Jun 2026· Annals medicus· Vol 58 1, pp.
2695494
· 0 citations· 22 references
Medicine
TL;DR
The overall influenza vaccination rate among medical staff remains relatively low, and targeted health education should be carried out by focusing on reducing perceived barriers and improving health beliefs, so as to effectively enhance the influenza vaccination status of medical staff.
Abstract
Background: This study investigated influenza vaccination coverage and its predictors among medical staff in multiple Chinese regions to develop targeted vaccination promotion measures.Methods: A cross-sectional questionnaire survey was conducted on medical workers from Beijing, Hebei, Hunan, Shaanxi, Yunnan and other provinces. Questionnaires collected demographic information, influenza/vaccine knowledge, personal and family vaccination history, and vaccine-related health beliefs. We calculated intra-class Correlation Coefficient (ICC) to evaluate hospital clustering due to nested data, adopted binary logistic regression as primary analysis, and applied two-level multilevel logistic regression to correct biased standard errors for robustness.Results: 476 valid questionnaires were retrieved from 483 distributed ones (98.6%). ICC = 0.021 suggested negligible hospital clustering, and the overall vaccination rate was only 16.4% (78/476). Multivariate analysis identified three positive predictors: vaccine training (OR = 2.503, 95% CI 1.337-4.686), family influenza infection (OR = 2.606, 95% CI 1.338-5.076) and family vaccination (OR = 8.266, 95% CI 4.100-16.663). Perceived barriers negatively predicted uptake (OR = 0.589, 95% CI 0.452-0.767). Staff in primary hospitals had higher coverage than those in tertiary hospitals (OR = 3.640, 95% CI 1.420-9.333).Conclusion: The overall influenza vaccination rate among medical staff remains relatively low. To increase the vaccination rate, in addition to strengthening professional training on influenza vaccine-related knowledge, it is also essential to optimize vaccination accessibility and foster a positive social and occupational vaccination atmosphere. Meanwhile, based on the health belief model of influenza vaccination, targeted health education should be carried out by focusing on reducing perceived barriers and improving health beliefs, so as to effectively enhance the influenza vaccination status of medical staff.
BACKGROUND
Influenza presents a severe health threat to children, and influenza vaccination represents the most cost-effective preventive measure. This study was conducted to investigate parents' knowledge, attitudes, and practices (KAP) regarding childhood influenza vaccination and identify key factors affecting vaccination behavior.
RESEARCH DESIGN AND METHODS
A cross-sectional survey was performed among parents of children aged 6 months to 18 years in Jiangsu Province, China, in January 2026. Data were collected using a structured KAP questionnaire. Univariate analyses and multivariate binary logistic regression were used to examine associated factors and independent predictors.
RESULTS
A total of 718 valid questionnaires were analyzed. KAP scores differed significantly by demographic variables. Major barriers to vaccination included safety/side-effect concerns (23.40%), time shortage (14.48%), lack of recommendation (11.84%) and unawareness(10.72%). Regression showed child age, specific vaccine knowledge, perceived necessity, and side-effect worries were independent influencing factors.(all P < 0.05).
CONCLUSIONS
Parents in Jiangsu showed moderate knowledge and positive attitudes but low actual vaccination rates. Targeted interventions such as government subsidies, health education, and safety promotion are needed to reduce the cognition-practice gap and improve childhood influenza vaccination coverage.
Zhaohan Wei, Xiaolei Feng, Qin Sun et al.· Vaccine· 0 citations
Background: Influenza poses a serious threat to the health of older adults, and vaccination is a key strategy for prevention. As an economically developed city, Suzhou has a rapidly aging population, yet the influenza vaccination rate among older adults remains substantially lower than that in developed countries. There is an urgent need to understand the current vaccination status and its associated factors to inform future strategies for improving vaccination coverage. Objectives: To compare influenza- and vaccine-related knowledge, attitudes, practices, and information access channels between vaccinated and unvaccinated older adults (≥60 years) in Suzhou, and to identify factors associated with vaccination behavior in economically developed areas. Methods: A comparative cross-sectional survey was conducted from April to August 2024 across six districts or county-level cities randomly selected from Suzhou’s ten county-level administrative divisions. Participants were divided into vaccinated and unvaccinated groups based on their influenza vaccination status during the 2023–2024 influenza season. A two-stage sampling method was employed: the six districts were selected as primary sampling units; within each district, eligible older adults (aged ≥60 years) were randomly selected from two independent sampling frames—the vaccination information system for the vaccinated group and the basic public health service system for the unvaccinated group. Face-to-face structured interviews were conducted using a questionnaire consisting of four sections; data were entered using EpiData 13.1 and analyzed using SPSS 27.0. The χ2 test, t-test, and multivariable logistic regression were used for statistical analysis. Results: Among 4622 valid older adults (vaccinated: n = 2007; unvaccinated: n = 2615), the vaccinated group scored significantly higher on influenza-related knowledge (4.06 ± 2.21 vs. 3.16 ± 2.33, p < 0.001), vaccine-related knowledge (2.10 ± 1.18 vs. 0.67 ± 1.07, p < 0.001), and perceived influenza risk scores (2.72 ± 1.42 vs. 2.26 ± 1.64, p < 0.001). Vaccine safety and efficacy endorsement were also markedly higher among the vaccinated group (70.3% vs. 22.0%; 49.7% vs. 