Do superstitious beliefs affect influenza vaccine uptake through shaping health beliefs?

This study examined the impact of superstitious beliefs on influenza vaccine uptake and investigated the role of health beliefs as underlying psychological mechanisms. It is hypothesized that superstitious beliefs predict greater perceived risks in influenza and vaccines, which in turn affect influenza vaccine uptake. A cross-sectional survey of Singaporeans and Singapore Permanent Residents aged between 21 and 70 (N = 668) was conducted using computer-assisted telephone interviews. The survey covered beliefs in superstition, health beliefs in influenza and vaccines, and influenza vaccine uptake intention and behavior using the Health Belief Model. Path analysis was adopted to examine the hypothesized model. Approximately 60% of the sample had never obtained influenza vaccination. The path analysis found that superstitious beliefs significantly predicted higher perceived barriers and lower perceived benefits of vaccines, which in turn predicted a lower intention to take influenza vaccine in the next year and/or a lower probability of ever taking influenza vaccine. In contrast, superstitious beliefs predicted higher perceived susceptibility and severity of influenza that in turn predicted higher influenza vaccine uptake intention and/or probability. Examining demographic variables and past experience on influenza as control and confounding factors did not significantly affect the results. The findings imply that beliefs in superstitions can have mixed effects on vaccine uptake and intention through shaping beliefs of the disease and vaccines. Significant implications in health education and persuasion on vaccine uptake are discussed.

Lu J ，Luo M ，Yee AZH ，Sheldenkar A ，Lau J ，Lwin MO ... -  《-》

Workplace availability, risk group and perceived barriers predictive of 2016-17 influenza vaccine uptake in the United States: A cross-sectional study.

Seasonal influenza, though mostly self-limited in the healthy adult, may lead to severe disease and/or complications in subpopulations. Annual influenza vaccination is available in many countries with coverage goals rarely being met. We conducted a cross-sectional study of influenza vaccine uptake and explored socio-demographic, economic, and psychological factors that explained vaccine uptake. The survey was administered via Amazon Mechanical Turk (MTurk) to United States residents in January 2017, using the Qualtrics platform. Using principal axis factor analysis, we reduced the 25 items theory-based psychological determinants into the primary constructs they measure if/when internal consistency was sufficient (Cronbach's alpha >0.60). Logistic regression models were used to quantify the association of socio-demographic, economic, and psychological factors with reported vaccine behavior in the 2016-17 flu season. 1007 participants completed the survey, sex distribution was even, 67% had 25-44years of age, and 61% annual household income of $30-99 thousand United States dollars. About 25% had the flu shot offered at their workplace and 20% reported belonging to a group for whom the flu shot is recommended. Vaccine uptake was 31.5%. Eight predictors remained in the final adjusted model (R2=0.489), having the vaccine offered at the workplace, belonging to a group for whom the vaccine is recommended, and higher perceived barriers were the strongest predictors of vaccine uptake, increasing (and decreasing in the case of barriers) the odds by >3-fold. Additionally, higher household income, higher perceived susceptibility and higher perceived benefits also independently predicted vaccine uptake. We found evidence that perceived barriers significantly impaired vaccine uptake to the same extent that having the vaccine offered at the workplace or belonging to a group for whom the vaccine is recommended facilitated uptake. Ideally, a better understanding of drivers of vaccine hesitancy will result in improved interventions to increase vaccine uptake.

Luz PM ，Johnson RE ，Brown HE 《-》

Parental perceptions of childhood seasonal influenza vaccination in Singapore: A cross-sectional survey.

Seasonal influenza vaccination is recommended in children aged 6-59months, but little is known about child vaccination coverage and determinants in Asian settings. We report the results of a survey of knowledge, attitudes, practices, and determinants of child influenza vaccination in Singapore. In December 2015-March 2016, we conducted a survey of 332 parents of children aged 6months to 5years attending pre-schools. We assessed child influenza vaccine coverage and parental knowledge, attitudes, and practices of child influenza vaccination. We used multivariable regression and structural equation models to identify factors associated with child influenza vaccination. Knowledge about influenza, perceived benefit of vaccination, and willingness to vaccinate were high. However, only 32% of children had ever received influenza vaccine, and only 15% in the past year. Factors independently associated with child influenza vaccination included: being recommended influenza vaccine by a child's doctor (prevalence ratio (PR)=2.47, 95% CI: 1.75-3.48); receiving influenza vaccine information from a private general practitioner (PR=1.47, 95% CI: 1.05-2.04); regularly receiving pre-travel influenza vaccine (PR=1.64, 95% CI: 1.19-2.25); higher willingness to vaccinate (PR=1.58, 95% CI:1.24-2.04 per unit increase in willingness score); and feeling well-informed about influenza vaccine (PR=1.44, 95% CI: 1.04-1.99). Parents who obtained influenza vaccine information from television were less likely to have vaccinated their child (PR=0.44, 95% CI: 0.23-0.85). Path analysis indicated that being recommended vaccination by a child's doctor increased willingness to vaccinate and self-efficacy (feeling well-informed about influenza vaccine). Median willingness-to-pay for a dose of influenza vaccine was SGD30 (interquartile range: SGD20-SGD50), and was higher in parents of vaccinated compared with unvaccinated children (SGD45vs SGD30, p=0.0012). Knowledge and willingness to vaccinate was high in this parent population, but influenza vaccine uptake in children was low. Encouraging medical professionals to recommend vaccination of eligible children is key to improving uptake.

Low MSF ，Tan H ，Hartman M ，Tam CC ，Hoo C ，Lim J ，Chiow S ，Lee S ，Thng R ，Cai M ，Tan Y ，Lock J ... -  《-》

A Comparison between the Predictors of Vaccine Uptake Intentions for Influenza and Dengue.

Panchapakesan C ，Sheldenkar A ，Cayabyab YM ，Ng JS ，Lu J ，Lwin MO ... -  《-》

Predicting intention to uptake H1N1 influenza vaccine in a university sample.

Global pandemic H1N1 was atypical of influenza in that it was associated with high symptom severity among young adults. Higher education institutions were therefore understandably concerned about the potential for high infection rates among students. This study examined intention to uptake H1N1 vaccine between November and December 2009, when the virus was classified by the World Health Organization (WHO) as being in the pandemic phase. A cross-sectional survey design was employed. Two hundred university students completed a questionnaire battery comprised of health, belief/attitudes, and behavioural intention measures. Findings suggested that non-intention to vaccinate is associated with a strong disbelief in its efficacy, in negative attitudes towards vaccinations, and in lack of perceived threat, which is underscored by a disinterest in others' opinions, including authoritative bodies. Findings also suggested that there is resistance to the idea of vaccinations being mandatory. Vaccination intent is in some way linked to a range of attitudes and beliefs. The implication for health practitioners is that behaviour intent may be open to influence where psycho-education can create pro-vaccine attitudes and beliefs.

Byrne C ，Walsh J ，Kola S ，Sarma KM ... -  《-》