Influenza vaccination in Austria: Persistent resistance and ignorance to influenza prevention and control

Kunze, Ursula; Böhm, Gabriela; Prager, Bernhard; Groman, Ernest

doi:10.21101/cejph.a5010

Cited by 12 publications

(9 citation statements)

References 15 publications

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“…The influenza vaccination status data in the elderly ≥ 65 years was obtained from OECD (organization for economic cooperation and development) data (12). The data of countries that are not available in the OECD data were obtained from various publications (13,14) 1 , (15,16). At the time of this writing, the details of the COVID-19 were obtained from worldometer data/coronavirus, and the current mortality worldwide is 725,000.…”

Section: Methodsmentioning

confidence: 99%

Considering Interim Interventions to Control COVID-19 Associated Morbidity and Mortality—Perspectives

Arokiaraj

2020

Front. Public Health

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Aims and objectives: The pandemic of COVID-19 is evolving worldwide, and it is associated with high mortality and morbidity. There is a growing need to discuss the elements of a coordinated strategy to control the spread and mitigate the severity of COVID-19. H1N1 and Streptococcus pneumonia vaccines are available. The current analysis was performed to analyze the severity of COVID-19 and influenza (H1N1) vaccination in adults ≥ 65. Also, to correlate the lower respiratory tract infections (LRIs), and influenza attributable to the lower respiratory tract infections' incidence with Covid-19 mortality. Evolutionarily influenza is close in resemblance to SARS-CoV-2 viruses and shares some common epitopes and mechanisms. Methods: Recent influenza vaccination data of 34 countries from OECD and other publications were correlated with COVID-19 mortality from worldometer data. LRIs attributable to influenza and streptococcus pneumonia were correlated with COVID-19 mortality. Specifically, influenza-attributable LRI incidence data of various countries (n = 182) was correlated with COVID-19 death by linear regression and receiver operating characteristic (ROC) curve analyzes. In a logistic regression model, population density and influenza LRI incidence were correlated with COVID-19 mortality. Results: There is a correlation between COVID-19-related mortality, morbidity, and case incidence and the status of influenza vaccination, which appears protective. The tendency of correlation is increasingly highlighted as the pandemic is evolving. In countries where influenza immunization is less common, there is a correlation between LRIs and influenza attributable to LRI incidence and COVID-19 severity, which is beneficial. ROC curve showed an area under the curve of 0.86 (CI 0.78 to 0.944, P < 0.0001) to predict COVID-19 mortality >150/million and a decreasing trend of influenza LRI episodes. To predict COVID-19 mortality of >200/million population, the odds ratio for influenza incidence/100,000 was −1.86 (CI −2.75 to −0.96, P < 0.0001). To predict the parameter Covid-19 mortality/influenza LRI episodes * 1000>1000, the influenza parameter had an odd's ratio of −3.83 (CI −5.98 to −1.67), and an AUC of 0.94. Arokiaraj Influenza Reduces COVID-19 Severity Conclusion: Influenza (H1N1) vaccination can be used as an interim measure to mitigate the severity of COVID-19 in the general population. In appropriate highrisk circumstances, Streptococcus pneumonia vaccination would also be an adjunct strategy, especially in countries with a lower incidence of LRIs.

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Section: Methodsmentioning

confidence: 99%

Considering Interim Interventions to Control COVID-19 Associated Morbidity and Mortality—Perspectives

Arokiaraj

2020

Front. Public Health

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“…With this information, recently published estimates for the influenza vaccination rate of the Austrian population went down from 15.4% in the 2006/2007 season to 6.1% for the 2015/2016 season. In additional telephone surveys the influenza vaccination rate in people older than 60 years was determined at 14% [21]. As age distribution of vaccinated persons for other vaccinations is unknown, they provide no reliable estimate for vaccine coverage.…”

