Promotion of seasonal influenza vaccination among staff in residential care homes for elderly in Hong Kong

Abstract

Annual influenza epidemics continue to cause worldwide morbidity, mortality and societal disruption, especially among the aged residents of residential care homes for the elderly (RCHEs). Vaccination remains the most effective measure to prevent influenza and its associated complications. The seasonal influenza vaccine uptake rates among RCHE staff were much lower than that among residents. In order to increase uptake of influenza vaccination among RCHE staff in Hong Kong, this study developed and evaluated a multimodal vaccine promotion program (VPP) based on identified factors affecting vaccination acceptance or refusal within the Hong Kong Chinese context. Vaccine acceptance was found to be significantly associated with belief in vaccine efficacy, duration of service, staff group and providing direct care to residents. The focus group study revealed that RCHE staff's belief in the efficacy and safety of the vaccine played a major role in vaccine acceptance. VPP effectiveness was evaluated with a cluster randomised controlled trial among RCHEs with staff vaccination rates below 50%. Compared with 2008/09, the 2009/10 mean staff vaccination rates increased significantly in both the intervention (39.4% to 59.6% (P < 0.001)) and control groups (36.3% to 47.6% (P = 0.008)). RCHE staff in the intervention group had a higher vaccination rate than in the control group (59.6% versus 47.6%, P = 0.072). This program reinforces the importance of a comprehensive and culturally sensitive approach to promote influenza vaccination for RCHE staff.

Determinants of seasonal influenza vaccination hesitancy among healthcare personnel: An integrative review

“…The Health Belief Model (Rosenstock, 1974) was identified in this review as the most applied model for seasonal influenza vaccine hesitancy with nine studies discussing and utilising the health behavioural change framework (Boey et al, 2018; Chen et al, 2010; Chewey, 2016; Flanagan et al, 2020; Hopman et al, 2011; Kyaw et al, 2019; Looijmans‐van den Akker et al, 2009; Mo et al, 2017; Shahar et al, 2017). The six constructs prioritising threat perception and behavioural evaluation (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, health motivation and cues to action) (Abraham & Sheeran, 2015) could be aligned with several of the themes explored in this review to facilitate the development of educational interventions to increase HCP uptake of influenza vaccines.…”

A Systematic Review of Barriers and Enablers Associated with Uptake of Influenza Vaccine Among Care Home Staff

“…Study characteristics are summarized in Table 1. All of the studies were conducted in high-income countries (United States 13 [59][60][61][62][63][64][65][66][67][68][69][70][71], Ireland 5 [72][73][74][75][76],Canada 4 [77][78][79][80],Australia 4 [81][82][83][84], Hong Kong 4 [29,[85][86][87],Italy 3 [88][89][90], Belgium 2 [91,92],France 2 [93,94], Netherlands 2 [95,96], Germany 1 [97], UK 1 [100], Israel 1 [98]). The included articles were published between 1993 and 2022, with half of the articles (n = 20) published from 2015 to 2022.…”

“…In two studies, the questionnaires were based on previously published questionnaires [91,92], whereas three studies utilized pre-tested questionnaires but did not report any information on their validity [93,97,98]. Additionally, eight studies included in the review reported conducting a sample size calculation and aimed to recruit all eligible participants [78,85,87,91,93,94,98,99]. There are concerns in terms of quality due to the possibility of selection bias, representativeness of the sample, and lack of pre-study calculation of statistical power.…”

“…The quality assessment of the qualitative studies is presented in Table 3. The qualitive content of four studies was part of interventional studies [59,64,67,68,100], whereas four studies used mixed-methods [78,87,90,91]. Therefore, the quality assessment was focused on the qualitative part of the studies.…”

“…CH staff who were reluctant to accept the influenza vaccine lacked belief in its effectiveness [66,71,72,74,77,78,81,90,93,61,62,[86][87][88] and were concerned about the side effects and safety of the vaccine [60,62,66,68,78,81,[72][73][74][75][76][86][87][88][90][91][92][93]. The perception that the influenza vaccine is not necessary [60,81,72,73,[90][91][92], influenza is not serious [73,77,81,86,88,91,92,98], and a lack of concern about getting influenza act as further critical barriers to the uptake of the influenza vaccine [86,…”