A comparative assessment of attitudes and hesitancy for influenza vis-à-vis COVID-19 vaccination among healthcare students and professionals in Malta.

Introduction: Vaccine hesitancy has been a public health threat for decades, even among healthcare professionals. The study explored vaccination attitudes and hesitancy with regard to seasonal influenza and the anticipated Covid-19 vaccines among healthcare professionals and students. Methods: Anonymous questionnaires were distributed through electronic mail to healthcare professionals working in Malta's Health Division, at University of Malta, and in community pharmacies, and to members of Malta College of Family Doctors. Results: The response rate was 18.60% (n = 1802). The percentages of those who took the influenza vaccine last year (2019) and who will take it this year (2020) increased across professionals, highest for family doctors and lowest for trainees in family medicine. The proportion of those likelier to take the Covid-19 vaccine was directly related to likelihood of taking influenza vaccination. Both family doctor trainees and nurses showed the highest Covid-19 vaccine hesitancy. Concerns pertaining to COVID-19 vaccination were mostly related to insufficient knowledge, although pharmacists (community, academic and students) were concerned about the rapid approval of the vaccine. Conclusion: An increase in influenza vaccine uptake is expected in view of the current Covid-19 pandemic. Of concern is the hesitancy towards Covid-19 vaccine particular within healthcare professionals, a cohort expected to be insightful and potential role models for the community. The associated hesitancy for both COVID-19 and influenza vaccination infers an intrinsic degree of vaccine hesitancy, which brings forward the need for healthcare professionals to be engaged in education, vaccination policies and administration in order to ensure compliance. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-021-01585-z.

[Influenza]. / Influenza.

Influenza is the infectious disease with the highest population-based mortality. It mainly affects those aged 60 years and older, mainly due to immune senescence, which also favors complicated courses and compromises vaccine effectiveness. Therefore, various approaches have been developed for more immunogenic vaccines, which are now available for use. The Ständige Impfkommission (STIKO) has taken this into account in its current recommendation on influenza vaccination and has recommended a quadrivalent, inactivated high-dose vaccine as the standard vaccine for all ≥ 60-year-olds. Despite these successes, vaccination for prevention remains underutilized. Germany has never reached the WHO vaccination target of 75% of the elderly population. The main reasons for this are a lack of confidence in the effectiveness of vaccination, a lack of/restricted risk perception of the disease, and barriers to implementation. Initial approaches to overcoming these barriers, such as low-threshold vaccination services by involving pharmacies, are being implemented. However, further steps are needed to realize the potential of influenza vaccination, especially for such vulnerable groups as older adults.

Internet use habits and influenza vaccine uptake among US adults: results from seven years (2012-2018) of the National Health Interview Survey.

STUDY DESIGN: This is a Cross-sectional data analysis study. OBJECTIVES: Our goal was to examine the association between internet use habits and influenza vaccination uptake using a nationally representative sample of non-institutionalised US adults. STUDY DESIGN: This is a Cross-sectional data analysis study. METHODS: We pooled data from seven years (2012-2018) of the National Health Interview Survey for secondary data analysis (N = 220,570). We estimated influenza vaccination uptake among different population groups. We performed multivariable logistic regression models with influenza vaccination uptake as a dichotomous dependent variable. RESULTS: Influenza vaccination uptake was highest among those who used the internet for formal health information and communication with a provider (55.1%), and lowest among those internet users who did not use the internet for any type of formal or informal health information and communication (35.6%). About 45.2% of non-internet users received an influenza vaccination during the last 12 months. After controlling for covariates, compared with those who did not use the internet, adults who used the internet for formal health information and communication with providers were 1.52 times more likely to uptake an influenza vaccine (odds ratio [OR] = 1.52; 95% confidence interval [CI] = 1.45-1.59). Internet users who did not use the internet for any health information were significantly less likely to get vaccinated against influenza (OR = 0.92; 95% CI = 0.88-0.96). CONCLUSIONS: It appears that internet use habit impacts influenza vaccination uptake. Internet users who do not use the internet for any formal or informal health information tend to have lower rates of influenza vaccine uptake than other groups. Customised interventions for different populations based on their internet use habits can help increase the national influenza vaccination rate and other immunisation efforts for contagious diseases.

Will Participatory Syndromic Surveillance Work in Latin America? Piloting a Mobile Approach to Crowdsource Influenza-Like Illness Data in Guatemala.

BACKGROUND: In many Latin American countries, official influenza reports are neither timely nor complete, and surveillance of influenza-like illness (ILI) remains thin in consistency and precision. Public participation with mobile technology may offer new ways of identifying nonmedically attended cases and reduce reporting delays, but no published studies to date have assessed the viability of ILI surveillance with mobile tools in Latin America. We implemented and assessed an ILI-tailored mobile health (mHealth) participatory reporting system. OBJECTIVE: The objectives of this study were to evaluate the quality and characteristics of electronically collected data, the user acceptability of the symptom reporting platform, and the costs of running the system and of identifying ILI cases, and to use the collected data to characterize cases of reported ILI. METHODS: We recruited the heads of 189 households comprising 584 persons during randomly selected home visits in Guatemala. From August 2016 to March 2017, participants used text messages or an app to report symptoms of ILI at home, the ages of the ILI cases, if medical attention was sought, and if medicines were bought in pharmacies. We sent weekly reminders to participants and compensated those who sent reports with phone credit. We assessed the simplicity, flexibility, acceptability, stability, timeliness, and data quality of the system. RESULTS: Nearly half of the participants (47.1%, 89/189) sent one or more reports. We received 468 reports, 83.5% (391/468) via text message and 16.4% (77/468) via app. Nine-tenths of the reports (93.6%, 438/468) were received within 48 hours of the transmission of reminders. Over a quarter of the reports (26.5%, 124/468) indicated that at least someone at home had ILI symptoms. We identified 202 ILI cases and collected age information from almost three-fifths (58.4%, 118/202): 20 were aged between 0 and 5 years, 95 were aged between 6 and 64 years, and three were aged 65 years or older. Medications were purchased from pharmacies, without medical consultation, in 33.1% (41/124) of reported cases. Medical attention was sought in 27.4% (34/124) of reported cases. The cost of identifying an ILI case was US $6.00. We found a positive correlation (Pearson correlation coefficient=.8) between reported ILI and official surveillance data for noninfluenza viruses from weeks 41 (2016) to 13 (2017). CONCLUSIONS: Our system has the potential to serve as a practical complement to respiratory virus surveillance in Guatemala. Its strongest attributes are simplicity, flexibility, and timeliness. The biggest challenge was low enrollment caused by people's fear of victimization and lack of phone credit. Authorities in Central America could test similar methods to improve the timeliness, and extend the breadth, of disease surveillance. It may allow them to rapidly detect localized or unusual circulation of acute respiratory illness and trigger appropriate public health actions.

