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1.
MMWR Morb Mortal Wkly Rep ; 69(39): 1391-1397, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33001873

RESUMEN

Vaccination of pregnant women with influenza vaccine and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) can decrease the risk for influenza and pertussis among pregnant women and their infants. The Advisory Committee on Immunization Practices (ACIP) recommends that all women who are or might be pregnant during the influenza season receive influenza vaccine, which can be administered at any time during pregnancy (1). ACIP also recommends that women receive Tdap during each pregnancy, preferably during the early part of gestational weeks 27-36 (2,3). Despite these recommendations, vaccination coverage among pregnant women has been found to be suboptimal with racial/ethnic disparities persisting (4-6). To assess influenza and Tdap vaccination coverage among women pregnant during the 2019-20 influenza season, CDC analyzed data from an Internet panel survey conducted during April 2020. Among 1,841 survey respondents who were pregnant anytime during October 2019-January 2020, 61.2% reported receiving influenza vaccine before or during their pregnancy, an increase of 7.5 percentage points compared with the rate during the 2018-19 season. Among 463 respondents who had a live birth by their survey date, 56.6% reported receiving Tdap during pregnancy, similar to the 2018-19 season (4). Vaccination coverage was highest among women who reported receiving a provider offer or referral for vaccination (influenza = 75.2%; Tdap = 72.7%). Compared with the 2018-19 season, increases in influenza vaccination coverage were observed during the 2019-20 season for non-Hispanic Black (Black) women (14.7 percentage points, to 52.7%), Hispanic women (9.9 percentage points, to 67.2%), and women of other non-Hispanic (other) races (7.9 percentage points, to 69.6%), and did not change for non-Hispanic White (White) women (60.6%). As in the 2018-19 season, Hispanic and Black women had the lowest Tdap vaccination coverage (35.8% and 38.8%, respectively), compared with White women (65.5%) and women of other races (54.0%); in addition, a decrease in Tdap vaccination coverage was observed among Hispanic women in 2019-20 compared with the previous season. Racial/ethnic disparities in influenza vaccination coverage decreased but persisted, even among women who received a provider offer or referral for vaccination. Consistent provider offers or referrals, in combination with conversations culturally and linguistically tailored for patients of all races/ethnicities, could increase vaccination coverage among pregnant women in all racial/ethnic groups and reduce disparities in coverage.


Asunto(s)
Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/administración & dosificación , Disparidades en Atención de Salud/etnología , Vacunas contra la Influenza/administración & dosificación , Mujeres Embarazadas/etnología , Cobertura de Vacunación/estadística & datos numéricos , Adolescente , Adulto , Grupos de Población Continentales/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Femenino , Humanos , Persona de Mediana Edad , Embarazo , Estados Unidos , Adulto Joven
3.
PLoS One ; 15(8): e0237218, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32760143

RESUMEN

Influenza is an infectious respiratory illness caused by influenza viruses. Despite yearly updates, the efficacy of influenza vaccines is significantly curtailed by the virus antigenic drift and antigenic shift. These constant changes to the influenza virus make-up also challenge the development of a universal flu vaccine, which requires conserved antigenic regions shared by influenza viruses of different subtypes. We propose that it is possible to bypass these challenges by the development of an influenza vaccine based on conserved proteins delivered in an adjuvanted nanoparticle system. In this study, we generated influenza nanoparticle constructs using trimethyl chitosan nanoparticles (TMC nPs) as the carrier of recombinant influenza hemagglutinin subunit 2 (HA2) and nucleoprotein (NP). The purified HA2 and NP recombinant proteins were encapsulated into TMC nPs to form HA2-TMC nPs and NP-TMC nPs, respectively. Primary human intranasal epithelium cells (HNEpCs) were used as an in vitro model to measure immunity responses. HA2-TMC nPs, NP-TMC nPs, and HA2-NP-TMC nPs (influenza nanoparticle constructs) showed no toxicity in HNEpCs. The loading efficiency of HA2 and NP into the TMC nPs was 97.9% and 98.5%, respectively. HA2-TMC nPs and NP-TMC nPs more efficiently delivered HA2 and NP proteins to HNEpCs than soluble HA2 and NP proteins alone. The induction of various cytokines and chemokines was more evident in influenza nanoparticle construct-treated HNEpCs than in soluble protein-treated HNEpCs. In addition, soluble factors secreted by influenza nanoparticle construct-treated HNEpCs significantly induced MoDCs maturation markers (CD80, CD83, CD86 and HLA-DR), as compared to soluble factors secreted by protein-treated HNEpCs. HNEpCs treated with the influenza nanoparticle constructs significantly reduced influenza virus replication in an in vitro challenge assay. The results indicate that TMC nPs can be used as influenza vaccine adjuvants and carriers capable of delivering HA2 and NP proteins to HNEpCs.


