influenza during the 2012/13 season; 15.9% during their pregnancy. Major reasons for being unvaccinated (n = 686 respondents) were lack of confidence in the vaccine (60.4%) and the perception that vaccination was not necessary (40.3%). Influenza vaccination during pregnancy was independently associated with having received influenza vaccine in the previous season, having received a recommendation from a physician, a high level of vaccine-related knowledge and of perceived disease severity. In contrast, knowledge of the recommendation for regular hand-washing to prevent influenza and the perception that vaccine-related side effects were likely to occur or likely to be severe were negatively associated with vaccine uptake. Receipt of a pertussis vaccine in the past 10 years was reported by 22.5% of participants. Pertussis vaccine uptake was independently associated with living in the Eastern federal states and receiving seasonal influenza vaccination annually, while a migration background was associated with a lower uptake. To enhance vaccine uptake in pregnant women and women of childbearing age, special efforts must be undertaken to improve knowledge of both recommendations and the benefits of vaccination. Gynecologists could serve as important facilitators.     

Influenza vaccination among adults living with persons at high-risk for complications from influenza during early 2016–17 influenza season

BackgroundThe Advisory Committee on Immunization Practices (ACIP) recommends all persons aged ≥6 months get vaccinated for influenza annually, placing particular emphasis on persons who are at increased risk for influenza-related complications and persons living with or caring for them.MethodsData from the 2016 National Internet Flu Survey (NIFS), a nationally representative, probability-based Internet panel survey of the noninstitutionalized U.S. civilian population aged ≥18 years, was used to compare influenza vaccination coverage among adults who live with household members at high-risk for complications from influenza with those who do not. Logistic regression was used to evaluate the difference in the adjusted vaccination coverage prevalence between persons living with and without high-risk household members.ResultsFrom the 2016 NIFS (n = 4,113), we estimated that 29.2% of noninstitutionalized U.S. adults had at least one household member at increased risk for influenza-related complications. Unadjusted influenza vaccination coverage was significantly higher for adults with a high-risk household member compared with those without (46.7% vs 38.6%, respectively). After adjustment for demographic and access-to-care factors, adults with high-risk household members were more likely to be vaccinated than those without (adjusted prevalence difference = 5.3 [0.3, 10.3]). Among vaccinated respondents with high-risk household members, 88.7% reported that protection of their family and close contacts was one of the reasons they were vaccinated.ConclusionApproximately half of adults living with someone at increased risk of complications from influenza did not report receiving an influenza vaccination. Vaccination reminder/recall for persons at increased risk should include reminders for their household contacts.     

Influenza vaccination hesitancy and its determinants among elderly in China: A national cross-sectional study

BackgroundThe Chinese elderly face a significant threat from seasonal influenza, owing to the consistently low vaccination coverage. This study investigated the prevalence and determinants of influenza vaccination hesitancy among the Chinese elderly.MethodsIn 2019, 3849 elderly individuals from 10 provinces in China were recruited in a cross-sectional survey. Multinomial logistic regression was applied to investigate the determinants of influenza vaccination hesitancy.ResultsAmong the elderly respondents, 37.18% expressed some degree of hesitancy towards influenza vaccination: 19.28% were hesitant, and 17.90% refused influenza vaccination, including 19.28% acceptors with doubts and 17.90% refusers. Only 39.10% of the respondents considered themselves as the priority group for influenza vaccination, and 13.93% reported receiving a recommendation for vaccination from healthcare workers. Respondents with higher education levels and from urban areas had significantly higher odds of vaccine hesitancy than their counterparts. Confidence in the safety of vaccines was negatively associated with vaccine hesitancy, but confidence in vaccine efficacy had no such association. Respondents who perceived themselves as highly susceptible to influenza (AOR = 0.85; 95 %CI = 0.77–0.93) and those aware of the elderly as a priority group for influenza vaccination (AOR = 0.51; 95 %CI = 0.41–0.64) had a significantly lower odds of being refusers.ConclusionThis study found a high prevalence of hesitancy towards influenza vaccination among the Chinese elderly, especially well-educated and urban-dwelling respondents. The government should address vaccine hesitancy through culturally appropriate communication, subsidies for vaccination, and actively promoting vaccines through primary care professionals.     

医院门诊就诊者流感相关知识及行为状况调查

目的了解医院就诊者流感传播和预防知识认识及行为状况。方法采用开放式调查方法 ,用自行设计的调查表对来北京大学第一医院就诊的患者进行问卷调查。结果认为流感是通过飞沫传染他人的占98.1%,认为戴口罩可以在很大程度上阻断传播的占96.3%,认为身边流感患者通过打喷嚏、咳嗽传染自己的占75.0%,关注公共场所空气污染的占96.5%。家庭中感冒患者戴口罩的占21.4%,感冒者外出戴口罩的占42.8%,退热后有较重感冒症状但坚持上班(上学)的占82.1%,不同年龄段和不同受教育程度人员感冒在家中戴口罩的比例存在统计学差异;不同年龄段人员感冒时外出戴口罩的比例存在统计学差异。结论被调查者中了解流感相关知识与传播途径的人员所占比例较大,但采取预防行为的人较少。应加大力度强化感冒患者戴口罩意识和行为;对流感患者应有相应隔离政策;强化预防流感宣传教育。     

A community-based survey on influenza and vaccination knowledge,perceptions and practices in Peru