Cell alterations induced by a biotherapic for influenza / Cell alterations induced by a biotherapic for influenza

Introduction: Influenza viruses have been responsible for highly contagious acute respiratory illnesses with high mortality, mainly in the elderly, which encourages the development of new drugs for the treatment of human flu. The biotherapics are medicines prepared from biological products, which are not chemically defined. They are compounded following the homeopathic procedures indicated for infectious diseases with known etiology [1]. Aim: The purpose of the present study is to verify cellular alterations induced by a biotherapic prepared from the infectious influenza A virus. Methodology: This biotherapic was prepared for this study in the homeopathic potency of 30X according to the Brazilian Homeopathic Pharmacopeia [2]. The concentration of 10% was not cytotoxic to cells, as verified by neutral red assay. The cellular alterations observed in MDCK cells were analyzed by optical microscopy for the quantification of mitosis, nucleoli and lipid bodies. The mitochondrial activity was assessed by MTT assay and the phosphosfructokinase-1 (PFK-1) enzyme activity was analyzed on the MDCK cells treated for 5, 10 and 30 days. Macrophages J778.G8 were treated with this biotherapic to evaluate the immunostimulatory cytokine release. Results: The cellular alterations observed in MDCK cells were verified by optical microscopy. The number of lipid bodies present in MDCK cells stimulated for 10 days was significantly lower (p <0.05) when compared to controls. The biotherapic significantly increased (p <0.05) the number of mitosis and the mitochondrial activity of MDCK cells stimulated for 10 and 30 days. These changes were confirmed by a significant reduction (p <0.05) on the PFK-1 activity. These results suggest that the biotherapic was able to activate the Krebs cycle and pentosephosphate metabolism to the generation of amino acids and nucleotides, situations common to cells whose rate of mitosis is increased. The quantification of immunostimulatory cytokines by macrophages J774.G8 indicated that the tumor necrosis factor (TNF-?) production was higher (p <0.05) in the supernatant of the macrophages pre-treated with this biotherapic and infected with influenza virus, suggesting an activation of the macrophages by this biotherapic. Conclusion: This biotherapic is able to induce some cellular alterations, which show strong evidence that it might be a promising option for the human flu. New experiments are being developed to understand the mechanisms of action of this biotherapic.(AU)

Cell alterations induced by a biotherapic for influenza / Cell alterations induced by a biotherapic for influenza

Introduction: Influenza viruses have been responsible for highly contagious acute respiratory illnesses with high mortality, mainly in the elderly, which encourages the development of new drugs for the treatment of human flu. The biotherapics are medicines prepared from biological products, which are not chemically defined. They are compounded following the homeopathic procedures indicated for infectious diseases with known etiology [1]. Aim: The purpose of the present study is to verify cellular alterations induced by a biotherapic prepared from the infectious influenza A virus. Methodology: This biotherapic was prepared for this study in the homeopathic potency of 30X according to the Brazilian Homeopathic Pharmacopeia [2]. The concentration of 10% was not cytotoxic to cells, as verified by neutral red assay. The cellular alterations observed in MDCK cells were analyzed by optical microscopy for the quantification of mitosis, nucleoli and lipid bodies. The mitochondrial activity was assessed by MTT assay and the phosphosfructokinase-1 (PFK-1) enzyme activity was analyzed on the MDCK cells treated for 5, 10 and 30 days. Macrophages J778.G8 were treated with this biotherapic to evaluate the immunostimulatory cytokine release. Results: The cellular alterations observed in MDCK cells were verified by optical microscopy. The number of lipid bodies present in MDCK cells stimulated for 10 days was significantly lower (p <0.05) when compared to controls. The biotherapic significantly increased (p <0.05) the number of mitosis and the mitochondrial activity of MDCK cells stimulated for 10 and 30 days. These changes were confirmed by a significant reduction (p <0.05) on the PFK-1 activity. These results suggest that the biotherapic was able to activate the Krebs cycle and pentosephosphate metabolism to the generation of amino acids and nucleotides, situations common to cells whose rate of mitosis is increased. The quantification of immunostimulatory cytokines by macrophages J774.G8 indicated that the tumor necrosis factor (TNF-?) production was higher (p <0.05) in the supernatant of the macrophages pre-treated with this biotherapic and infected with influenza virus, suggesting an activation of the macrophages by this biotherapic. Conclusion: This biotherapic is able to induce some cellular alterations, which show strong evidence that it might be a promising option for the human flu. New experiments are being developed to understand the mechanisms of action of this biotherapic.