Asunto(s)
Adyuvantes Inmunológicos/farmacología , Quitosano/farmacología , Subtipo H1N1 del Virus de la Influenza A/inmunología , Vacunas contra la Influenza/farmacología , Gripe Humana/prevención & control , Adyuvantes Inmunológicos/administración & dosificación , Animales , Línea Celular , Células Cultivadas , Quitosano/administración & dosificación , Perros , Portadores de Fármacos/administración & dosificación , Portadores de Fármacos/farmacología , Glicoproteínas Hemaglutininas del Virus de la Influenza/administración & dosificación , Glicoproteínas Hemaglutininas del Virus de la Influenza/farmacología , Humanos , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/inmunología , Células de Riñón Canino Madin Darby , Nanopartículas/administración & dosificación , Infecciones por Orthomyxoviridae/inmunología , Infecciones por Orthomyxoviridae/prevención & control , Proteínas de Unión al ARN/administración & dosificación , Proteínas de Unión al ARN/farmacología , Proteínas del Núcleo Viral/administración & dosificación , Proteínas del Núcleo Viral/farmacología
7.
Public Health Rep ; 135(5): 640-649, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32783780

RESUMEN

OBJECTIVE: The objective was to compare estimates of childhood influenza vaccination across 7 consecutive influenza seasons based on 2 survey systems. METHODS: We analyzed data from the National Health Interview Survey (NHIS) and the National Immunization Survey-Flu (NIS-Flu) using Kaplan-Meier survival analysis to estimate receipt, based on parental report, of at least 1 dose of influenza vaccine among children aged 6 months to 17 years. RESULTS: We found no significant increasing trend in influenza vaccination coverage among children overall from 2012 to 2018 based on the NHIS or from 2012 to 2019 based on the NIS-Flu. We found 4 seasons with a significant increase in influenza vaccination coverage compared with the previous season (2012-2013 [NHIS, NIS-Flu], 2013-2014 [NIS-Flu], 2017-2018 [NHIS], and 2018-2019 [NIS-Flu]). As of the 2018-2019 season, based on NIS-Flu, influenza vaccination coverage was only 62.6%. Children with health conditions that put them at increased risk for complications from influenza had higher influenza vaccination coverage than children without these health conditions for all the seasons studied except 2014-2015. For all seasons studied, influenza vaccination coverage estimates for children were higher based on NIS-Flu data compared with NHIS data. Trends across seasons and differences in vaccination coverage between age groups were similar between the 2 surveys. CONCLUSIONS: Influenza vaccination coverage among children appears to have plateaued. Only about half of the children in the United States were vaccinated against influenza. Improvements in measurement of influenza vaccination and development and review of strategies to increase childhood influenza vaccination coverage are needed.


