The intentions to get vaccinated against influenza and actual vaccine uptake among diabetic patients in Ningbo, China: identifying motivators and barriers

Lixia Ye; Ting Fang; Jun Cui; Guanghui Zhu; Rui Ma; Yexiang Sun; Pingping Li; Hui Li; Hongjun Dong; Guozhang Xu

doi:10.1080/21645515.2020.1761201

The intentions to get vaccinated against influenza and actual vaccine uptake among diabetic patients in Ningbo, China: identifying motivators and barriers

Hum Vaccin Immunother. 2021 Jan 2;17(1):106-118. doi: 10.1080/21645515.2020.1761201. Epub 2020 May 27.

Authors

Lixia Ye¹, Ting Fang¹, Jun Cui², Guanghui Zhu³, Rui Ma¹, Yexiang Sun⁴, Pingping Li⁵, Hui Li², Hongjun Dong¹, Guozhang Xu¹

Affiliations

¹ Department of Immunization and Prevention, Ningbo Municipal Center for Disease Prevention and Control , Ningbo, China.
² Department of Chronic Disease Prevention, Ningbo Municipal Center for Disease Prevention and Control , Ningbo, China.
³ Department of Preventive Health Care, Qianhu Hospital , Ningbo, China.
⁴ Information Center, Yinzhou District Center for Disease Prevention and Control , Ningbo, China.
⁵ Department of Immunization and Prevention, Jiangbei District Center for Disease Prevention and Control , Ningbo, China.

Abstract

Background: Health authorities recommend influenza vaccination to diabetic patients. Nevertheless, the vaccination coverage of adults was low in China. This study aimed to estimate influenza vaccination intentions and actual uptake among diabetic patients in China and identify the motivators and barriers associated with vaccination.

Methods: During Nov 2016-Jan 2017, 1960 diabetic patients were invited to participate in the investigation about influenza vaccination based on health belief model (HBM). To link vaccination intention to behavior, a follow-up survey was conducted to collect vaccination records of the 2016-2017 season. Predictors of the motivation to obtain influenza vaccination were assessed using logistic regressions.

Results: 1914 diabetic patients completed the survey. 46.13% participants reported intentions to be vaccinated against influenza and 7.84% actually received vaccination. In the multivariate models, while all the domains of HBM constructs were associated with intentions, age, increasing numbers of comorbidity, urban residents, perceived susceptibility, perceived benefits, free vaccination, and vaccination history displayed positive associations with vaccine uptake while increasing income and perceptions of barriers were negative predictors of vaccine uptake. Besides, interactions between perceived susceptibility and healthcare workers' (HCW's) recommendation, perceived severity and benefits, perceived severity and health-seeking behaviors, perceived benefits, and influence of family/friends had a significant positive effect modification on the vaccine uptake.

Conclusion: To improve diabetic patients' influenza vaccination and close the intention-behavior gap, multipronged strategies are required not only to increase vaccination intention by promoting HCW's recommendation to improve perceptions about influenza vaccination but also facilitate a follow through on initial intentions by implementing free influenza vaccination program funded by the government.

Keywords: Seasonal influenza vaccine; diabetes; vaccination intention; vaccine uptake.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
China
Cross-Sectional Studies
Diabetes Mellitus*
Health Knowledge, Attitudes, Practice
Humans
Influenza Vaccines*
Influenza, Human* / prevention & control
Intention
Surveys and Questionnaires
Vaccination

Substances

Influenza Vaccines

Grants and funding

This work was supported by Ningbo Health Branding Subject Fund [ppxk2018–10]; Zhejiang Provincial Key Medical Discipline “Field Epidemiology” program [07–013]; The Science and Technology Planning Project of Ningbo [2017C50063]. The views expressed in this report are those of the authors and not necessarily the official position of the Centers for Disease Control and Prevention.