Relationship between intention of novel influenza A (H1N1) vaccination and vaccination coverage rate

We carried out this study to describe the difference between intention to receive vaccine against influenza A (H1N1) before the vaccination campaign and actual vaccine coverage rate after vaccination campaign; and to find out the factors affecting the acceptability. We analyzed data on intention to receive vaccine against influenza A (H1N1) and actual vaccination coverage rate from IR (immunization registry). In a survey of pre-vaccination, the sample size was 1042 and the survey results were weighted with gender and age distribution for sample distribution to be similar to population distribution. Although the intention to receive vaccine against influenza A (H1N1) was high, the actual vaccination coverage was lower than their intention. The factors affecting their intention were the degree of fear for novel influenza A (H1N1), the possibility to be infected with the virus, priority for production of novel influenza vaccine between timing and safety, and belief for effectiveness of novel influenza vaccine. Besides 2009 influenza A (H1N1) vaccination experience developing to resolve the effecting factors on intentions to receive vaccine, which would be the effective way to prepare for anther pandemic in the future.     

2009年上海市甲型H1N1流感疫苗大规模人群接种免疫学效果评价

目的评价2009-2010年上海市甲型H1N1流行性感冒疫苗(甲流疫苗)的免疫学效果。方法以公安人员、中小学生、医务人员这三类重点人群作为免疫学评价的对象,采用分层抽样的方法在上海市4个区县抽取公安人员110人,中小学生146人,医务人员306人,于甲流疫苗接种前和接种后5~6周分别采集外周静脉血,检测甲型H1N1流感(甲流)抗体水平,进行甲流疫苗免疫学效果评价。结果总体上,甲流抗体阳性率由接种前34.9%提高到98.9%,抗体几何平均滴度(GMT)由接种前1∶17提高到1∶351,抗体≥4倍增长率为85.6%。结论 2009年上海市大规模人群接种的甲流疫苗具有良好的免疫学效果。     

北京市2009年甲型H1N1流感疫苗接种影响因素分析

2009年9月北京市重点人群接种甲型H1N1流感疫苗,并逐步将接种范围扩大到全人群.截止2009年12月31日估算接种率为12.58%.为了解甲型H1N1流感疫苗接种的影响因素,开展了此次调查.     

Immune response of single dose vaccination against 2009 pandemic influenza A (H1N1) in the Taiwanese elderly

We conducted a multi-center, randomized and laboratory-blinded clinical trial with subgroup analyses, involving adults aged greater than 60 years old (range 61–86 years old), to investigate the immunogenicity and the potential factors affecting the immune response of a monovalent, unadjuvanted, inactivated, split-virus vaccine. A total of 107 subjects were randomized to receive 15 and 30 μg of hemagglutinin antigen in a 1:1 ratio. The immunogenicity was detected through hemagglutination inhibition (HAI) test of serum obtained before and 3 weeks after vaccination. By 3 weeks after vaccination, HAI titer ≧1:40 was observed in 75.5% and 81.1% of participants receiving 15 and 30 μg of hemagglutinin antigen, respectively. Positive seroconversion was observed in 71.7% and 81.1% of recipients of the 15 and the 30 μg, respectively. The GMTs increased by a factor of 10.7 and 17.4 in the groups of 15 and 30 μg, respectively. This study indicated that one dose of 15 μg hemagglutinin antigen without adjuvant induced protective immune response in the majority of elderly. Multivariate logistic regression analyses showed that gender, age and diabetes were statistically significant factors affecting the seroprotection rate (p = 0.04, 0.01 and 0.01, respectively) and seroconversion rate (p = 0.01, 0.01 and 0.01, respectively).     

Pandemic influenza A (H1N1) vaccination in The Netherlands: parental reasoning underlying child vaccination choices

Introduction

During the 2009 influenza A (H1N1) pandemic, parents in the Netherlands were recommended to vaccinate healthy children between six months and five years of age. The aim of this study was to examine reasons for (non-)acceptance, risk perception, feelings of doubt and regret, influence of the social network, and information-seeking behavior of parents who accepted or declined H1N1 vaccination.

Methods

Data on accepters were collected via exit interviews following the second-dose vaccination round in December 2009 (n = 1227). Data on decliners were gathered in June and July 2010 with questionnaires (n = 1900); 25 parents participated in in-depth interviews.

