Vaccine hesitancy (VH) remains a prime contributor to poor influenza vaccine uptake. This study explores the knowledge, attitudes and practices of community pharmacists toward influenza VH, including their personal influenza immunization attitudes and behaviours.
Methods:
A web-based cross-sectional survey questionnaire was administered to community pharmacists practising in Ontario, Canada. A 38-question survey tool explored 5 domains, including pharmacists’ personal attitudes and behaviour toward influenza immunization, their self-reported knowledge of influenza, its vaccine and vaccine hesitancy, and their attitudes, practices and experiences with influenza VH at the community pharmacy. The data were analyzed descriptively.
Results:
A total of 5530 survey invitations were e-mailed, and 885 responses were collected (response rate 16%). Two-thirds (n = 568, 65.7%) of the respondents reported receiving the influenza vaccine in the preceding season. The most frequent reasons for personal influenza immunization were prevention of disease transmission to patients, friends and family, and contribution to herd immunity. In addition to their confidence and perceived ability to identify and address influenza VH, respondents’ self-reported knowledge across a 15-item Likert questionnaire was high. Respondents reported coming across an average of 16 (SD 28) individuals hesitant to receive the influenza vaccine each week. Regular workload (n = 419, 65.6%) and insufficient time (n = 406, 65.3%) were reported as the most limiting barriers to engagement in influenza vaccine conversations.
Conclusion:
Facilitating optimal practice scope for pharmacists, and capitalizing on the convenience and accessibility of the community pharmacy setting, presents a promising means to address influenza VH. However, barriers to pharmacist-initiated engagement on influenza vaccine must be explored and addressed. Can Pharm J (Ott) 2020;153:xx-xx.
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References
1.
GlezenWP.Clinical practice. prevention and treatment of seasonal influenza. N Engl J Med2008;359(24):2579-2585.
2.
TalbotHKZhuYChenQWilliamsJVThompsonMGGriffinMR.Effectiveness of influenza vaccine for preventing laboratory-confirmed influenza hospitalizations in adults, 2011-2012 influenza season. Clin Infect Dis2013;56(12):1774-1777.
CampbellDSRumleyMH.Cost-effectiveness of the influenza vaccine in a healthy, working-age population. J Occup Environ Med1997;39(5):408-414.
5.
CiancioBCRezzaG.Costs and benefits of influenza vaccination: more evidence, same challenges. BMC Public Health2014;14:81-818.
6.
O’ReillyDJBlackhouseGBurnsS, et al. Economic analysis of pharmacist-administered influenza vaccines in Ontario, Canada. Clinicoecon Outcomes Res2018;10:655-663.
7.
OsterholmMTKelleyNSSommerABelongiaEA.Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. Lancet Infect Dis2012;12(1):36-44.
8.
JuurlinkDNStukelTAKwongJ, et al. Guillain-barre syndrome after influenza vaccination in adults: a population-based study. Arch Intern Med2006;166(20):2217-2221.
9.
HerreraGAIwaneMKCorteseM, et al. Influenza vaccine effectiveness among 50-64-year-old persons during a season of poor antigenic match between vaccine and circulating influenza virus strains: Colorado, United States, 2003-2004. Vaccine2007;25(1):154-160.
10.
NordinJMulloolyJPobleteS, et al. Influenza vaccine effectiveness in preventing hospitalizations and deaths in persons 65 years or older in Minnesota, New York and Oregon: data from 3 health plans. J Infect Dis2001;184(6):665-670.
11.
MacDonaldNE, SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: definition, scope and determinants. Vaccine2015;33(34):4161-4164.
12.
DubeEMacDonaldNE.Addressing vaccine hesitancy and refusal in Canada. CMAJ2016;188(1):17.
DubeELabergeCGuayMBramadatPRoyRBettingerJ.Vaccine hesitancy: an overview. Hum Vaccin Immunother2013;9(8):1763-1773.
15.
LarsonHJJarrettCEckersbergerESmithDMPatersonP.Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012. Vaccine2014;32(19):2150-2159.
16.
Peretti-WatelPLarsonHJWardJKSchulzWSVergerP.Vaccine hesitancy: clarifying a theoretical framework for an ambiguous notion. PLoS Curr2015;7:10.1371.
17.
SchmidPRauberDBetschCLidoltGDenkerML.Barriers of influenza vaccination intention and behavior: a systematic review of influenza vaccine hesitancy, 2005-2016. PLoS One2017;12(1):e0170550.
18.
MeyerSBLumR.Explanations for not receiving the seasonal influenza vaccine: an Ontario Canada based survey. J Health Commun2017;22(6):506-514.
19.
GarganoLMPainterJESalesJM, et al. Seasonal and 2009 H1N1 influenza vaccine uptake, predictors of vaccination and self-reported barriers to vaccination among secondary school teachers and staff. Hum Vaccin2011;7(1):89-95.
20.
WuSSuJYangP, et al. Factors associated with the uptake of seasonal influenza vaccination in older and younger adults: a large, population-based survey in Beijing, China. BMJ Open2017;7(9):e017459.
21.
DubeEGagnonDOuakkiM, et al. Understanding vaccine hesitancy in Canada: results of a consultation study by the Canadian immunization research network. PLoS One2016;11(6):e0156118.