9.3%). Regarding information sources, the vaccinated group relied more on healthcare institutions (54.56% vs. 46.92%), whereas the unvaccinated group relied more on television (60.34% vs. 51.17%). Multivariable logistic regression revealed that awareness of the influenza vaccine (aOR = 9.151, 95%CI: 6.32–13.25), having a planned vaccination site (aOR = 2.66, 95%CI: 2.01–3.54), and perceiving the vaccine as safe (aOR = 1.81, 95%CI: 1.31–2.49) were positively associated with vaccination, while rural household registration (aOR = 0.76, 95%CI: 0.63–0.93), full-time employment (aOR = 0.41, 95%CI: 0.28–0.60), and hypertension (aOR = 0.79, 95%CI: 0.65–0.94) were inversely associated. Conclusions: Compared with the unvaccinated group, the vaccinated group demonstrated significantly better influenza- and vaccine-related knowledge, risk perception, and recognition of vaccine safety and efficacy, and relied more on healthcare institutions for information. Multivariable regression analysis identified awareness of the influenza vaccine as the strongest associated factor. These findings suggest that vaccination coverage could be improved by strengthening vaccine knowledge promotion through healthcare professionals and increasing awareness of vaccination policies that integrate medical insurance reimbursement.
Ningning Du, Shuai Shao, Yuanyuan Zhang et al.· Vaccines· 0 citations
ABSTRACT Aimed to identify the key motivators and barriers influencing influenza vaccination uptake among healthcare workers -and to examine the behavioral, social, and practical factors associated with vaccination acceptance and future vaccination intentions. A cross-sectional survey was conducted to assess the social and behavioral drivers (BeSD) of influenza vaccination among healthcare workers. A total of 523 Jordanian healthcare workers employed in healthcare institutions across the three regions of Jordan were recruited. Descriptive statistics, chi-square tests and Univariable logistic regression analyses were used. A total of 523 healthcare workers participated in the study, with 48.0% reporting receipt of the influenza vaccine within the previous three years. Awareness of influenza vaccination was high (96.2%), although only 24.1% considered its benefits very important and 31.7% perceived it as very safe. Previous vaccination experience was the strongest predictor of motivation to vaccinate (OR = 24.38, 95% CI: 15.33–38.76). Confidence in vaccine benefits (OR = 16.97, 95% CI: 10.95–26.29), vaccine effectiveness (OR = 15.08, 95% CI: 9.70–23.42), social responsibility (OR = 11.33, 95% CI: 7.51–17.09), and satisfaction with vaccination services (OR = 6.60, 95% CI: 4.45–9.79) were significantly associated with motivation to receive influenza vaccination (all p < .001). Influenza vaccination uptake among healthcare workers in Jordan remains suboptimal despite high awareness. Belief in vaccine benefits, effectiveness, and safety, along with previous vaccination experience, social influences, and vaccine accessibility, were key determinants of uptake and motivation. Targeted interventions addressing misconceptions and strengthening vaccine confidence may improve vaccination coverage among healthcare workers.
Z. Al-Hamdan, Mohammad Al Hamdan, H. Bawadi et al.· Human Vaccines & Immunothera...· 1 citation
Background Chikungunya (CHIK) is an emerging mosquito-borne disease with increasing importation risk in China. In non-endemic settings, delayed detection may facilitate local transmission, making healthcare workers’ knowledge and attitudes critical for rapid response. Objective To assess CHIK-related knowledge and attitudes among medical personnel in Chengdu, Sichuan Province, and identify factors associated with positive prevention attitudes. Methods A cross-sectional, self-administered online survey was executed from July 30 to August 6, 2025, targeting medical workers across 20 healthcare institutions in Chengdu using the Wenjuanxing platform. The questionnaire gathered demographic information, CHIK-related training exposure (yes/no), and assessments of knowledge and attitudes. Knowledge was assessed using 15 items (range 0–15; 1 point awarded for each right response). Attitudes were evaluated using Likert-type items; a cumulative attitude score of ≥20 signified a favorable attitude. Group disparities were analyzed with Chi-square tests alongside suitable parametric and nonparametric assessments. Hierarchical logistic regression (Block 1: demographics/occupational characteristics; Block 2: training; Block 3: knowledge score) was employed to ascertain factors correlated with positive attitudes. Results 1,092 questionnaires were included, yielding an effective response rate of 90.10%; 83.70% indicated they had received training relevant. The average knowledge score was 11.66 ± 2.15. Despite high performance in primary prevention and clinical management, significant deficiencies were noted in early detection and surveillance-related operational knowledge: merely 42.58% accurately interpreted the RT-PCR Ct criterion, 54.85% recognized suspected cases, 56.14% comprehended diagnostic criteria, and 59.80% were aware of the 24 h online reporting requirement. Knowledge scores were elevated among individuals with advanced education, physicians, tertiary hospital personnel, and those who had training (p < 0.05). Attitude scores varied according to age, job type, hospital type, practice category, years of experience, and professional title (p < 0.05). In hierarchical logistic regression, training (OR = 3.971, p < 0.001) and elevated knowledge scores (OR per point = 1.130, p < 0.001) were independently linked to a favorable prevention-and-control attitude. Conclusion Chengdu medical personnel demonstrated general CHIK knowledge and positive attitudes, yet significant operational gaps persist in early detection and reporting protocols. Training and knowledge are key determinants of favorable attitudes, highlighting the need for standardized, process-oriented training emphasizing diagnostic and reporting procedures.