BackgroundAlthough Peru provides safe and effective influenza vaccines free-of-charge, coverage among vaccine target groups like pregnant women and older adults remains low. To improve risk communication messages and vaccine uptake, we explored knowledge, perceptions and practices about influenza illness and vaccination.MethodsA cross-sectional, community-based survey with a three-stage cluster sampling design was conducted in three cities in Peru. We included mothers of young children, pregnant women and persons ≥65 years. Participants completed a questionnaire about knowledge, perceptions and practices about influenza illness and vaccination against influenza during the past year. Generalized linear models were used to explore factors associated with vaccination in the past year.Results624/645 (97%) mothers, 54/55 (98%) pregnant women and 622/673 (92%) older adults approached provided informed consent and were surveyed. While most mothers, pregnant women and older adults (94%, 96% and 91%, respectively) perceived influenza as a potentially serious illness, few pregnant women (13%) and older adults (34%) self-identified themselves as a target group for influenza vaccination. Only 28% of mothers, 19% pregnant women, and 27% older adults were vaccinated against influenza during the previous year. Among the participants that did not get vaccinated against influenza in the previous year, “being afraid of vaccination and its effects” was the most commonly cited barrier. Knowledge of the recommendation for annual vaccination was significantly associated with vaccination status among pregnant women (p = 0.048) and older adults (p = 0.004).ConclusionDespite a government subsidized vaccine program, vaccine utilization remained low among pregnant women and older adults, who seemed typically unaware of their status as high-risk groups targeted for vaccination. Those aware of the recommendations for annual vaccination were more likely to be vaccinated. Information campaigns addressing fears and highlighting populations at risk for severe influenza illness that are targeted for vaccination might increase vaccine coverage in Peru.     

Attitudes toward influenza vaccination improvement strategies in Veterans Affairs health care workers providing care for patients with spinal cord injuries and disorders: Acceptability of a declination form program

BackgroundInfluenza is associated with high rates of morbidity and mortality. The most effective way to prevent influenza or severe consequences from the illness is vaccination, and key organizations recommend that all health care workers (HCWs) be vaccinated annually for influenza. Recent literature suggests declination form programs (DFPs) are a useful approach to improve HCW influenza vaccination rates.ObjectiveTo understand support for and beliefs about use of an influenza vaccination DFP, and how this is associated with HCW beliefs about other influenza vaccination improvement strategies.MethodsData were collected via a cross-sectional mailed national survey. Participants included HCWs providing care to Veterans with spinal cord injuries and disorders (SCI/D) from 23 nationwide Veterans Affairs facilities. Analyses included bivariate analyses of outcomes among DFP supporters vs. non-supporters.ResultsOf the HCW respondents, 67% reported that they would support a DFP at their facility. A greater proportion of HCWs who support (vs. do not support) DFPs reported receiving an annual influenza vaccination (86.35% vs. 65.81%, p < 0.0001). Similarly, a significantly greater proportion of HCWs who support DFPs (vs. do not support) reported willingness to receive an influenza vaccination (83.79% vs. 61.48%, p < 0.0001) and nasal spray influenza vaccination (45.75% vs. 32.50%, p = 0.0156). HCWs who support DFPs were more likely to report a great deal of influence in almost all typical vaccination improvement campaign strategies on their decision to be vaccinated, and less likely to endorse commonly provided reasons for refusing vaccination as valid.ConclusionMore HCWs who support DFPs engage in important influenza-related health behaviors (e.g., vaccination), and support other influenza vaccination improvement strategies. Facilities may benefit from implementing DFPs as part of their vaccination improvement campaign. Support for DFPs among HCWs is high, suggesting implementing this as a policy would be well-received by staff, and potentially effective in increasing HCW influenza vaccination.     

Effectiveness of influenza vaccination during pregnancy to prevent severe infection in children under 6 months of age,Spain, 2017–2019

IntroductionInfluenza vaccination is recommended to pregnant women in Spain to reduce the risk of influenza-related complications. Influenza related hospitalizations pose a significant disease burden in children every year. Although children below 6 months are too young to be vaccinated, they can receive protection against influenza through vaccination of their mothers during pregnancy. We estimated the effectiveness of maternal influenza vaccination to prevent influenza hospitalizations in infants under 6 months of age.MethodsThis is a retrospective pilot study, using data from the Severe Hospitalized Confirmed Influenza Cases (SHCIC) surveillance system in seasons 2017/18 and 2018/19 in Spain. Maternal vaccination status during pregnancy was collected for cases in children 6 months and younger hospitalized with confirmed influenza infection. Influenza vaccine effectiveness was estimated using the screening method, by comparing the proportion of children with vaccinated mothers during pregnancy (proportion of cases vaccinated, PCV), with the vaccination coverage among pregnant women in Spain (proportion of population vaccinated, PPV).ResultsFor all the study period, the PCV was 17% and the PPV was 35%. Influenza vaccination in mothers during pregnancy prevented influenza confirmed hospitalizations in infants aged 6 months and younger with a 61% (95%CI: 27–79%) effectiveness.ConclusionsIn line with evidence from other countries, influenza vaccination during pregnancy protects infants up to 6 months of age from influenza hospitalizations in Spain. These results support current recommendations of influenza vaccination in pregnant women, and more studies are needed in Spain to confirm the double protection of maternal vaccination in mothers and infants.