22.
LeeTSaskinRMcArthurMMcGeerA.Beliefs and practices of Ontario midwives about influenza immunization. Vaccine2005;23(13):1574-1578.
23.
DubeEGilcaVSauvageauC, et al. Acute otitis media and its prevention by immunization: a survey of Canadian pediatricians’ knowledge, attitudes and beliefs. Hum Vaccin. 2011;7(4):429-435.
24.
DubeEGilcaVSauvageauC, et al. Canadian paediatricians’ opinions on rotavirus vaccination. Vaccine2011;29(17):3177-3182.
25.
HerzogRÁlvarez-PasquinMJDíazCDel BarrioJLEstradaJMGilÁ.Are health care workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review. BMC Public Health2013;13:154.
26.
GilcaVBoulianneNDubéESauvageauCOuakkiM.Attitudes of nurses toward current and proposed vaccines for public programs: a questionnaire survey. Int J Nurs Stud2009;46(9):1219-1235.
27.
PatersonPMeuriceFStanberryLRGlismannSRosenthalSLLarsonHJ.Vaccine hesitancy and health care providers. Vaccine2016;34(52): 6700-6706.
28.
GodinGVézina-ImLNaccacheH.Determinants of influenza vaccination among health care workers. Infect Control Hosp Epidemiol2010;31(7): 689-693.
29.
CoraceKPrematungeCMcCarthyA, et al. Predicting influenza vaccination uptake among health care workers: what are the key motivators?Am J Infect Control2013;41(8):679-684.
30.
PrematungeCCoraceKMcCarthyA, et al. Qualitative motivators and barriers to pandemic vs. seasonal influenza vaccination among health care workers: a content analysis. Vaccine2014;32(52):7128-7134.
31.
UsamiTHashiguchiMKouharaTIshiiANagataTMochizukiM.Impact of community pharmacists advocating immunization on influenza vaccination rates among the elderly. Yakugaku Zasshi2009;129(9):1063-1068.
32.
Van AmburghJAWaiteNMHobsonEHMigdenH.Improved influenza vaccination rates in a rural population as a result of a pharmacist-managed immunization campaign. Pharmacotherapy2001;21(9):1115-1122.
33.
AlsabbaghMWChurchDWengerL, et al. Pharmacy patron perspectives of community pharmacist administered influenza vaccinations. Res Social Adm Pharm2019;15(2):202-206.
WarwickDP.The KAP survey: dictates of mission versus demands of science. In: BulmerMWarwickDP, eds. Social research in developing countries: surveys and censuses in the third World. Chichester (UK): Wiley; 1993;1:349-364.
36.
PatelTChangFMohammedHT, et al. Knowledge, perceptions and attitudes toward chronic pain and its management: a cross-sectional survey of frontline pharmacists in Ontario, Canada. PloS One2016;11(6):e0157151.
37.
MuliiraJKD’SouzaMSAhmedSMAl-DhahliSNAl-JahwariFRM. Barriers to colorectal cancer screening in primary care settings: attitudes and knowledge of nurses and physicians. Asia Pac J Oncol Nurs2016;3(1):98-107.
38.
LalondeLLeroux-LapointeVChoinièreM, et al. Knowledge, attitudes and beliefs about chronic noncancer pain in primary care: a Canadian survey of physicians and pharmacists. Pain Res Manag2014;19(5):241-250.
39.
TavakolMDennickR.Making sense of Cronbach’s alpha. Int J Med Educ2011;2:53-55.
BuchanSAKwongJC.Trends in influenza vaccine coverage and vaccine hesitancy in Canada, 2006/07 to 2013/14: results from cross-sectional survey data. CMAJ Open2016;4(3):E45-E462.
42.
BetschCSchmidPHeinemeierDKornLHoltmannCBöhmR.Beyond confidence: development of a measure assessing the 5C psychological antecedents of vaccination. PLoS One2018;13(12):e0208601.
43.
KizawaYMoritaTMiyashitaM, et al. Improvements in physicians’ knowledge, difficulties and self-reported practice after a regional palliative care program. J Pain Symptom Manage2015;50(2):232-240.
44.
KarpelJPPetersJISzemaAMSmithBAndersonPJ.Differences in physicians’ self-reported knowledge of, attitudes toward and responses to the black box warning on long-acting β-agonists. Ann Allergy Asthma Immunol2009;103(4):304-310.
45.
StaffordSSedlakTFokMCWongRY.Evaluation of resident attitudes and self-reported competencies in health advocacy. BMC Med Educ2010;10:82.
46.
GinsburgLRTregunnoDNortonPG.Self-reported patient safety competence among new graduates in medicine, nursing and pharmacy. BMJ Qual Saf2013;22(2):147-154.
47.
DoylePVanDenKerkhofEGEdgeDSGinsburgLGoldsteinDH.Self-reported patient safety competence among Canadian medical students and postgraduate trainees: a cross-sectional survey. BMJ Qual Saf2015;24(2):135-141.
48.
DubeEVivionMMacDonaldNE.Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: influence, impact and implications. Expert Rev Vaccin2015;14(1):99-117.