Asunto(s)
Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Vigilancia de la Población/métodos , Análisis de Supervivencia , Cobertura de Vacunación/estadística & datos numéricos , Cobertura de Vacunación/tendencias , Adolescente , Niño , Preescolar , Femenino , Predicción , Humanos , Lactante , Gripe Humana/epidemiología , Masculino , Encuestas y Cuestionarios , Estados Unidos/epidemiología
8.
PLoS Med ; 17(8): e1003238, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32810149

RESUMEN

BACKGROUND: It is estimated that vaccinating 50%-70% of school-aged children for influenza can produce population-wide indirect effects. We evaluated a city-wide school-located influenza vaccination (SLIV) intervention that aimed to increase influenza vaccination coverage. The intervention was implemented in ≥95 preschools and elementary schools in northern California from 2014 to 2018. Using a matched cohort design, we estimated intervention impacts on student influenza vaccination coverage, school absenteeism, and community-wide indirect effects on laboratory-confirmed influenza hospitalizations. METHODS AND FINDINGS: We used a multivariate matching algorithm to identify a nearby comparison school district with pre-intervention characteristics similar to those of the intervention school district and matched schools in each district. To measure student influenza vaccination, we conducted cross-sectional surveys of student caregivers in 22 school pairs (2017 survey, N = 6,070; 2018 survey, N = 6,507). We estimated the incidence of laboratory-confirmed influenza hospitalization from 2011 to 2018 using surveillance data from school district zip codes. We analyzed student absenteeism data from 2011 to 2018 from each district (N = 42,487,816 student-days). To account for pre-intervention differences between districts, we estimated difference-in-differences (DID) in influenza hospitalization incidence and absenteeism rates using generalized linear and log-linear models with a population offset for incidence outcomes. Prior to the SLIV intervention, the median household income was $51,849 in the intervention site and $61,596 in the comparison site. The population in each site was predominately white (41% in the intervention site, 48% in the comparison site) and/or of Hispanic or Latino ethnicity (26% in the intervention site, 33% in the comparison site). The number of students vaccinated by the SLIV intervention ranged from 7,502 to 10,106 (22%-28% of eligible students) each year. During the intervention, influenza vaccination coverage among elementary students was 53%-66% in the comparison district. Coverage was similar between the intervention and comparison districts in influenza seasons 2014-2015 and 2015-2016 and was significantly higher in the intervention site in seasons 2016-2017 (7%; 95% CI 4, 11; p < 0.001) and 2017-2018 (11%; 95% CI 7, 15; p < 0.001). During seasons when vaccination coverage was higher among intervention schools and the vaccine was moderately effective, there was evidence of statistically significant indirect effects: The DID in the incidence of influenza hospitalization per 100,000 in the intervention versus comparison site was -17 (95% CI -30, -4; p = 0.008) in 2016-2017 and -37 (95% CI -54, -19; p < 0.001) in 2017-2018 among non-elementary-school-aged individuals and -73 (95% CI -147, 1; p = 0.054) in 2016-2017 and -160 (95% CI -267, -53; p = 0.004) in 2017-2018 among adults 65 years or older. The DID in illness-related school absences per 100 school days during the influenza season was -0.63 (95% CI -1.14, -0.13; p = 0.014) in 2016-2017 and -0.80 (95% CI -1.28, -0.31; p = 0.001) in 2017-2018. Limitations of this study include the use of an observational design, which may be subject to unmeasured confounding, and caregiver-reported vaccination status, which is subject to poor recall and low response rates. CONCLUSIONS: A city-wide SLIV intervention in a large, diverse urban population was associated with a decrease in the incidence of laboratory-confirmed influenza hospitalization in all age groups and a decrease in illness-specific school absence rate among students in 2016-2017 and 2017-2018, seasons when the vaccine was moderately effective, suggesting that the intervention produced indirect effects. Our findings suggest that in populations with moderately high background levels of influenza vaccination coverage, SLIV programs are associated with further increases in coverage and reduced influenza across the community.


Asunto(s)
Absentismo , Vacunas contra la Influenza/administración & dosificación , Servicios de Salud Escolar/normas , Población Urbana , Cobertura de Vacunación/normas , Vacunación/normas , Adolescente , California/epidemiología , Niño , Preescolar , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Masculino , Instituciones Académicas/normas , Estudiantes , Vacunación/métodos , Cobertura de Vacunación/métodos
12.
Trends Biotechnol ; 38(9): 943-947, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32600777

