Knowledge, Perception, Attitudes and Behavior on Influenza Immunization and the Determinants of Vaccination

Abstract

Background: We sought to determine the knowledge of, perception, attitudes, and behaviors toward influenza virus and immunization, and the determinants of vaccination among students, patients, and Healthcare Workers (HCWs) at the American University of Beirut and its affiliated Medical Center. Methods: We conducted a cross-sectional study between October 2016 and January 2017 utilizing a self-administered questionnaire that was provided to 247 randomly selected adult participants. Data collected included socio-demographic characteristics, prior vaccination against influenza, knowledge, perception, attitudes, and behaviors toward influenza and influenza immunization. A multivariable regression model was used to evaluate for independent associations between the different variables and regular or yearly vaccination as a primary outcome. Results: The overall survey response rate was 77%. A substantial proportion of respondents (47.4%) had never received the influenza vaccine. Only 10.2% of students, 19.1% of patients, and 35.6% of HCWs reported regular or yearly influenza vaccine uptake. HCWs had the lowest knowledge score about influenza and its vaccine despite high self-reported levels of knowledge. Barriers to vaccinations included lack of information (31%), fear of adverse effects (29%), and a perception of not being at risk (23%). Several factors were independently associated with regular or yearly vaccination uptake including having children (adjusted OR = 3.8; 95% CI 1.2–12.5), a “very good” self-reported level of knowledge (OR = 16.3; 95% CI 1.4–194.2) and being afraid of the consequences of influenza (OR = 0.2; 95% CI 0.1–0.6). Conclusion: Adherence rates with regular or yearly vaccination against influenza remain low across all study groups. We were able to identify predictors as well as barriers to vaccination. Future awareness and vaccination campaigns should specifically aim at correcting misconceptions about vaccination, particularly among HCWs, along with addressing the barriers to vaccination. Predictors of vaccination should be integrated in the design of future campaigns.

Evaluation of knowledge and barriers of influenza vaccine uptake among university students in Saudi Arabia; a cross-sectional analysis

“…This survey reported that only one-third of the students were vaccinated before the arrival of the winter season. These results corroborate the findings of other studies ( Choucair et al, 2021 ; Benjamin & Bahr, 2016 ; Endrich, Blank & Szucs, 2009 ; Blank, Schwenkglenks & Szucs, 2009 ). However, these findings are evidently lower than the previously conducted studies in Saudi Arabia ( Rogers, Bahr & Benjamin, 2018 ; Alkathlan et al, 2020 ; Alshammari et al, 2014 ), which might be possible due to a wide disparity in study population and methodology.…”

“…, 90% ( Lee et al, 2012 ; Nichol, D’Heilly & Ehlinger, 2008 ; Bednarczyk et al, 2015 ; Merrill et al, 2010 ). Some additional barriers influencing the willingness include affordability, inaccessibility, inconvenience, false perception, lack of knowledge, and awareness ( Choucair et al, 2021 ; Ryan et al, 2019 ; Alhawsawi et al, 2020 ; Silva, Bratberg & Lemay, 2021 ). However, due to reportedly rising outbreaks of different types of seasonal flu in Saudi Arabia, a proactive understanding of barriers and motivators of vaccine uptake by the university students is of paramount importance to curb the growing encumbrance of vaccine-preventable diseases (VPDs) ( WHO, 2019b ; Balkhy et al, 2004 ).…”

A Systematic Review and Meta-Analysis of Seasonal Influenza Vaccination of Health Workers

“…Further effort is necessary to increase the HWs' awareness regarding influenza vaccination. Suitable awareness initiatives include, for instance, sending textmessage/e-amils when influenza season comes, implementing peer support (i.e., support from others HWs with high awareness of influenza vaccinations), conducting targeted training courses to pursue the academic detailing methodology [68,69], providing in-service education [70,71], and implementing awareness campaigns [68,72]. Last, vaccination healthcare services should be improved, such as vaccine supply, accessibility of services, and notifications of potential side effects.…”

The Knowledge and Attitudes of Medical Students, Nurse Trainees, and Pediatric Patients’ Caregivers About Influenza and Influenza Vaccination in Prepandemic Era

“…In the literature, one of most important barrier to vaccinations has been reported as lack of information. 19 Anti-vaccination trend has started to become a big challenge before the Covid-19 pandemic, especially among the caregivers of children and these movements against vaccination take a large place especially in social media.…”