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Acceptance and feasibility of school-based seasonal influenza vaccination in Singapore: A qualitative study |
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| Institution: | 1. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 117549 Singapore;2. Harvard T.H. Chan School of Public Health, Harvard University, MA 02138 Cambridge, USA;3. London School of Hygiene & Tropical Medicine, WC1E 7HT London, United Kingdom;1. UNC Gillings School of Global Public Health, Chapel Hill, North Carolina;2. Division of Health Behavior and Health Promotion, The Ohio State University, Columbus, Ohio;3. Division of Cancer Prevention and Control, The Ohio State University, Columbus, Ohio;4. Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio;5. UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina;1. Faculty of Health, University of Technology Sydney, 235 Jones Street, Ultimo, NSW, Australia;2. Faculty of Health, University of Technology Sydney, 235 Jones Street, Ultimo, NSW, Australia;3. Faculty of Health, University of Technology Sydney, 235 Jones Street, Ultimo, NSW, Australia;4. School of Public Health & Community Medicine, University of New South Wales, Randwick, Australia;5. Faculty of Health, University of Technology Sydney, 235 Jones Street, Ultimo, NSW, Australia;6. Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, Australia;1. Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado;2. Children''s Outcomes Research Program, Children''s Hospital Colorado, Aurora, Colorado;3. Colorado Health Outcomes Program, University of Colorado Denver, Aurora, Colorado;4. Department of Pediatrics, University of Colorado Denver, Aurora, Colorado;5. Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado;6. Denver Public Health, Denver, Colorado;7. Department of Family Medicine, University of Colorado Denver, Aurora, Colorado;1. Department of Epidemiology, Korea University Graduate School of Public Health, Seoul, Korea;2. Department of Internal Medicine, Korea University Kuro Hospital, Seoul, Korea;3. Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea;4. Guro-gu Public Health Center, Guro-gu, Korea;1. College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States;2. Florida Department of Health in Alachua County, Gainesville, FL, United States;3. Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States;4. College of Medicine, University of Florida, Gainesville, FL, United States;1. Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan;2. Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan;3. Faculty of Medicine, Jordan University of Science and Technology, Jordan |
| Abstract: | IntroductionInfluenza is a major cause of disease in children. School-based seasonal influenza vaccination can be a cost-effective tool to improve vaccine uptake among children, and can bring substantial health and economic benefits to the broader community. The acceptance and feasibility of school-based influenza vaccination are likely to be highly context-specific, but limited data exist from tropical settings with year-round influenza transmission. We conducted a qualitative study to assess acceptability and feasibility of a school-based seasonal influenza vaccination programme in Singapore.MethodsWe conducted qualitative in-depth interviews with key stakeholders, including healthcare professionals, representatives of relevant ministries, preschool principals and parents to understand their perspectives on a proposed school-based seasonal influenza vaccination programme. Interviews were transcribed verbatim and analysed using thematic analysis.ResultsWe conducted 40 interviews. Although preschool-aged children are currently the recommended age group for vaccination, stakeholders suggested introducing the programme in primary and/or secondary schools, where existing vaccination infrastructure would facilitate delivery. However, more comprehensive evidence on the local influenza burden and transmission patterns among children is required to develop an evidence-based, locally relevant rationale for a school-based vaccination programme and effectively engage policy-makers, school staff, and parents. Extensive, age-appropriate public education and awareness campaigns would increase the acceptability of the programme among stakeholders. Stakeholders indicated that an opt-out programme with free or subsidised vaccination would be the most likely to achieve high vaccine coverage and make access to vaccination more equitable.ConclusionsOverall, participants were supportive of a free or subsidised school-based influenza vaccination programme in primary and/or secondary schools, although children in this age group are not currently a recommended group for vaccination. However, a better informed, evidence-based rationale to estimate the programme’s impact in Singapore is currently lacking. Extensive, age-appropriate public education and awareness campaigns will help ensure full support across key stakeholder groups. |
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