Factors Affecting the Acceptance of Pandemic Influenza A H1N1 Vaccine amongst Essential Service Providers: A Cross Sectional Study

Abstract

Although mentioned in the UK pandemic plan, essential service providers were not among the priority groups. They may be important targets of future influenza pandemic vaccination campaigns. Therefore, we conducted a cross-sectional survey among 380 employees from West Midlands police headquarters and 15 operational command units in the West Midlands Area during December 2009–February 2010 to identify factors affecting intention to accept the pandemic influenza A (H1N1) vaccine. One hundred and ninety nine (52.4%) employees completed the questionnaire. 39.7% were willing to accept the vaccine. The most common reasons for intention to accept were worry about catching Swine Flu (n = 42, 53.2%) and about infecting others (n = 40, 50.6%). The most common reason for declination was worry about side effects (n = 45, 57.0%). The most important factor predicting vaccine uptake was previous receipt of seasonal vaccine (OR 7.9 (95% CI 3.4, 18.5)). Employees aged <40 years, males, current smokers, and those who perceived a greater threat and severity of swine flu were also more likely to agree to the vaccine. The findings of this study could be used to improve future pandemic immunization strategies. Targeted education programs should be used to address misconceptions; the single most important factor which might lead to a large improvement in uptake is to allay concern about side effects.

Barriers of Influenza Vaccination Intention and Behavior – A Systematic Review of Influenza Vaccine Hesitancy, 2005 – 2016

“…In line with this, the cognitive parameters of risk perception were frequently identified as significant barriers, i.e. perceiving the likelihood of getting the disease as low (HCP 4/117 [ 43 , 73 – 75 ]; Pregnant 1/35 [ 76 ]; Elderly 1/62 [ 77 ]; Public 9/191 [ 68 , 72 , 78 – 84 ]) and perceiving the severity of the disease as low (HCP 8/117 [ 44 , 85 – 91 ]; Pregnant 3/35 [ 92 – 94 ]; Chronic 3/45 [ 58 , 95 , 96 ]; Children 2/18 [ 97 , 98 ]; Elderly 4/62 [ 96 , 99 – 101 ]; Public 16/191 [ 65 , 71 , 72 , 81 , 83 , 99 , 102 – 111 ]). Additionally, perceiving oneself as less susceptible to the disease decreased the uptake of the influenza vaccine in 23 studies (HCP 4/117 [ 42 , 112 – 114 ]; Pregnant 3/35 [ 115 – 118 ]; Chronic 1/45 [ 95 ]; Children 1/18 [ 119 ]; Elderly 1/62 [ 99 ]; Public 11/191 [ 99 , 107 , 108 , 120 – 128 ]).…”

“…Perceiving low risk of the disease was identified as a barrier to influenza vaccine uptake in most risk groups and the general public (HCP 18/117 [ 39 – 56 ]; Pregnant 1/35 [ 57 ]; Chronic 1/45 [ 58 ]; Elderly 2/62 [ 59 , 60 ]; Public 12/191 [ 61 – 72 ]). For example, an Australian study found that among members of the general public the two most stated reasons for not accepting the vaccine were “situation is not serious enough” and “I am not at risk” [ 70 ].…”

“…Individuals who had already been vaccinated against influenza in previous seasons showed higher vaccine uptake in all risk groups (HCP 43/117 [ 42 , 44 , 50 , 51 , 54 , 74 , 75 , 86 , 87 , 112 , 113 , 160 , 161 , 190 , 193 , 214 , 216 , 230 , 265 – 289 ]; Chronic 9/45 [ 197 , 248 , 249 , 290 – 295 ]; Pregnant 10/35 [ 76 , 93 , 115 , 116 , 167 , 178 , 195 , 296 – 298 ]; Children 2/18 [ 223 , 299 ]; Elderly 7/62 [ 100 , 168 , 258 , 300 – 303 ]; Public 50/191 [ 62 , 66 , 69 – 72 , 81 , 99 , 101 , 103 , 125 , 140 , 143 ,…”

“…Several studies have found that unhealthy lifestyles have a negative impact on vaccine uptake, such as alcohol consumption (Chronic 1/45 [ 321 ]; Public 3/191 [ 345 – 347 ]) and smoking habits (Pregnant 3/35 [ 296 – 298 ]; Chronic 11/45 [ 95 , 249 , 321 , 325 , 348 – 354 ]; Elderly 9/62 [ 346 , 350 , 355 – 361 ]; Public 9/191 [ 317 , 346 , 347 , 361 – 366 ]). However, smoking was also a promoter in some cases (HCP 1/117 [ 367 ]; Public 3/191 [ 72 , 192 , 368 ]), and alcohol consumption did not reveal a clear picture in the reviewed studies (Pregnant 1/35 [ 297 ]; Elderly 1/62 [ 346 ]; Public 2/191 [ 346 , 365 ]). More consistently, having given up smoking was reported to increase the uptake of vaccination (HCP 2/117 [ 367 , 369 ]; Chronic 4/45 [ 321 , 370 – 372 ]; Elderly 3/62 [ 346 , 361 , 373 ]; Public 6/191 [ 192 , 318 , 346 , 347 , 373 , 374 ];).…”

“…Most sociodemographic factors present a mixed picture of results. As such, higher age was reported as a barrier to vaccine uptake (HCP 5/117 [ 53 , 54 , 89 , 285 , 331 ]; Chronic 3/45 [ 291 , 431 , 445 ], Children 3/18 [ 97 , 402 , 446 ]; Public 8/191 [ 72 , 108 , 224 , 309 , 396 , 447 – 449 ]) but also as a promotor (HCP 30/117 [ 45 , 46 , 51 , 55 , 75 , 91 , 131 , 133 , 274 , 280 , 289 , 323 , 374 , 450 – 465 ]; Pregnant 3/35 [ 57 , 297 , 324 ]; Chronic 21/45 [ 95 , 238 , 290 , 294 , 321 , 325 , 349 – 354 , 370 – 372 , 386 – 388 , 399 , 466 – 468 ]; Children 2/18 [ 119 ,…”