Influenza vaccination rates and determinants among Spanish medical students

Hernández-García, Ignacio; Domínguez, Begoña; González, R. Rubio

doi:10.1016/j.vaccine.2012.10.104

Cited by 17 publications

(22 citation statements)

References 5 publications

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“…To determine the reproducibility of this finding, we used 10 samples from a previous trial in which the volunteers were vaccinated ID with an equivalent dose of MVA85A [36]. We measured the expression of the nine genes by qPCR and again classified the volunteers as high or low responders based on the median AUC value for their ELISpot responses (in both trials, the medians were 41000 spots.…”

Section: Resultsmentioning

confidence: 99%

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Roles for Treg Expansion and HMGB1 Signaling through the TLR1-2-6 Axis in Determining the Magnitude of the Antigen-Specific Immune Response to MVA85A

et al. 2013

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A better understanding of the relationships between vaccine, immunogenicity and protection from disease would greatly facilitate vaccine development. Modified vaccinia virus Ankara expressing antigen 85A (MVA85A) is a novel tuberculosis vaccine candidate designed to enhance responses induced by BCG. Antigen-specific interferon-γ (IFN-γ) production is greatly enhanced by MVA85A, however the variability between healthy individuals is extensive. In this study we have sought to characterize the early changes in gene expression in humans following vaccination with MVA85A and relate these to long-term immunogenicity. Two days post-vaccination, MVA85A induces a strong interferon and inflammatory response. Separating volunteers into high and low responders on the basis of T cell responses to 85A peptides measured during the trial, an expansion of circulating CD4+ CD25+ Foxp3+ cells is seen in low but not high responders. Additionally, high levels of Toll-like Receptor (TLR) 1 on day of vaccination are associated with an increased response to antigen 85A. In a classification model, combined expression levels of TLR1, TICAM2 and CD14 on day of vaccination and CTLA4 and IL2Rα two days post-vaccination can classify high and low responders with over 80% accuracy. Furthermore, administering MVA85A in mice with anti-TLR2 antibodies may abrogate high responses, and neutralising antibodies to TLRs 1, 2 or 6 or HMGB1 decrease CXCL2 production during in vitro stimulation with MVA85A. HMGB1 is released into the supernatant following atimulation with MVA85A and we propose this signal may be the trigger activating the TLR pathway. This study suggests an important role for an endogenous ligand in innate sensing of MVA and demonstrates the importance of pattern recognition receptors and regulatory T cell responses in determining the magnitude of the antigen specific immune response to vaccination with MVA85A in humans.

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Section: Resultsmentioning

confidence: 99%

“…IFN-γ ELISpots were performed ex-vivo at screening and weeks 1,2,4,12, and 24 post-vaccination as previously described [29]. The safety and primary immunological outcomes of these trials have been published elsewhere [30,36]. …”

Section: Methodsmentioning

confidence: 99%

Roles for Treg Expansion and HMGB1 Signaling through the TLR1-2-6 Axis in Determining the Magnitude of the Antigen-Specific Immune Response to MVA85A

et al. 2013

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“…One study reports a lack of knowledge, while the others highlight the reasons for accepting or refusing influenza vaccination. [23][24][25][26]29 Self-protection, patient protection, free offer were the reasons for vaccination acceptance. Forgetfulness, concerns about side-effects, low risk-perception were the reasons for vaccination refusal.…”

Section: Discussionmentioning

confidence: 99%

“…Forgetfulness, concerns about side-effects, low risk-perception were the reasons for vaccination refusal. [23][24][25][26]29 One of the mentioned study demonstrated that occupational risk perception is greater for Hepatitis B than influenza. 23 The determinants of vaccination acceptance highlighted in the cited surveys are similar to ones analyzed in our study, but none of these studies analyzed the potential role of academic institution in the vaccine promotion and this is the principal strength of our study.…”

Section: Discussionmentioning

confidence: 99%

Medical students' attitude toward influenza vaccination: Results of a survey in the University of Bari (Italy)

Gallone

Cappelli

Fortunato

et al. 2017

Human Vaccines & Immunotherapeutics

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Influenza vaccination is strongly recommended for Italian healthcare professionals, but vaccine coverage is low. Since 2012, vaccination is also offered to medical students as part of the National Immunization Plan; however, few Medical Schools has implemented the plan so far. To study determinants of vaccination compliance, we conducted a survey among medical students at the University of Bari, where influenza vaccination has been actively offered since 2013. Information was obtained by means of an online anonymous questionnaire administered in April 2014. We enrolled 669 students, 383 (57%) vaccinated; 54% were female and the average age was 23.9 § 4.9 y. Determinants of getting vaccinated were analyzed in a multivariate logistic model. Receiving invitation from the University (aOR D 3.8; 95%CI D 1.2-12.3; p D 0.026), the opinion that vaccine is safe (aOR D 2.8; 95%CI D 1.5-5.0; p D 0.001) and useful (aOR D 3.4; 95%CI D 1.7-6.7; p<0.0001), a specific training about influenza vaccination during the course (aOR D 1.5; 95%CI D 1.1-2.1; p D 0.043), and considering himself as at a major risk of influenza complication (aOR D 1.8; 95% CI D 1.1-2.9; p D 0.001) were significantly associated with vaccine acceptance. Active invitation and training are confirmed as key actions (as in children vaccination strategies) and, according to our results, they could be routinely used to promote vaccination in hard-toreach groups such as healthcare workers.

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“…We identified only few studies that focused exclusively on medical students [ 21 - 25 ]. Two of these studies report insufficient knowledge [ 21 , 22 ], while the other three studies focus on medical student’s reasons for acceptance and refusal of influenza vaccination [ 23 - 25 ]. In these cross-sectional studies, reported vaccination coverage rates range from 4.7 to 58.1%.…”

Section: Discussionmentioning

confidence: 99%

Medical students’ attitude towards influenza vaccination

et al. 2015

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BackgroundInfluenza vaccination is recommended for all healthcare personnel (HCP) and most institutions offer vaccination for free and on site. However, medical students do not always have such easy access, and the predictors that might guide the motivation of medical students to get vaccinated are largely unknown.MethodsWe conducted a cross-sectional survey study among pre-clinical medical students in a German University hospital to assess the social cognitive predictors of influenza vaccination, as well as reasons for refusal and acceptance of the vaccine.ResultsFindings show that pre-clinical medical students have comparable knowledge gaps and negative attitudes towards influenza vaccination that have previously been reported among HCP. Lower injunctive norms and higher feelings of autonomy contribute to no intention to get vaccinated against influenza, while a positive instrumental attitude and higher feelings of autonomy contribute to a high intention to get vaccinated. The variables in the regression model explained 20% of the variance in intention to get vaccinated.ConclusionsThe identified factors should be addressed early in medical education, and hospitals might benefit from a more inclusive vaccination program and accessibility of free vaccines for their medical students.

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Influenza vaccination rates and determinants among Spanish medical students

Cited by 17 publications

References 5 publications

Roles for Treg Expansion and HMGB1 Signaling through the TLR1-2-6 Axis in Determining the Magnitude of the Antigen-Specific Immune Response to MVA85A

Roles for Treg Expansion and HMGB1 Signaling through the TLR1-2-6 Axis in Determining the Magnitude of the Antigen-Specific Immune Response to MVA85A

Medical students' attitude toward influenza vaccination: Results of a survey in the University of Bari (Italy)

Medical students’ attitude towards influenza vaccination

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