Results

The most reported reasons for parental acceptance of H1N1 vaccination were “I don’t want my child to become sick” (43%), “Mexican flu can be severe” (10%), “the government advises it, so I do it” (6%), and “if I don’t do it, I will regret it” (6%). The most reported reasons declining the vaccination were “fear of side effects/harmful consequences” (51%), “just having a bad feeling about it” (46%), and “the vaccine was not thoroughly tested” (39%). More decliners than accepters experienced feelings of doubt about the vaccination decision (decliners 63% versus accepters 51%, p < 0.001), and decliners reported more often information-seeking behavior (decliners 76% versus accepters 56%, p < 0.001). Decliners more frequently solicited advice from their social network than accepters (decliners 72% versus accepters 61%, p < 0.001). Furthermore, accepters more often reported social influence on their vaccination decision (accepters 58% versus decliners 38%, p < 0.001) and experienced more negative feelings after their vaccination decision (accepters 8% versus decliners 2%, p < 0.001). Immigrant accepters and decliners more often had feelings of doubt and regret about the vaccination decision, solicited advice more often from their social network, and were more often influenced by this advice compared to native Dutch parents.

Conclusion

To optimize response rates in future vaccination campaigns, health authorities should provide more information on vaccine benefits and possible risks, tailoring this information to specific risk groups. Health authorities should also invest in the development and implementation of effective vaccine risk/benefit communication tools.     

北京市人群甲型H1N1流感血清流行病学调查

目的 了解和掌握北京市人群对甲型H1N1流感的免疫水平.方法 在2009年11月27日至12月23日从医院患者(排除感染科和呼吸科)、血液中心志愿者和体检中心健康体检者中随机选取调查对象进行问卷调查,并采集血清标本进行甲型H1N1流感病毒血凝抑制(HI)抗体检测.结果 共选取调查对象856名,其中127名(14.8%)调查对象体内甲型H1N1流感病毒HI抗体为阳性.0～5岁、6～17岁、18～55岁、≥56岁年龄组HI抗体阳性率分别为14.5%、19.4%、17.4℅和8.0%(P=0.009).不同性别HI抗体阳性率差异无统计学意义(P=0.693).人群血清HI抗体年龄加权阳性率为15.8%.多因素logistic回归分析显示,年龄、出现过急性呼吸道症状以及接种甲型H1N1流感疫苗与HI抗体阳性呈显著性相关.结论 北京市已经有超过15%的人群具有甲型H1N1流感保护性抗体,普通人群中已经建立一定的免疫屏障.     

Pandemic influenza A/H1N1 vaccination uptake among health care workers in Qatar: motivators and barriers

Influenza A/H1N1 new vaccine helps control disease spread. Cross-sectional survey was conducted at PHC & Emergency Departments in Qatar to determine influenza A/H1N1 vaccination rate among HCWs and associated factors, 523 HCWs were enrolled. The study showed that 13.4% HCWs received vaccination. Feeling protected strongly influenced vaccination decision (OR = 14.5). Uncertainty about vaccine efficacy and fear of side effects strongly influenced decision to reject the vaccine (OR = 0.3 and 0.2 respectively). Vaccination coverage was very low. The most common barriers were uncertainty about vaccine efficacy and fear of side effects. Health authorities should build message highlighting how the benefit of vaccination outweighs risk.     

妊娠合并甲型H1N1流感患者的预后随访分析

目的:研究妊娠期甲型H1N1流感对母儿的长期影响.方法:收集16例妊娠合并甲型H1N1流感患者的临床资料,随访5年后的临床症状、胸部CT检查及肺功能检测,探讨各项检查指标的变化.结果:随访5年后,16例患者存在临床慢性呼吸道症状3例,胸部CT异常8例,肺功能异常9例;轻症与重症(包括危重症)甲型H1N1流感患者的胸部CT及肺功能随访结果对比,差异有统计学意义(P＜0.05).10例新生儿未发现H1N1流感病毒感染,在随后的5年随访中,生长发育与其他婴幼儿无异.结论:妊娠合并甲型H1N1流感患者出院5年后,仍有部分患者残留胸部CT异常和肺功能障碍,应重视对此类患者临床检查,以指导长期治疗.     

Contact and communication with healthcare providers regarding influenza vaccination during the 2009-2010 H1N1 pandemic

Objective

The existence of two vaccines—seasonal and pandemic—created the potential for confusion and misinformation among consumers during the 2009-2010 vaccination season. We measured the frequency and nature of influenza vaccination communication between healthcare providers and adults for both seasonal and 2009 influenza A(H1N1) vaccination and quantified its association with uptake of the two vaccines.

Methods

We analyzed data from 4040 U.S. adult members of a nationally representative online panel surveyed between March 4th and March 24th, 2010. We estimated prevalence rates and adjusted associations between vaccine uptake and vaccination-related communication between patients and healthcare providers using bivariate probit models.

Results

64.1% (95%-CI: 61.5%-66.6%) of adults did not receive any provider-issued influenza vaccination recommendation. Adults who received a provider-issued vaccination recommendation were 14.1 (95%-CI: − 2.4 to 30.6) to 32.1 (95%-CI: 24.3-39.8) percentage points more likely to be vaccinated for influenza than adults without a provider recommendation, after adjusting for other characteristics associated with vaccination.