RESUMEN

Vaccine solutions rarely reach the public until after an outbreak abates; an Ebola vaccine was approved 5 years after peak outbreak and SARS, MERS, and Zika vaccines are still in clinical development. Despite massive leaps forward in rapid science, other regulatory bottlenecks are hamstringing the global effort for pandemic vaccines.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Aprobación de Drogas/organización & administración , Fiebre Hemorrágica Ebola/prevención & control , Gripe Humana/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Vacunas Virales/biosíntesis , Betacoronavirus/efectos de los fármacos , Betacoronavirus/inmunología , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/virología , Vacunas contra el Virus del Ébola/administración & dosificación , Vacunas contra el Virus del Ébola/biosíntesis , Ebolavirus/efectos de los fármacos , Ebolavirus/inmunología , Ebolavirus/patogenicidad , Europa (Continente)/epidemiología , Salud Global/tendencias , Regulación Gubernamental , Fiebre Hemorrágica Ebola/epidemiología , Fiebre Hemorrágica Ebola/inmunología , Fiebre Hemorrágica Ebola/virología , Humanos , Subtipo H1N1 del Virus de la Influenza A/genética , Subtipo H1N1 del Virus de la Influenza A/inmunología , Vacunas contra la Influenza/administración & dosificación , Vacunas contra la Influenza/biosíntesis , Gripe Humana/epidemiología , Gripe Humana/inmunología , Gripe Humana/virología , Coronavirus del Síndrome Respiratorio de Oriente Medio/efectos de los fármacos , Coronavirus del Síndrome Respiratorio de Oriente Medio/inmunología , Coronavirus del Síndrome Respiratorio de Oriente Medio/patogenicidad , Neumonía Viral/epidemiología , Neumonía Viral/inmunología , Neumonía Viral/virología , Virus del SRAS/efectos de los fármacos , Virus del SRAS/inmunología , Virus del SRAS/patogenicidad , Síndrome Respiratorio Agudo Grave/epidemiología , Síndrome Respiratorio Agudo Grave/inmunología , Síndrome Respiratorio Agudo Grave/prevención & control , Síndrome Respiratorio Agudo Grave/virología , Estados Unidos/epidemiología , Vacunas Virales/administración & dosificación , Virus Zika/efectos de los fármacos , Virus Zika/inmunología , Virus Zika/patogenicidad , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/inmunología , Infección por el Virus Zika/prevención & control , Infección por el Virus Zika/virología
15.
Cent Eur J Public Health ; 28(2): 124-129, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32592557

RESUMEN

OBJECTIVE: The aim of the study was to evaluate the knowledge and perceptions of the pregnant women presenting to our hospital for seasonal vaccination for influenza and to determine the factors associated with it. METHOD: In this cross-sectional study pregnant woman presenting to our hospital between October 2018 and March 2019 were evaluated. A non-validated, well-detailed questionnaire addressing the vaccination rates, participants' perceptions about the facts behind the vaccination for influenza and the factors associated with refusal of vaccination was performed. Women's knowledge level provided by their healthcare providers was also questioned. RESULTS: A total of 250 participants were included in the study. The average age of the patients was 28.85 ± 5.42 years (range 18-43); and the average pregnancy week was 19 ± 9.75. It was determined that 98% (n = 245) of the participants did not have any vaccinations before, and 98.8% (n = 247) did not have any vaccination during their current pregnancy. 65.2% (n = 163) of the participants did not know that the vaccination for influenza was safe in pregnancy; and 64% (n = 160) did not know that the vaccination for influenza was recommended in pregnancy. The most frequent responses given by the participants to justify their refusal for the vaccination was "my doctor was against" and "it can be harmful to my baby" (25.6% and 24%, respectively). It was determined that 98.4% (n = 246) of the participants were not recommended about the vaccination for influenza by any healthcare centres; and 92.8% (n = 232) did not receive any information on vaccination for influenza. CONCLUSION: The knowledge of the participants on vaccination for influenza was inadequate and had misconceptions. The inadequacy of healthcare employees, government institutions and the media may have played roles in this outcome. The reasons underlying the inadequacy of the healthcare providers on vaccination for influenza may be questioned.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Complicaciones Infecciosas del Embarazo/prevención & control , Mujeres Embarazadas/psicología , Vacunación/psicología , Adolescente , Adulto , Actitud del Personal de Salud , Comunicación , Estudios Transversales , Femenino , Encuestas de Atención de la Salud , Humanos , Masculino , Aceptación de la Atención de Salud , Embarazo , Encuestas y Cuestionarios , Turquia , Adulto Joven
16.
PLoS Comput Biol ; 16(6): e1007989, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32542015

