One-Year Temporal Changes in Long COVID Prevalence and Characteristics: A Systematic Review and Meta-Analysis.

OBJECTIVES: This study aimed to explore the 1-year temporal change in prevalence, variety, and potential risk factors of long COVID symptoms and to further predict the prognostic trends of long COVID. METHODS: We searched electronic databases for related studies published from January 2020 to February 2022 and conducted 1-group meta-analysis and locally weighted regression to explore the monthly temporal change in the prevalence of each long COVID symptom in 1-year follow-up period. RESULTS: A total of 137 studies were included in meta-analysis, including 134 093 participants. The temporal change of any long COVID symptom showed a steep decrease initially (from 92% at acute phase to 55% at 1-month follow-up), followed by stabilization at approximately 50% during 1-year follow-up. Six months or more after the acute phase, the odds ratio of population characteristic-related factors increased, such as female (from 1.62 to 1.82), whereas the odds ratio value of acute phase-related factors (severe or critical cases and hospitalization) decreased. As for specific symptoms, approximately two-thirds of the symptoms did not significantly reduce during the 1-year follow-up, and the neuropsychiatric symptoms showed a higher long-term prevalence (approximately 25%) and longer persistence than physical symptoms. CONCLUSIONS: The temporal changes in the prevalence and characteristics speculate that long COVID may persist longer than expected. In particular, we should pay more attention to neuropsychiatric symptoms and other symptoms for which there is no significant downward trend in prevalence. The influence of acute phase-related factors for long COVID gradually decreases over time, whereas the influence of population characteristic-related factors gradually increases.

Humoral responses after inactivated COVID-19 vaccination in individuals with and without prior SARS-CoV-2 infection: A prospective cohort study.

We evaluated and compared humoral immune responses after inactivated coronavirus disease 2019 (COVID-19) vaccination among naïve individuals, asymptomatically infected individuals, and recovered patients with varying severity. In this multicenter, prospective cohort study, blood samples from 666 participants were collected before and after 2 doses of inactivated COVID-19 vaccination. Among 392 severe acute respiratory syndrome coronavirus 2-naïve individuals, the seroconversion rate increased significantly from 51.8% (median antispike protein pan-immunoglobulins [S-Igs] titer: 0.8 U/ml) after the first dose to 96% (median S-Igs titer: 79.5 U/ml) after the second dose. Thirty-two percent of naïve individuals had detectable neutralizing antibodies (NAbs) against the original strain but all of them lost neutralizing activity against the Omicron variant. In 274 individuals with natural infection, humoral immunity was significantly improved after a single vaccine dose, with median S-Igs titers of 596.7, 1176, 1086.5, and 1828 U/ml for asymptomatic infections, mild cases, moderate cases, and severe/critical cases, respectively. NAb titers also improved significantly. However, the second dose did not substantially increase antibody levels. Although a booster dose is needed for those without infection, our findings indicate that recovered patients should receive only a single dose of the vaccine, regardless of the clinical severity, until there is sufficient evidence to confirm the benefits of a second dose.

Willingness to accept herpes zoster vaccines and the influencing factors in China.

BACKGROUND: Herpes zoster increases the burden on the elderly in an aging society. Although an effective vaccine licensed by China Food and Drug Administration in 2019 was introduced into the market in June 2020, the willingness and influencing factors of herpes zoster vaccines in Chinese adults ≥ 50-years-old during coronavirus disease-2019 pandemic are yet to be elucidated. METHODS: An online questionnaire survey was conducted using a simple random sampling method in October 2021 for viewers of the broadcast program. A binary logistic regression and multiple response analysis were conducted for herpes zoster vaccine and vaccination willingness. Pareto's graphs were plotted to present the multiple-choice questions of influencing factors. RESULTS: A total of 3838 eligible participants were included in this study. Among them, 43.02% intended to be vaccinated, including 10.34% self-reported about receiving at least one shot of shingles vaccine, 30.22% declined, and 26.76% were hesitant. This population comprised a large proportion of middle-aged and older people (≥ 50-years-old) who have not experienced an episode of herpes zoster (54.98%) or are unaware of the virus (33.22%). The strongest determinants of vaccine hesitancy among older people were education background of Master's degree or above compared to senior high or equivalent and below, personal monthly income < 3000 RMB compared to 3000-5999 RMB, and living in a rural area. CONCLUSIONS: The willingness to get shingles vaccines can be improved further. Professional education and credible recommendation might prompt the elderly to improve their willingness and reassure them of the safety and efficacy of the vaccine. Also, accessibility and affordability should also be improved in the future.

Factors Affecting Public Adoption of COVID-19 Prevention and Treatment Information During an Infodemic: Cross-sectional Survey Study.

