Background: Vaccine hesitancy (VH) remains a prime contributor to poor influenza vaccine uptake. This study explores the knowledge, attitudes and practices of community pharmacists toward influenza VH, including their personal influenza immunization attitudes and behaviours. Methods: A web-based cross-sectional survey questionnaire was administered to community pharmacists practising in Ontario, Canada. A 38-question survey tool explored 5 domains, including pharmacists’ personal attitudes and behaviour toward influenza immunization, their self-reported knowledge of influenza, its vaccine and vaccine hesitancy, and their attitudes, practices and experiences with influenza VH at the community pharmacy. The data were analyzed descriptively. Results: A total of 5530 survey invitations were e-mailed, and 885 responses were collected (response rate 16%). Two-thirds ( n = 568, 65.7%) of the respondents reported receiving the influenza vaccine in the preceding season. The most frequent reasons for personal influenza immunization were prevention of disease transmission to patients, friends and family, and contribution to herd immunity. In addition to their confidence and perceived ability to identify and address influenza VH, respondents’ self-reported knowledge across a 15-item Likert questionnaire was high. Respondents reported coming across an average of 16 (SD 28) individuals hesitant to receive the influenza vaccine each week. Regular workload ( n = 419, 65.6%) and insufficient time ( n = 406, 65.3%) were reported as the most limiting barriers to engagement in influenza vaccine conversations. Conclusion: Facilitating optimal practice scope for pharmacists, and capitalizing on the convenience and accessibility of the community pharmacy setting, presents a promising means to address influenza VH. However, barriers to pharmacist-initiated engagement on influenza vaccine must be explored and addressed. Can Pharm J (Ott) 2020;153:xx-xx.
Objective: The analysis estimates projected population outcomes resulting from the introduction of a plant-derived influenza vaccine formulated as quadrivalent virus-like particles (QVLP) in Canada. Methods: Using Monte Carlo simulations, the number of influenza cases, general practitioner visits, inpatient admissions, intensive care unit (ICU) admissions, and deaths due to influenza-associated illness were estimated under no vaccination, plant-derived QVLP vaccines only, or egg-derived vaccines only. The base case analysis examined the adult Canadian population in two subgroups: 18-64 years of age during the 2017/18 season and 65+ years of age during the 2018/19 season. Efficacy data were obtained from QVLP clinical trials. Vaccine effectiveness data for egg-derived vaccines were calculated from observational studies from the corresponding influenza seasons. Scenario analyses examined the impact of varying absolute vaccine effectiveness or vaccination coverage from base case inputs. Results: In the base case analysis, plant-derived QVLP vaccines led to an additional reduction in the burden of influenza over egg-derived vaccines for both population subgroups. In the 18-64 subgroup, QVLP vaccines were associated with 2.63% (48,029; 95% credible interval [Crl]: 42,336) fewer influenza cases than egg-derived vaccines. In the 65+ subgroup, QVLP vaccines led to 4.82% (27,918; 95% Crl: 25,397) fewer influenza cases, and reductions in the number of inpatient admissions by 4.77% (1167; 95% CrI: 851-1483) and deaths by 4.75% (326; 95% CrI: 107-546) compared to egg-derived vaccines. Further reductions were observed in scenario analyses considering the potential increase in vaccine coverage. Conclusion: Use of plant-derived QVLP influenza vaccines may contribute to greater reductions in influenza cases and influenza-related outcomes, including inpatient admissions and deaths, compared to egg-derived vaccines currently available in Canada.
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