Qin Zhang, Yiting Du, Mei Cha et al.· Frontiers in Public Health· 0 citations
This study aimed to investigate the intention-action discrepancy in influenza vaccination and identify factors associated with vaccination behavior among healthcare professionals.
This was a cross-sectional study. An anonymous questionnaire survey was conducted with healthcare professionals at a hospital in Chengdu, China from May to June 2025. Stratified convenience sampling was used. Data concerning respondents’ sociodemographic characteristics, knowledge of influenza and vaccines, and perceptions of and attitudes toward vaccination were collected. The chi-square test was performed for comparisons between intentions and actions. Multivariate logistic regression analysis was performed to analyze the factors associated with healthcare professionals’ vaccination behavior.
A total of 570 questionnaires were distributed, and 547 (95.95%) valid responses were collected. Among the 547 healthcare professionals, 316 (57.77%) intended to be vaccinated, and 251 (45.89%) were vaccinated during the previous influenza season. Having the intention to be vaccinated but not being vaccinated during the previous influenza season was considered an intention-action discrepancy. Among the 316 healthcare professionals who intended to be vaccinated, 96 were not vaccinated, indicating an intention-action discrepancy rate of 30.38%. Healthcare professionals who intended to be vaccinated but were not vaccinated accounted for 17.55% (96/547) of the participants finally included in the study. Professional title (odds ratio (OR) = 1.421, 95% confidence interval (CI): 1.079–1.872), hospital department type (OR = 0.467, 95% CI: 0.312–0.698), mastery of knowledge about influenza and vaccines (OR = 1.874, 95% CI: 1.256–2.807), concerns about severe adverse reactions following vaccination (OR = 2.479, 95% CI: 1.646–3.733), opinion on the statement that receiving an influenza vaccine is an effective way to reduce the incidence of severe influenza (OR = 0.427, 95% CI: 0.214–0.852), and awareness of the hospital’s free or convenient vaccination services (OR = 0.217, 95% CI: 0.126–0.374) were major factors associated with healthcare professionals’ vaccination behavior (all
p
< 0.05).
A
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trong intention to be vaccinated and a low vaccination rate were observed among healthcare professionals, indicating an intention-action discrepancy. It is advisable to strengthen targeted health education and optimize vaccination services to promote the transformation of intention into action in influenza vaccination among healthcare professionals.
Qinghua Tang, Ruixue Hu, Mei Cha et al.· Frontiers in Public Health· 0 citations
ABSTRACT The World Health Organization prioritizes pregnant women for influenza vaccination; in China, flu vaccination during pregnancy has not been widely adopted. This gap is due to a lack of targeted policies and limited public health promotion. We aimed to describe knowledge and attitudes toward seasonal influenza vaccination among women of reproductive age (15–49 y old) (WRA), to inform evidence-based policy interventions. A cross-sectional survey assessed WRA’s influenza and vaccine awareness, vaccination route preference, and influencing factors, analyzed via chi-square tests and multivariate logistic regression. The knowledge score among WRA in Shanghai Pudong was 3.77 ± 1.23, and the influenza vaccine knowledge score was 3.55 ± 1.66; the pass rates were 60.61% and 56.46%, respectively. Healthcare workers had the highest cognitive levels. Multivariate analysis indicated that education level and being a healthcare professional were predictors of the influenza vaccine pass rate. In particular, the preference for injection decreased sharply from 41.25% among non-pregnant women to 13.31% in the hypothetical pregnancy scenario. In comparison, nasal spray preference rose from 10.60% to 23.17%, and unwillingness increased from 10.19% to 35.58% (P < .05). Pregnant women preferred the nasal spray at 41.67%, a rate significantly higher than that of non-pregnant women (10.60%, P < .05). When receiving influenza vaccine recommendations, 87.63% of participants were more inclined to follow the advice of obstetricians and gynecologists. While WRA in Pudong New Area, Shanghai, demonstrates a relatively high level of attention to influenza and influenza vaccines, key gaps still exist. Strengthening obstetricians’ guidance, promoting non-injectable influenza vaccines, and delivering targeted health education are important strategies to improve vaccination uptake in this population.
Peipei Liu, Yanfang Min, Chunmei Cai et al.· Human Vaccines & Immunothera...· 0 citations