BACKGROUND: With the spread of COVID-19, an infodemic is also emerging. In public health emergencies, the use of information to enable disease prevention and treatment is incredibly important. Although both the information adoption model (IAM) and health belief model (HBM) have their own merits, they only focus on information or public influence factors, respectively, to explain the public's intention to adopt online prevention and treatment information. OBJECTIVE: The aim of this study was to fill this gap by using a combination of the IAM and the HBM as the framework for exploring the influencing factors and paths in public health events that affect the public's adoption of online health information and health behaviors, focusing on both objective and subjective factors. METHODS: We carried out an online survey to collect responses from participants in China (N=501). Structural equation modeling was used to evaluate items, and confirmatory factor analysis was used to calculate construct reliability and validity. The goodness of fit of the model and mediation effects were analyzed. RESULTS: The overall fitness indices for the model developed in this study indicated an acceptable fit. Adoption intention was predicted by information characteristics (ß=.266, P<.001) and perceived usefulness (ß=.565, P<.001), which jointly explained nearly 67% of the adoption intention variance. Information characteristics (ß=.244, P<.001), perceived drawbacks (ß=-.097, P=.002), perceived benefits (ß=.512, P<.001), and self-efficacy (ß=.141, P<.001) jointly determined perceived usefulness and explained about 81% of the variance of perceived usefulness. However, social influence did not have a statistically significant impact on perceived usefulness, and self-efficacy did not significantly influence adoption intention directly. CONCLUSIONS: By integrating IAM and HBM, this study provided the insight and understanding that perceived usefulness and adoption intention of online health information could be influenced by information characteristics, people's perceptions of information drawbacks and benefits, and self-efficacy. Moreover, people also exhibited proactive behavior rather than reactive behavior to adopt information. Thus, we should consider these factors when helping the informed public obtain useful information via two approaches: one is to improve the quality of government-based and other official information, and the other is to improve the public's capacity to obtain information, in order to promote truth and fight rumors. This will, in turn, contribute to saving lives as the pandemic continues to unfold and run its course.

Employees' seeking preference towards influenza vaccination in organization: A discrete choice experiment in China.

To clarify the preferences of employees seeking influenza vaccination, a discrete choice experiment aims to understand the essential factors that close the gap between intention and behavior. A total of 866 employees with vaccination willingness willing to participated in a discrete choice experiment (DCE) between October 31st and December 6th, 2022 in China including the following attributes: price, vaccination setting, appointment mode, and service time. The data was analyzed using mixed logit models. Employees from smaller enterprises were more likely to get vaccinated collectively. For employees willing to get the influenza vaccine, 95.08 % of their choice was dominated by price. Employees' behavior varied according to their socioeconomic characteristics. Only female employees strongly favored work-site-based vaccination. Price was the primary factor considered by employees for getting the influenza vaccine. DCE would help to develop influenza vaccination intervention targeted at different groups in future studies.

Attitudes Regarding Influenza Vaccination Among Public Health Workers during COVID-19 Pandemic - China, September 2022.

What is already known about this topic?: Public health workers (PHWs) were listed as a priority group recommended for influenza vaccination during the coronavirus disease 2019 (COVID-19) pandemic. Understanding the drivers of influenza vaccine hesitancy among PHWs can promote influenza vaccination in the COVID-19 pandemic. What is added by this report?: The study found that 10.7% of PHWs were hesitant to get an influenza vaccination. Drivers associated with vaccine hesitancy were assessed based on "3Cs model." The absence of a government or workplace requirement and concerns about vaccine safety were the biggest obstacles for PHWs to recommend influenza vaccination. What are the implications for public health practice?: Interventions are needed to improve PHWs' influenza vaccine coverage to prevent the co-circulation of influenza and COVID-19.

Healthcare Workers' Attitudes toward Influenza Vaccination: A Behaviour and Social Drivers Survey.

This study aimed to understand the intention and correlation of receiving and recommending influenza vaccine (IV) among healthcare workers (HCWs) in China during the 2022/2023 season using the behavior and social drivers (BeSD) tools. A self-administered electronic survey collected 17,832 participants on a media platform. We investigated the willingness of IV and used multivariate logistic regression analysis to explore its associated factors. The average scores of the 3Cs' model were compared by multiple comparisons. We also explored the factors that potentially correlated with recommendation willingness by partial regression. The willingness of IV was 74.89% among HCWs, and 82.58% of the participants were likely to recommend it to others during this season. Thinking and feeling was the strongest domain independently associated with willingness. All domains in BeSD were significantly different between the hesitancy and acceptance groups. Central factors in the 3Cs model were significantly different among groups (p < 0.01). HCWs' willingness to IV recommendation was influenced by their ability to answer related questions (r = 0.187, p < 0.001) after controlling for their IV willingness and perceived risk. HCWs' attitudes towards IV affect their vaccination and recommendation. The BeSD framework revealed the drivers during the decision-making process. Further study should classify the causes in detail to refine HCWs' education.

Association between influenza vaccination and SARS-CoV-2 infection and its outcomes: systematic review and meta-analysis.