Conclusions

Influenza vaccination communication between healthcare providers and adults was relatively uncommon during the 2009-2010 pandemic. Increased communication could significantly enhance influenza vaccination rates.     

无锡市甲型H1N1流感及季节性流感疫苗接种效果分析

目的调查流感样病例(ILI)和无锡市一般人群中甲型H1N1流感疫苗及季节性流感疫苗的接种情况,评估疫苗接种后对人群的保护效果。方法以无锡市2家哨点医院为基础,采集流感样病例病毒核酸检测阳性的病例作为病例组,共1 529人,同时按照"病例"的电话信息,随机产生电话号码选择、年龄匹配的一般人群作为对照组,共380人。结果病例组甲型H1N1流感疫苗接种率为6.1%(94/1 529),对照组甲型H1N1流感疫苗接种率为12.1%(46/380),两组比较,差异有统计学意义(P0.01);甲型H1N1流感病例中接种甲型H1N1流感疫苗的比例为12.5%(3/24),门诊检测阴性的ILI病例接种甲型H1N1流感疫苗的比例为6.1%(78/1 273),"接种甲型H1N1流感疫苗"因素的OR值为0.457(P=0.201);以电话调查一般人群(330例)作为对照组,接种甲型H1N1流感疫苗的比例为13.3%(44/330),OR值为1.077(P=0.908)。结论该次调查说明接种甲型H1N1流感疫苗对预防流感样病例有一定效果,但由于样本量较少,24种方法病例对照分析均未得出差异有统计学意义。     

妊娠合并重症新型甲型H1N1流感患者抗H1N1抗体IgG亚类的分布

目的探讨妊娠合并重症甲型H1N1流感患者抗H1N1抗体各IgG亚类在血清中的分布特点。方法收集2009年11月14日-12月31日,确诊的女性甲型H1N1流感患者,分为妊娠病例组,非妊娠病例组,同时收集抗甲型H1N1抗体阳性的健康妊娠女性作为妊娠对照组,采用ELISA法检测各组血清特异性IgG及亚类的百分结合率。结果妊娠病例组的IgG2I、gG3I、gG4亚类的百分结合率中位数分别为53.0%、65.0%、61.6%,均低于妊娠对照组,差异有统计学意义(P<0.05);各组的特异性抗甲型H1N1 IgG均以IgG1亚类为主,为>70.0%,妊娠病例组的IgG2亚类占5.0%,低于非妊娠病例组的10.0%和妊娠对照组的8.0%,(P<0.05)。结论妊娠合并甲型H1N1流感患者中,特异性抗甲型H1N1 IgG以IgG1亚类为主,IgG2亚类的绝对及相对下降与甲型H1N1感染相关。     

2009年上海市中小学生甲型H1N1流感疫苗大规模接种流行病学效果评价

目的 评价2009年上海市中小学生接种甲型H1N1流行性感冒疫苗(简称甲流疫苗)的流行病学效果.方法 研究对象为长宁、杨浦、闸北、普陀、浦东新区和崇明县内接受甲流疫苗接种(接种组)和未接受甲流疫苗接种(对照组)的在校中小学生,分别收集接种组与对照组学生每日的发热和流感样病例数,通过计算疫苗保护率和保护效果指数,以评价甲流疫苗的流行病学效果.结果 甲流疫苗接种前,流感样病例的发病高峰是在2009年11月,流感样病例罹患率达6.19%.接种疫苗后,接种组发热的罹患率为0.98%,流感样病例的罹患率为0.61%;对照组发热的罹患率为2.37%,流感样病例的罹患率为1.75%.与对照组相比,接种组甲流疫苗接种后控制发热的保护率为58.65%,保护效果指数为2.42,控制流感样病例的保护率为65.14%,保护效果指数为2.87.结论 接种甲流疫苗可以降低中小学生发热及流感样病例的发生率,具有一定的保护作用.     

Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for 2009 pandemic influenza A(H1N1) vaccination

The 2009 influenza A(H1N1) pandemic is markedly different from seasonal influenza with the disease affecting the younger population and a larger than expected number of severe or fatal cases has been seen in pregnant women, obese people and in people who were otherwise healthy. In Europe, influenza activity caused by the 2009 influenza A(H1N1) virus has passed the winter peak with nearly all countries now reporting lower influenza activity. However, although the rate of 2009 pandemic influenza A(H1N1) is declining, fatal cases continue to be reported and the future is hard to predict. The most effective protection against influenza is vaccination and increasing vaccine coverage is the only way to eliminate uncertainties regarding possible future waves of 2009 pandemic influenza A(H1N1). Recommendations have been developed for several central European countries but there is no clear or uniform definition with respect to priority groups or age groups who should receive vaccination. This paper contains the Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for the vaccination of adults and children against 2009 pandemic influenza A(H1N1). CEVAG recommends vaccination of all health-care workers, pregnant women, children ≥6 months and <2 years of age and people with chronic medical conditions as a first priority.     

