Willingness to vaccinate against influenza A (H1N1)pdm09 among Brazilian civil servants: Pró-Saúde cohort study

Abstract

Objective: To investigate sociodemographic factors associated with the willingness to take the pandemic influenza vaccine. Methods: This is a cross-sectional study of Brazilian civil servants participating in the fourth wave (2012–2013) of the longitudinal Pró-Saúde Study. Associations were expressed as odds ratios (OR) and 95% confidence intervals (95%CI), estimated by multivariate logistic regression models. Results: Among 2,828 participants, 15.9% would not be willing to vaccinate in the future if the Brazilian Ministry of Health promoted a new vaccination campaign against pandemic influenza. Not willing to vaccinate in the future was strongly associated with not taking the pandemic influenza vaccine in 2010 (OR = 9.0, 95%CI 6.9 – 11.6). Among the unvaccinated, females, those aged > 60 years, and non-health care workers were less willing to vaccinate in the future. Again, in the vaccinated group, females were less willing to vaccinate. Conclusion: Multidisciplinary efforts should be encouraged in order to identify reasons for refusing vaccination, focusing on the individual and group perceptions of susceptibility, severity, benefits, and barriers to vaccination. Such information is needed to identify target groups for the delivery of customized interventions towards preventing emerging pandemics, such as avian influenza and COVID-19.

Understanding the Barriers and Attitudes toward Influenza Vaccine Uptake in the Adult General Population: A Rapid Review

“…There was a slightly higher agreement with willingness to be vaccinated observed in males (45.6%) compared to females (43.6%) [ 25 , 51 , 85 ]. This trend was further supported by a lower number of male participants being unwilling to be vaccinated (43.5%) than females (52.4%) [ 25 , 85 , 86 , 90 , 91 ]. Five studies reported the difference in willingness to be vaccinated between participants with a previous history of vaccination.…”

“…Intent to vaccinate against influenza in the current or following season was reported by 34 publications, 17 of which reported data on participants willing to be vaccinated, whereas 19 reported on participants unwilling to be vaccinated (2 publications reported data for participants willing and unwilling to be vaccinated) [ 18 , 19 , 20 , 21 , 23 , 24 , 25 , 28 , 29 , 34 , 37 , 39 , 40 , 42 , 44 , 48 , 49 , 51 , 53 , 61 , 71 , 73 , 75 , 83 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 ]. Of the 17 publications investigating participant’s willingness to be vaccinated, 44.6% of participants agreed that they would be willing to vaccinate against influenza in the current or following season.…”

“…The Werneck et al 2021 study was one of two studies identified by this review that investigated racial differences between participants unwilling to be vaccinated in the future. It was found that Brazilian civil servants, no matter their race, showed comparable intent towards the influenza vaccine, whereas approximately 16% were not willing to be vaccinated [ 91 ]. The second study, Crouse-Quinn et al 2017, conducted in the US, reported that significantly fewer high-risk black participants (those with chronic comorbidities, which would be exacerbated by influenza) were willing to immunize against influenza than white participants with comorbidities, suggesting racial disparity in vaccine uptake [ 40 ].…”

“…To elucidate reasons for low vaccination coverage rates, this review aimed to understand the attitudes and perceived barriers of the adult general population toward influenza vaccine uptake from a global viewpoint. Data identified in this review suggested that approximately 50% of the adults surveyed intended to receive the vaccination in the following/upcoming influenza season [ 18 , 19 , 20 , 21 , 23 , 24 , 25 , 28 , 29 , 34 , 37 , 39 , 40 , 42 , 44 , 48 , 49 , 51 , 53 , 61 , 71 , 73 , 75 , 83 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 ]. The most frequently agreed upon barrier to uptake was a perceived lack of knowledge of the influenza vaccine, while trust in healthcare services was the most agreed upon promoter for vaccine uptake.…”

“…Two publications identified in this review reported intention to be vaccinated by race. Werneck et al 2021 found no significant difference between white and black/Hispanic Brazilian civil servants not willing to be vaccinated against influenza in the upcoming season, while Crouse-Quinn et al 2017 reported that significantly fewer high-risk black participants were immunizing than high-risk white participants [ 40 , 91 ]. The latter finding was consistent with the published literature, as multiple studies have identified a significantly reduced likelihood to be vaccinated against influenza among black and Hispanic populations compared to white people [ 13 , 102 ].…”