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      Awareness, Attitude, and Current Practices Toward Influenza Vaccination Among Physicians in India: A Multicenter, Cross-Sectional Study

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          Abstract

          Background: Although annual influenza vaccination is recommended for healthcare providers (HCPs), vaccination rate among HCPs in India is generally low. This cross-sectional survey was conducted to evaluate physicians' awareness, attitude, and current practices toward influenza vaccination in high-risk groups in India.

          Methods: The survey was performed in June–July 2020, wherein consulting physicians, pulmonologists, diabetologists, obstetricians/gynecologists, or cardiologists across 14 cities completed a 39-item questionnaire consisting of 3 sections, one each on awareness, attitude, and practice patterns. Descriptive statistics were used to summarize the study results. Statistical analysis was performed for comparison of subgroups by physician specialty, city of practice (metro/non-metro), and zone of practice (north/south/east/west). Level of statistical significance was set at p < 0.05.

          Results: In all, 780 physicians completed the survey. Of these, 3.97, 53.08, and 42.95% had high, medium, and low level of awareness about influenza/influenza vaccination, respectively. Statistically significant ( p < 0.05) between-group differences were found by physician specialty and zone of practice. In terms of attitude toward vaccination of high-risk group subjects, only 0.9% physicians were “extremely concerned,” while the majority (92.56%) were “quite concerned” and 6.54% were a “little concerned,” with no reported significant differences between different subgroups. With regard to practice patterns, 82.82% of physicians offered influenza vaccines to their patients, 32.69% vaccinated 10–25% of patients per month, and 38.85% required and offered the vaccine to their office staff. Physicians' reasons for not prescribing influenza vaccines to patients included fear of side effects (16.54%), cost (15.64%), lack of awareness about availability (15.38%), absence of belief that it is beneficial (14.36%), history of side effects (13.46%), and patients' fear of needles (11.28%).

          Conclusion: These findings suggest the need to implement educational strategies among physicians to enhance their awareness about influenza vaccination and improve their attitudes and current practices toward influenza vaccination especially in high-risk groups in India.

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          Most cited references37

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          Estimates of global seasonal influenza-associated respiratory mortality: a modelling study

          Estimates of influenza-associated mortality are important for national and international decision making on public health priorities. Previous estimates of 250 000-500 000 annual influenza deaths are outdated. We updated the estimated number of global annual influenza-associated respiratory deaths using country-specific influenza-associated excess respiratory mortality estimates from 1999-2015.
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            Influenza vaccination of health care workers in hospitals--a review of studies on attitudes and predictors.

            Immunization guidelines from many countries recommend influenza vaccination of health care workers (HCW). However, influenza vaccination rates among HCW are universally low. To aid in designing effective immunization programs we reviewed the literature for studies reporting on (1) self-reported reasons of HCW regarding vaccination against influenza and (2) predictive factors for influenza vaccination in HCW. We searched PUBMED for relevant publications from 1980 to 2008 with predetermined search strategies and applied pre-defined criteria for inclusion or exclusion. To be included in the review as a predictor study, a multivariate analysis must have been conducted. We included 25 studies relevant to self-reported reasons for rejecting or accepting vaccination. These studies identified two major reasons for lack of vaccine uptake by HCW: firstly, a wide range of misconceptions or lack of knowledge about influenza infection; and secondly, a lack of convenient access to vaccine. In contrast, among studies reporting on reasons for vaccination acceptance, all but two found that HCW stated self-protection was the most important reason. In the area of "predictive factors for influenza vaccination", we included 13 studies. At least five of them identified the following three factors: previous receipt of influenza vaccine, belief in the vaccine's effectiveness, and older age. Our findings indicate that if HCW get immunized against influenza, they do so primarily for their own benefit and not for the benefit to their patients. Misconceptions about influenza and influenza vaccine could be improved by education, and organizational barriers could be bridged with sustainable, structural changes to allow flexible and workplace vaccine delivery.
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              Viral Shedding and Transmission Potential of Asymptomatic and Paucisymptomatic Influenza Virus Infections in the Community.

              Influenza virus infections are associated with a wide spectrum of disease. However, few studies have investigated in detail the epidemiological and virological characteristics of asymptomatic and mild illness with influenza virus infections.
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                Author and article information

                Contributors
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                23 August 2021
                2021
                : 9
                : 642636
                Affiliations
                [1] 1Vora Clinic , Mumbai, India
                [2] 2Abbott India Limited , Mumbai, India
                Author notes

                Edited by: Nasir Salam, Central University of Punjab, India

                Reviewed by: Iftikhar Ali, Paraplegic Center, Pakistan; Faris Hasan al Lami, University of Baghdad, Iraq

                *Correspondence: Agam Vora dragamvora@ 123456gmail.com

                This article was submitted to Infectious Diseases - Surveillance, Prevention and Treatment, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2021.642636
                8419342
                60a8180d-d83f-4963-9072-e0c5ff2be4b6
                Copyright © 2021 Vora and Shaikh.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 16 December 2020
                : 02 August 2021
                Page count
                Figures: 3, Tables: 4, Equations: 0, References: 43, Pages: 14, Words: 8706
                Categories
                Public Health
                Original Research

                attitude,awareness,current practices,india,influenza,influenza vaccination,healthcare providers

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