Pharmacists' attitudes toward influenza vaccination: does the COVID-19 pandemic make a difference?

Background: Influenza vaccine uptake in most European countries remains low, despite the World Health Organization's target of 75%. Community pharmacists play a vital role in promoting vaccination; however, they have been reported to be vaccine-hesitant. This study aimed to investigate changes in pharmacists' attitudes toward influenza vaccination since the onset of the COVID-19 pandemic, as well as their COVID-19 vaccination intentions. Methods: In December 2020, all members of the Swiss Association of Pharmacists were invited to participate in an online, cross-sectional survey. This study assessed pharmacists' attitudes toward influenza vaccination by surveying influenza vaccine uptake during the 2019-20 influenza season and possible reasons for their decision(s), in addition to their intention to receive COVID-19 and seasonal influenza vaccination(s) during the 2020-21 influenza season. Descriptive analysis and multinomial logistic regression were used to assess predictors of vaccine uptake and intention. Results: Of 5900 Swiss pharmacists, 569 (9.6%) completed the survey. The self-reported influenza vaccination coverage among pharmacists during the 2019-20 season was 48.0%. The primary reason for vaccine uptake was the belief that all healthcare workers should be vaccinated, whereas the main reason for refusal was a lack of concern about contracting influenza. The proportions of participants who intend to accept influenza and COVID-19 vaccinations in the 2020-2021 season, when available, were 63.3% and 66.5%, respectively. The most important predictor of high willingness to be vaccinated against influenza in 2020-21 was vaccination history (OR = 3.73; 95% CI = 1.47-9.50), while the most critical predictor of willingness to be vaccinated against COVID-19 was the intention to be vaccinated against influenza (OR = 3.45; 95% CI = 1.74-6.84). Conclusions: Findings indicated that although pharmacists' readiness to accept seasonal influenza vaccination significantly increased during the COVID-19 pandemic, influenza vaccine uptake among them remains suboptimal. This is consistent with what has been reported in the literature.

Pharmacists' Seasonal Influenza Vaccine Recommendations.

Seasonal influenza vaccination rates among European countries remain low despite the World Health Organization's recommendations to vaccinate high-risk groups. Healthcare worker recommendations are strong predictors of increased vaccination uptake in the population. Therefore, this study aimed to analyze seasonal influenza vaccination recommendation behavior among pharmacists towards high-risk groups including patients, coworkers, and pharmacists' family members during the COVID-19 pandemic. This cross-sectional, questionnaire-based research was conducted in Switzerland during the flu season and sent to all members of the Swiss Pharmacist Association. In December 2020, 569 community pharmacists completed the online survey. The influenza vaccination recommendation rates for high-risk patients were 93.6% for the elderly, 70.7% for pregnant women, 65.2% for immunocompromised people, and 60.3% for patients with chronic diseases. Pharmacists tend to recommend influenza immunization to patients more than to family members and colleagues. Holding a certification to administer immunization and personal influenza vaccine history were the main predictors for recommending influenza vaccination to patients, family members, and colleagues. Our results indicated that influenza vaccination recommendation rates in our whole sample of pharmacists, were higher for vaccinated and immunizing pharmacists. Ensuring high vaccinations rates and high ratio of immunizing pharmacists may be important in promoting seasonal influenza vaccination in the general population.

Influenza vaccination coverage of health care workers: a cross-sectional study based on data from a Swiss gynaecological hospital.

