Knowledge, attitudes, and practices about influenza illness and vaccination: a cross‐sectional survey in two South African communities

Abstract

BackgroundUnderstanding knowledge and sentiment toward influenza and vaccination is important for effective health messages and prevention strategies. We aimed to characterize knowledge, attitudes, and practices surrounding influenza illness and vaccination in two South African communities and explore reasons for vaccine hesitancy.MethodsHousehold primary caregivers in Soweto and Klerksdorp townships were interviewed about knowledge of influenza and intention to receive an influenza vaccine using a structured questionnaire. Factors associated with unwillingness to receive vaccine were explored using multivariable regression.ResultsWe interviewed representatives of 973 households in Soweto and 1,442 in Klerksdorp. Most respondents in Soweto (692, 71%) and Klerksdorp (1247, 87%) thought weather or cold caused influenza. While most would get a free influenza vaccine, those unwilling to receive vaccine had concerns about efficacy (Soweto: 19%; Klerksdorp: 19%) and safety (Soweto: 17%; Klerksdorp: 10%). In Soweto, females (aRR 2·0, 95% CI 1·3–3·2) and those with higher household income (aRR 1·8, 95% CI 1·2–2·7) were less willing to receive vaccine. In Klerksdorp, more educated respondents (aRR 1·6, 95% CI 1·1–2·4) were less willing to receive vaccine; households reporting an HIV‐positive member were more willing to receive vaccine (aRR 0·3, 95% CI 0·1–0·8).ConclusionsAlthough findings suggest most community participants were amenable to influenza vaccination, knowledge gaps were present. Emphasizing the importance of influenza as a health problem and addressing vaccine safety and efficacy concerns may improve uptake. Populations less amenable to vaccination, including those with higher education and income, may benefit from targeted messaging efforts.

Public knowledge, attitudes and practices towards COVID-19: A cross-sectional study in Malaysia

“…Cultural norms may have been influential in the decision to attend these gatherings despite the health risks, especially among the older generation. Previous research has also shown that those with higher income were less willing to comply with health recommendations [21] perceived less fear and more control in pandemic situations [22].…”

Acceptability of intranasal live attenuated influenza vaccine, influenza knowledge and vaccine intent in The Gambia

“…However, emotions experienced at the point of decision-making may be as important in health behaviour as a cognitive assessment of the risk, such as worry and anticipated regret, which have also been shown to be predictive of influenza vaccination [20] , [25] , [26] . Few studies have used the HBM to study influenza vaccine behaviour in LMICs [27] , [28] , [29] , [30] , [31] .…”

Dust or disease? Perceptions of influenza in rural Southern Malawi

“…Participants often defined influenza as a condition characterized by nasal congestion or difficulty breathing, consistent with findings from South Africa [17,19]. Overlap in symptoms with other conditions meant some people saw influenza as a symptom or cause of conditions such as malaria and pneumonia.…”

“…There is considerable research on public perceptions of influenza in high-income countries [12,15,16], and growing research in middle-income countries. For example, research in South Africa, Kenya and India found varied understandings of influenza, including knowledge of viruses and contagion but also explanations that differed from biomedical models, such as influenza being caused by dust, weather and dirt [17–19]. Little is known about perceptions and behaviours about influenza in low-income countries [20].…”