BACKGROUND: World Health Organization recommends that influenza vaccines should benefit as much of the population as possible, especially where resources are limited. Corona virus disease 2019 (COVID-19) has become one of the greatest threats to health systems worldwide. The present study aimed to extend the evidence of the association between influenza vaccination and COVID-19 to promote the former. METHODS: In this systematic review, four electronic databases, including the Cochrane Library, PubMed, Embase, and Web of Science, were searched for related studies published up to May 2022. All odds ratios (ORs) with 95% confidence intervals (CIs) were pooled by meta-analysis. RESULTS: A total of 36 studies, encompassing 55,996,841 subjects, were included in this study. The meta-analysis for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection provided an OR of 0.80 (95% CI: 0.73-0.87). The statistically significant estimates for clinical outcomes were 0.83 (95% CI: 0.72-0.96) for intensive care unit admission, 0.69 (95% CI: 0.57-0.84) for ventilator support, and 0.69 (95% CI: 0.52-0.93) for fatal infection, while no effect seen in hospitalization with an OR of 0.87 (95% CI: 0.68-1.10). CONCLUSION: Influenza vaccination helps limit SARS-CoV-2 infection and severe outcomes, but further studies are needed. REGISTRATION: PROSPERO, CRD42022333747.

Perception of Patient Safety and the Reporting System Between Medical Staffs and Patients in China: A Cross-Sectional Online Study.

OBJECTIVE: This study aimed to understand the perception of patient safety and the reporting system in public in China, and make further recommendations for the optimization of the reporting system of patient safety. METHODS: The following data were collected through an online questionnaire from medical staffs and patients: recognition of patient safety, comments on patient participation, comments on spontaneous reports, attitudes toward the principles of spontaneous reports, and willingness to participate. This information was presented with frequency and percentage with 95% confidence intervals (CIs). Spearman rank correlation was used to evaluate the association of those data. RESULTS: A total of 27,493 valid questionnaires were collected in this study. The participants who knew patient safety very well, regarded patients as an essential part to enhance patient safety, viewed spontaneous reports helpful, agreed on the 3 principles of voluntariness, anonymity, and nonpunishment of the reporter, and were willing to participate in reporting were accounted for 39.2% (95% CI, 38.6%-39.8%), 31.2% (95% CI, 30.7%-31.8%), 25.2% (95% CI, 24.7%-25.7%), 24.0% (95% CI, 23.5%-24.5%), and 19.9% (95% CI, 19.4%-20.4%), respectively. A moderate positive correlation was observed between comments on spontaneous reports and attitudes toward the principles of spontaneous reports (medical staffs versus patients, rs = 0.452 versus rs = 0.439; both, P < 0.01), as well as comments on patient participation and comments on spontaneous reports (medical staffs versus patients, rs = 0.410 versus rs = 0.460; both, P < 0.01). CONCLUSIONS: The awareness of patient safety may influence the choices of the other questions subsequently and may affect their voluntariness for safety reports ultimately. Pertinent measures, such as publicity of the relevant concept, simplification of the reporting procedures, and promotion of incentive mechanisms, should be adopted to promote the optimization of the reporting system.

Awareness, knowledge and attitude toward influenza vaccination in several population groups in China: A cross-sectional study.

Background: We aimed to comprehensively analyze awareness, knowledge and attitude toward influenza vaccine and the factors associated to vaccine acceptance among the young and middle-aged general population, healthcare workers, and health-related administrators in China. The factors influencing the promotion of influenza vaccination were also evaluated among healthcare workers and administrators. Methods: This is a multicenter, cross-sectional study. General population adults, healthcare workers (HCWs), and health administrators were enrolled in seven regions across China during the 2020-2021 flu season. Data were collected via an online questionnaire, which included information request as to awareness, knowledge, and attitude toward influenza vaccination. Statistical significance set at p-values < 0.05. Results: A total of 3,239 individuals were included in our analyses. There were gaps in consciousness to action, especially between awareness (87.1%) and knowledge (57.7%), and between willingness (57.3%) and vaccination (22.3%). The downward trends were similar in all three groups. HCW group and the health administrator group showed more positive propensity to accept influenza vaccines than the general population group. For the general population group, those with a lower educational level (lower than a bachelor's degree) were less likely to be vaccinated (aOR = 0.66, 95% CI: 0.45-0.96). For the HCW group, practitioners older than 45 years were more reluctant to be vaccinated than those under 25 years (aOR = 0.41, 95% CI: 0.19-0.86). For the health administrator group, personnel aged 26 years and above were less inclined to be vaccinated (aORs = 0.17-0.20). In all groups, people who had received influenza vaccines in the past 5 years (aOR = 1.72, 95% CI: 1.31-2.26 in general population group, 13.05, 95% CI: 7.71-22.10 in HCW group, and 19.30, 95% CI: 9.66-42.63 in health administrator group) were more likely to be vaccinated in future seasons. People who were not covered by the free program or those without awareness of the related programs were less likely to be vaccinated (aORs < 0.63). Most (70.8%) of HCWs showed intention to recommend the influenza vaccine. Clinical doctors, those who had flu shots themselves, and those who had more knowledge, were more like to make recommendations. Health administrators stated that insufficient budget resources and workforce, and low public awareness are main difficulties in the promotion of influenza vaccine. Conclusion: The influencing factors of the attitude toward influenza vaccination vary across populations. Governments need to carry out focused vaccination promotion programs, especially for healthcare workers, to improve the coverage of influenza vaccination.