RESUMEN

Influenza epidemics cause substantial morbidity and mortality every year worldwide. Currently, two influenza A subtypes, A(H1N1) and A(H3N2), and type B viruses co-circulate in humans and infection with one type/subtype could provide cross-protection against the others. However, it remains unclear how such ecologic competition via cross-immunity and antigenic mutations that allow immune escape impact influenza epidemic dynamics at the population level. Here we develop a comprehensive model-inference system and apply it to study the evolutionary and epidemiological dynamics of the three influenza types/subtypes in Hong Kong, a city of global public health significance for influenza epidemic and pandemic control. Utilizing long-term influenza surveillance data since 1998, we are able to estimate the strength of cross-immunity between each virus-pairs, the timing and frequency of punctuated changes in population immunity in response to antigenic mutations in influenza viruses, and key epidemiological parameters over the last 20 years including the 2009 pandemic. We find evidence of cross-immunity in all types/subtypes, with strongest cross-immunity from A(H1N1) against A(H3N2). Our results also suggest that A(H3N2) may undergo antigenic mutations in both summers and winters and thus monitoring the virus in both seasons may be important for vaccine development. Overall, our study reveals intricate epidemiological interactions and underscores the importance of simultaneous monitoring of population immunity, incidence rates, and viral genetic and antigenic changes.


Asunto(s)
Subtipo H1N1 del Virus de la Influenza A/fisiología , Subtipo H3N2 del Virus de la Influenza A/fisiología , Gripe Humana/epidemiología , Hong Kong/epidemiología , Humanos , Subtipo H1N1 del Virus de la Influenza A/inmunología , Subtipo H3N2 del Virus de la Influenza A/inmunología , Vacunas contra la Influenza/administración & dosificación , Vacunas contra la Influenza/inmunología , Gripe Humana/prevención & control , Gripe Humana/virología
17.
Orv Hetil ; 161(23): 962-970, 2020 06.
Artículo en Húngaro | MEDLINE | ID: mdl-32453699

RESUMEN

INTRODUCTION: In recent years, a significant mortality peak has been observed several times during the first months in Hungary. So far, no mortality study clarified the connection between the mortality peaks and influenza with results comparable with findings from other countries. AIM: Calculation of the influenza-related number of death and excess mortality rates in Hungary for the period between 2009/10 and 2016/17, using the statistical package FluMONO. METHOD: We applied the FluMOMO methods, a multivariable time series model with all-cause mortality as outcome, and with influenza-activity and extreme temperature as explanatory variables adjusting for time trend and seasonality. As an indicator of weekly influenza-activity (IA), we used the percentage of consultations for influenza-like illness (ILI) in general practices. RESULTS: According to our estimation, 1091, 2969, 4036, 2336, 2608, 6470, 51 and 5162 deaths were attributable to influenza epidemics in the 2009/10, 2010/11, 2011/12, 2012/13, 2013/14, 2014/15, 2015/16 and 2016/17 seasons, respectively. The average annual mortality excess rate per 100,000 inhabitants ranged between 0.5 and 52.7. These results are similar to those from other countries regarding their order of magnitude. The Hungarian extra mortality, however, tends to be higher than that in countries with higher vaccination rates. CONCLUSIONS: Influenza-related mortality tends to be lower in countries with higher vaccination rates. Increase in vaccination rates seems to be necessary in Hungary. Orv Hetil. 2020; 161(23): 962-970.


