Willingness to accept a future influenza A(H7N9) vaccine in Beijing, China.

BACKGROUND: The present study aimed to estimate residents' willingness to accept a future H7N9 vaccine and its determinants in the general adult population in Beijing, China. METHODS: We conducted a multi-stage sampling, cross-sectional survey using self-administered anonymous questionnaires from May to June, in 2014. The main outcome variable was residents' willingness to accept a future H7N9 vaccine. Logistic regression was used to identify the predictors of vaccination willingness. RESULTS: Of the 7264 eligible participants, 14.5% of Beijing residents reported that they had not heard of H7N9. Among those who had heard of H7N9, 59.5% of the general adult population would be willing to accept a future H7N9 vaccine, and approximately half of them reported 'I am afraid of being infected by H7N9' and 'H7N9 vaccine can prevent infections', and 28.1% reported 'my daily life is affected by H7N9'. The variables that were significantly associated with a higher likelihood of reporting willingness were being younger adults (aged 18-29 years: OR = 1.52, 95% CI: 1.17-1.97; aged 30-39 years: OR = 1.39, 95% CI: 1.08-1.78), being farmers (OR = 1.61; 95% CI: 1.32-1.96), being unemployed people (OR = 1.36; 95% CI: 1.04-1.78), living in suburban areas (OR = 2.18; 95% CI: 1.89-2.51), having ≥2 children in the family (OR = 1.41; 95% CI: 1.03-1.92), perceived risk in China (OR = 1.30; 95% CI: 1.15-1.48), perceived susceptibility to disease (OR = 3.13; 95% CI: 2.73-3.58), perceived negative effect on daily life (OR = 1.32; 95% CI: 1.13-1.55), perceived effectiveness of vaccination (OR = 2.34; 95% CI: 2.07-2.64), and recent uptake of influenza vaccine (OR = 2.26; 95% CI: 1.92-2.66). CONCLUSIONS: A great number of Beijing residents had doubts about the vaccine's effectiveness and were not concerned about disease risk, which were the factors affecting willingness to be vaccinated. Targeted education programs on disease risk as well as vaccine's effectiveness are needed to improve the willingness of vaccination for potential H7N9 pandemic preparedness.

Factors associated with the uptake of seasonal influenza vaccination in older and younger adults: a large, population-based survey in Beijing, China.

OBJECTIVES: The present study aimed to estimate the influenza vaccination coverage rate in Beijing, China, and identify its determinants in older and younger adults. METHODS: A survey was conducted among Chinese adults using a self-administered, anonymous questionnaire in May-June 2015. The main outcome was seasonal influenza vaccination uptake. Multivariate logistic regression models were performed to identify factors associated with uptake. RESULTS: A total of 7106 participants completed the questionnaire. The overall coverage rate was 20.6% (95% CI 19.7% to 21.5%) in the 2014/2015 influenza season. Lower education (older adults: OR 1.6; 95% CI 1.2 to 2.1; younger adults: OR 1.9; 95% CI 1.4 to 2.6), having a chronic illness (older adults: OR 1.9; 95% CI 1.5 to 2.4; younger adults: OR 1.4; 95% CI 1.2 to 1.7) and recommendations from healthcare workers (older adults: OR 5.4; 95% CI 3.9 to 7.4; younger adults: OR 4.5; 95% CI 3.7 to 5.4) were positively associated with uptake; perceived side effects of vaccination had a negative impact (older adults: OR 0.6; 95% CI 0.4 to 0.7; younger adults: OR 0.8; 95% CI 0.7 to 1.0). Perceived susceptibility to influenza (OR 1.5; 95% CI 1.2 to 2.0) and awareness of the free influenza vaccine policy (OR 1.9; 95% CI 1.2 to 2.9) were only associated with vaccine uptake in older adults, while perceived effectiveness of vaccination (OR 2.2; 95% CI 1.7 to 2.8) was only a predictor for younger adults. Older adults were more likely to receive recommendations from healthcare professionals and perceive the severity of seasonal influenza, and less likely to worry about side effects of vaccination. CONCLUSION: The influenza vaccination coverage rate was relatively low in Beijing. Apart from free vaccinations for older adults, age disparity in the rate between older and younger adults (48.7% vs 16.0%) may be explained by differing professional recommendations and public perceptions. Vaccination campaigns targeting increasing professional recommendations and public perceptions should be implemented in the coming years.

Using a community based survey of healthcare seeking behavior to estimate the actual magnitude of influenza among adults in Beijing during 2013-2014 season.

BACKGROUND: Due to a lack of survey of health care seeking behavior for influenza, the actual magnitude of influenza in Beijing of China has not been well described. METHODS: During 2013-2014 influenza season, two cross-sectional household surveys were carried out respectively during the epidemic and non-epidemic season of influenza. A structured survey was undertaken with individuals who were ≥18 years selected by a multistage random sampling method in the study. Health care seeking behaviors were then examined to estimate the actual case number of influenza, using a multiplier model. RESULTS: A total of 14,665 adults were interviewed. 61.9% of ILI cases consulted a physician. The consultation rate during epidemic period is higher than that during non-epidemic period (67.9% vs. 52.3%). Similarly, the proportion of healthcare usage of general hospital during epidemic period is higher than that was during non-epidemic period (27.1% vs. 19.0%, p = 0.008). Lack of insurance and education reduced healthcare seeking significantly in this study. It was estimated that there were 379,767 (90% CI = [281,934, 526,565]) confirmed cases of influenza amongst adults in Beijing, during 2013-2014 influenza season, with an incidence rate of 2.0%. CONCLUSIONS: The surveillance system for ILI and virological data has the potential to provide baseline case number to estimate the actual annual magnitude of influenza. Given the changes in healthcare seeking behavior over time, sentinel surveillance on healthcare seeking behavior are required to be established for better estimate of the true case number of influenza.

Hygiene Behaviors Associated with Influenza-Like Illness among Adults in Beijing, China: A Large, Population-Based Survey.

The objective of this study was to identify possible hygiene behaviors associated with the incidence of ILI among adults in Beijing. In January 2011, we conducted a multi-stage sampling, cross-sectional survey of adults living in Beijing using self-administered anonymous questionnaires. The main outcome variable was self-reported ILI within the past year. Multivariate logistic regression was used to identify factors associated with self-reported ILI. A total of 13003 participants completed the questionnaires. 6068 (46.7%) of all participants reported ILI during the past year. After adjusting for demographic characteristics, the variables significantly associated with a lower likelihood of reporting ILI were regular physical exercise (OR 0.80; 95% CI 0.74-0.87), optimal hand hygiene (OR 0.87; 95% CI 0.80-0.94), face mask use when going to hospitals (OR 0.87; 95% CI 0.80-0.95), and not sharing of towels and handkerchiefs (OR 0.68; 95% CI 0.63-0.73). These results highlight that personal hygiene behaviors were potential preventive factors against the incidence of ILI among adults in Beijing, and future interventions to improve personal hygiene behaviors are needed in Beijing.