Section: Original Articlementioning

confidence: 99%

Towards understanding vaccine hesitancy and vaccination refusal in Austria

Bauer

Tiefengraber

Wiedermann

2020

Wien Klin Wochenschr

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SummaryIn Austria, data on vaccine hesitancy is scarce. Available studies suggest around 1-11% of parents refuse vaccination, while many more are hesitant and consider refraining from some but not all of the recommended vaccinations. However, the key drivers for vaccine hesitancy in Austria are largely unknown. To learn more about vaccination coverage, attitude towards and knowledge around immunization as well as views on mandatory vaccination, we conducted a survey in a rural Austrian lay population including adults and children. Two paper-based questionnaires, one for adults 16 years or older and one for children aged 6-15 years, were developed, then sent to all houses of a rural community in Austria as well as handed out at the local primary and middle school, respectively. Self-reported coverage rates of children and adults were found to be low. Within the surveyed population 3% of children had never been or do not get vaccinated. More than half (57%) of the survey participants had a positive attitude towards vaccines, 21% were without reserves, 16% were found skeptical and 5% had a generally negative attitude. Knowledge about immunization in general was poor. Younger adults and people with secondary education appear to be most skeptical and negative towards vaccination. Children’s attitudes were closely linked to those of their parents. The major concern around vaccination in adults was fear of side effects. In adults, 54.2% support mandatory vaccination for Health Care Workers and 20.7% are against it. 39% of adults and 37% of children wanted more information on vaccination, preferably provided by physicians. Knowledge about disease prevention by vaccination should be improved and children could also benefit from an early age-appropriate vaccine education to strengthen health literacy. Physicians are the most trusted source of health information. Medical doctors should be aware of their very important role in transmitting trusted health information. This should include an up-to-date education in communicable disease prevention and immunization during their whole medical career. Furthermore, the curricula of health-care workers may need to be improved and harmonized concerning prevention and vaccination.

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“…In addition, GPs in the UK receive financial incentives to deliver influenza vaccinations whereas GPs in the other countries do not [ 25 ]. These factors may contribute to the higher vaccine coverage among adults ≥65y observed in the UK (72.0% in 2018–2019 [ 26 ]) compared to the other countries (53.1% in Italy [ 27 ] and 52.1% in Spain [ 28 ] in 2018–2019, 14% in Austria in 2015–2016 [ 29 ]. Whilst most GPs in Austria, Italy and Spain believe that patients who perceive themselves to be a higher risk or who are more health conscious are more likely to accept influenza vaccination, this was only the case for respectively half and two thirds of GPs in the UK (although sample size was small).…”

Section: Discussionmentioning

confidence: 99%

“…Influenza vaccine acceptability in the UK may therefore be less susceptible to individual perception of vaccination than in other countries. Furthermore, in Austria influenza vaccination is not offered free of charge and patients usually have to buy the vaccine at the pharmacy prior to administration at the GP practice, which may constitute a barrier to vaccine uptake [ 29 , 32 ]. Accessibility has previously been shown to be an important determinant of vaccination [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Factors driving choices between types and brands of influenza vaccines in general practice in Austria, Italy, Spain and the UK

et al. 2021

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Influenza vaccine effectiveness (IVE) assessment is increasingly stratified by vaccine type or brand, such as done by the European network of DRIVE. In 2019/2020, eleven influenza vaccines were licensed in Europe. If more than one vaccine type is recommended or if more than one vaccine brand is available for a specific risk group, it is not clear which factors affect the choice of a specific vaccine (type or brand) by a health practitioner for individual patients. This is important for IVE assessment. A survey tailored to the 2019/20 local vaccine recommendations was conducted among GPs in four European countries (Austria, Italy, Spain, UK) to understand how influenza vaccine is offered to recommended risk groups and, if GPs have a choice between 2 or more vaccines, what factors influence their vaccine choice for patients. Overall, 360 GPs participated. In Austria, Italy and Spain GPs indicated that influenza vaccines are commonly offered when patients present for consultation, whereas in the UK all GPs indicated that all relevant patients are contacted by letter. In Austria and Italy, roughly 80% of GPs had only one vaccine type available for patients <65y. The use of any specific vaccine type in this age group is mostly determined by the availability of specific vaccine type(s) at the clinic. GPs frequently reported availability of more than one vaccine type for patients ≥65y in Austria (45%), Italy (70%) and Spain (79%). In this group, patient characteristics played a role in choice of vaccine, notably older age and presence of (multiple) comorbidities. Knowing that a non-patient related factor usually determines the vaccine type a patient receives in settings where more than one vaccine type is recommended for risk groups <65y, simplifies IVE assessment in this age group. However, patient characteristics need careful consideration when assessing IVE in those ≥65y.

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Influenza vaccination in Austria: Persistent resistance and ignorance to influenza prevention and control

Cited by 12 publications

References 15 publications

Considering Interim Interventions to Control COVID-19 Associated Morbidity and Mortality—Perspectives

Considering Interim Interventions to Control COVID-19 Associated Morbidity and Mortality—Perspectives

Towards understanding vaccine hesitancy and vaccination refusal in Austria

Factors driving choices between types and brands of influenza vaccines in general practice in Austria, Italy, Spain and the UK

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