Background: Pregnancy is a risk factor for severe influenza and related complications. The vaccination has been recommended in healthcare workers as a strategy for preventing influenza in risk patients. The aim of this study was to analyze the influenza vaccination rate of the department of obstetrics and gynaecology of the Cantonal hospital St. Gallen in Switzerland. Methods: A cross-sectional study was carried out to investigate the influenza vaccination rates of all staff members of the Department of obstetrics and gynaecology (n=259). The vaccination coverage was compared according to sociodemographic variables using Chi-squared test. Associations were determined using a logistic regression model. Possible reasons for and against vaccination coverage were then investigated. Results: 200 questionnaires were included (valid response rate 77%). 15% reported being vaccinated against influenza (n=29). Reasons to be vaccinated are the belief of protection of patients (82%), oneself (75%) or family (61%). Reasons not to get vaccinated, including beliefs regarding the vaccine is not important (49%) and its ineffectiveness (44%). In the logistic regression analysis, the vaccination coverage among doctors (61% vaccinated) and nurses/midwives (4% vaccinated) is different from the vaccination coverage among the non-medical staff reference category (16% vaccinated; p=0.004, p=0.027), after controlling for the effect of other variables sex (p=0.807), age (p=0.438) and full time employment (p=0.298). Discussion: This study showed that doctors have a higher vaccination rate compared to other job roles, whereas the nurses and midwives had very low vaccination rates, which indicate a significant public health communication gap that needs to be addressed.

[Complementary and alternative medicine in the German outpatient setting: extent, structure and reasons for provision]. / Komplementäre und alternative Heilverfahren im vertragsärztlichen Bereich: Ausmaß, Struktur und Gründe des ärztlichen Angebots.

BACKGROUND: Research on complementary and alternative medicine (CAM) has mainly focused on CAM utilisation by patients. Fewer studies have analysed extent and structure of CAM provision or the reasons why physicians offer CAM as a therapeutic option in the outpatient setting. METHODS: A standardised questionnaire was developed addressing reasons and patterns of CAM provision. The questionnaire was sent by post to 2,396 general practitioners and specialists in 9 selected German districts. 553 physicians participated in the survey (23%). RESULTS: 63% of the respondents (n=350) answered that they had provided some sort of CAM to their patients within a period of 12 months preceding the study. The most frequently provided methods were acupuncture/traditional Chinese medicine, herbal remedies and homeopathy. In the sample, 90% of the orthopaedists were CAM providers, the highest rate among the participating disciplines. Several reasons for offering CAM were identified: conviction of therapeutic effectiveness regarding the patient's situation (68%), aspects of therapeutic freedom (47%) or less harmful side effects than conventional therapies (34%). 6% provide CAM for monetary reasons. CONCLUSION: Findings suggest that the provision of CAM is widespread in the German outpatient setting. However, it has to be taken into account that a selection bias may apply which may lead to an overestimation of CAM provision. Doctors' reasons to offer CAM are manifold; therapeutic reasons seem to outweigh economic motives.

[Cooperation between physicians and non-medically trained practitioners: advantages and obstacles]. / Möglichkeiten und Grenzen einer Zusammenarbeit mit Heilpraktikern aus ärztlicher Sicht.

BACKGROUND: In Germany, not only physicians are allowed to practice medicine but also non-medically trained practitioners, so-called Heilpraktiker, can obtain a licensure to treat patients. In contrast to cooperation between doctors, a division of tasks and responsibilities between non-medically trained practitioners and physicians seems to be difficult. The aim of the study was to clarify to what extent doctors in private practice are willing to cooperate with non-medically trained practitioners. At the same time, conditions, opportunities, and obstacles of cooperation are described. METHODS: In order to evaluate the willingness to collaborate with non-medically trained practitioners, semi-structured interviews were conducted with 15 physicians and 2 dentists in an outpatient setting. The interviews further focused on conditions, advantages, and obstacles to cooperation. The interviews were transcribed literally and analyzed using qualitative content analysis. RESULTS: The interviews showed that physicians partly are willing to cooperate with non-medically trained practitioners, but there were strict conditions and also some serious obstacles to cooperation. Doctors who are open-minded about collaboration consider non-medically trained practitioners as additional therapists for minor ailments. Non-medically trained practitioners would have to respect their limitations, and health insurances should launch transparent contracts for remuneration and reimbursement. Physicians showed low confidence in training programs for Heilpraktiker. Additionally, it was thought to be harmful when non-medically trained practitioners interfere with the physician-patient relationship and try to interrupt conventional treatment or medication. CONCLUSIONS: Quantitative research is necessary to quantify data and generalize results from the sample to the population of physicians. Further, the willingness of non-medically trained practitioners to collaborate with physicians should be evaluated. Physicians should try to reduce communication obstacles so that patients can speak frankly about consultations of non-medically trained practitioners.