北京市部分优先接种甲型H1N1流感疫苗人群接种意向调查

2009年9月2日由我国自行研制生产的首批甲型H1N1流感疫苗获得国家食品药品监督管理局批准注册.为配合疫苗上市后的大规模使用,北京市疾病预防控制中心(CDC)受卫生部委托对优先接种人群进行了甲型H1N1流感疫苗的接种意向调查,现将结果报道如下.     

北京市甲型H1N1流行性感冒疫苗预防接种不良反应分析

目的 评价甲型H1N1流行性感冒(简称流感)疫苗在大规模人群预防接种中的安全性.方法 2009年9-12月期间北京市共接种甲型H1N1流感疫苗2 113 280人,通过监测系统收集疑似预防接种不良反应患者的个案信息,采用描述性方法对一般反应及异常反应特征进行流行病学分析.结果 北京市共报告疑似预防接种不良反应612例,其中不良反应321例,偶合症203例,心因性反应82例,待定6例.与疫苗相关的不良反应中,异常反应、一般反应报告发生率分别为5.54/10万(117/2 113 280)、9.65/10万(204/2 113 280);严重异常反应报告率为0.19/10万(4/2 113 280).城区、近郊及远郊县的不良反应报告率分别为:16.87/10万(36/213 519)、17.81/10万(187/1 049 817)及11.53/10万(98/849 944).不同年龄组异常反应、一般反应报告率介于3.65/10万(6/164 604)～8.99/10万(27/300 176)和0.61/10万(1/164 604)～22.06/10万(85/385 275)之间.117例异常反应中主要临床诊断为过敏性皮疹(107例),204例一般反应主要临床诊断为发热(176例).91.90%(295/321)不良反应发生于接种24 h以内,所有病例转归良好.结论 本市甲型H1N1流感疫苗接种后报告的不良反应以过敏及发热为主,不良反应类型及严重程度与预期一致,未发现新的或罕见的不良反应.     

合肥市2009流行年度甲型H1N1流感发病率估算

甲型H1N1流感实际病例数的估算比较困难[1].本研究在综合多种监测与现场调查的基础上,对合肥市2009年8月至2010年1月实际发生病例数和发病率进行估算.     

甲型(H1N1)流感现场流行病学的几点思考

甲型(H1N1)流感曾被称为人感染猪流感,最早发生于墨西哥和美国.WHO于2009年4月24日和美国疾病预防控制中心(CDC)4月23日分别在其网站上做了正式报道.该型流感由包含少见基因片段复合体的新病毒引起,甲型(H1N1)病毒此前在美国和世界其他地方的人和猪体内从未被发现[1,2].从甲型(H1N1)流感暴发的短短几天时间内,即被WHO确定为具有国际影响的公共卫生突发事件,并将大流感预警级别由开始的3级提升为4级后,再提升至5级.目前全球已经进入流感大流行的边沿[3-5].     

Acceptance of seasonal and pandemic a (H1N1) 2009 influenza vaccination by healthcare workers in a french teaching hospital

Introduction

The aim of this study was to highlight the perceived risks, behavioural changes and the rate of acceptance of seasonal and pandemic (H1N1) 2009 influenza vaccines by healthcare workers (HCWs) in a French Teaching Hospital.

Methods

We sampled HCWs from the Angers French Teaching Hospital (France) using a cross-sectional intercept design during phase 5A of the 2009 French National Plan for the Prevention and Control of ‘Pandemic Influenza’. From November 2009 to February 2010, HCWs were approached in the workplace to undertake the survey. The primary endpoint assessed immunization coverage among HCWs who had contact with at-risk-patients.

Results

Of the 532 HCWs who answered the questionnaire, 119 (22.4%) had received a seasonal vaccine and 194 (36.5%) the H1N1 pandemic vaccine. Coverage rate was significantly higher among physicians (45% for the seasonal vaccine, 61% for the H1N1 vaccine). The main reasons given for acceptance of the seasonal vaccine were “protection of the patient” and “self-protection”, whereas the main arguments against were “low risk of being infected” and “doubts about vaccine safety”. For the H1N1 vaccine, reasons for vaccination were to “protect the patient” and “protect the family”. The main arguments against were “fear of side effects” and “doubts about vaccine safety”.

Conclusion

This study emphasizes the lack of perception by HCWs of the importance of being immunized against seasonal and pandemic A (H1N1) 2009 Influenza. In the future, particular efforts are needed, during vaccination campaigns, to provide more information to HCWs regarding development process and safety of such vaccines.