Asunto(s)
Brotes de Enfermedades , Gripe Humana/mortalidad , Humanos , Hungría/epidemiología , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Mortalidad , Vigilancia de la Población , Estaciones del Año , Temperatura , Vacunación
18.
Pediatr Blood Cancer ; 67(8): e28358, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32469138

RESUMEN

BACKGROUND: Data are limited on the burden of influenza and seasonal influenza vaccine effectiveness (VE) in children with sickle cell disease (SCD). METHODS: We used a prospectively collected clinical registry of SCD patients 6 months to 21 years of age to determine the influenza cases per 100 patient-years, vaccination rates, and a test-negative case-control study design to estimate influenza VE against medically attended laboratory-confirmed influenza infection. Influenza-positive cases were randomly matched to test-negative controls on age and influenza season in 1:1 ratio. We used adjusted logistic regression models to compare odds ratio (OR) of vaccination in cases to controls. We calculated VE as [100% × (1 - adjusted OR)] and computed 95% confidence intervals (CIs) around the estimate. RESULTS: There were 1037 children with SCD who were tested for influenza, 307 children (29.6%) had at least one influenza infection (338 infections, incidence rate 3.7 per 100 person-years; 95% CI, 3.4-4.1) and 56.2% of those tested received annual influenza vaccine. Overall VE pooled over five seasons was 22.3% (95% CI, -7.3% to 43.7%). Adjusted VE estimates ranged from 39.7% (95% CI, -70.1% to 78.6%) in 2015/2016 to -5.9% (95% CI, -88.4% to 40.4%) in the 2016/17 seasons. Influenza VE varied by age and was highest in children 1-5 years of age (66.6%; 95% CI, 30.3-84.0). Adjusted VE against acute chest syndrome during influenza infection was 39.4% (95% CI, -113.0 to 82.8%). CONCLUSIONS: Influenza VE in patients with SCD varies by season and age. Multicenter prospective studies are needed to better establish and monitor influenza VE among children with SCD.


Asunto(s)
Síndrome Torácico Agudo/epidemiología , Costo de Enfermedad , Vacunas contra la Influenza/administración & dosificación , Gripe Humana , Vacunación , Adolescente , Adulto , Factores de Edad , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Vacunas contra la Influenza/efectos adversos , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Masculino , Estudios Prospectivos
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(3): 349-353, 2020 Mar 10.
Artículo en Chino | MEDLINE | ID: mdl-32294833

RESUMEN

Objective: To understand the cognition on and status quo of influenza vaccination among all age groups in the survey areas from 6 provinces so as to explore the main factors related to influenza vaccination. Methods: A cross-sectional survey method was conducted to study the knowledge on influenza prevention and control, as well as on the status of influenza vaccination in Beijing, Inner Mongolia, Shanghai, Guangdong, Yunnan, and Gansu provinces through 12320 health hotline telephone with method of random number table in Mar-May 2018. The survey sample size was 9 438 respondents. Results: The survey response rate was 46.4%(10 045/21 658). A total of 10 045 respondents were surveyed. The awareness on flu-related knowledge "influenza is different from the common cold" was 75.3% (7 564/10 045), rate on "influenza virus will cause serious consequences" was 82.0% (8 241/10 045). The rate of health behavior such as frequent hand, washing hand, wearing masks and isolating themselves were 80.41% (7 936/9 873), 75.8% (7 506/9 899) and 73.6%(7 228/9 822) respectively when the influenza-like symptoms already started. The influenza vaccination rate in the past year was only 5.7% (570/10 037). Multivariate logistic analysis of influenza vaccination rate in the past year showed that respondents who were from Gansu province or Beijing, respondents occupations were as medical staff or full-time students, respondents who were living with more than 2 people at the same house, respondents who had had influenza symptoms without wearing masks, the influenza vaccination rates were higher in the past year. Conclusions: Rates regarding the awareness of influenza-related knowledge, health behavior when the influenza-related symptoms already started and having received the influenza vaccine vaccination in the past year should be further improved in the six provinces. Health education on influenza-related knowledge and vaccine vaccination should be strengthened, strategies including free vaccination are bound to be explored.


Asunto(s)
Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Vacunación/psicología , China , Cognición , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Encuestas y Cuestionarios
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