Clinical Medicine Journal
Articles Information
Clinical Medicine Journal, Vol.7, No.1, Mar. 2021, Pub. Date: Mar. 17, 2021
A Cross Sectional Study: Knowledge, Attitude, Perception and Practice Towards Influenza Vaccine Among Undergraduate Students
Pages: 7-21 Views: 1091 Downloads: 221
Authors
[01] Kieren Low Chitra Karan, Faculty of Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia.
[02] Jemima Thomas, Faculty of Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia.
[03] Sonia Chitra Karan, Faculty of Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia.
[04] Muhammad Hafiz bin Abd Rahim, Faculty of Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia.
Abstract
Annual influenza epidemics are estimated to result in about 3 to 5 million cases of severe respiratory illness and about 290,000 to 650,000 respiratory deaths. These burden of illness causes considerably high morbidity and mortality worldwide. With that being said, vaccines have undoubtedly become the best preventive measure for various diseases, more so for the influenza. This study was conducted to understand the knowledge, perception, attitude and practice of undergraduate students towards the influenza vaccine. This cross-sectional study had been conducted from November 2020 to December 2020 with the help of a questionnaire. This questionnaire consisted of 5 sections which included: Sociodemographic information, knowledge of flu vaccines overall, attitude towards flu vaccinations, risk perception, and attitude towards the influenza vaccination which had all been completed by 280 students. Statistical tests (Unpaired T-test, ANOVA, Chi square, logistic regression) had been done using Epi info V7.2.4. From the knowledge section of the questionnaire, the participants can be divided into 3 categories for knowledge: high, low and moderate where at which, 3.57% of the participants had been in the high category, 71.07% for low and 25.36% had been in moderate. Attitude of the students towards influenza vaccination, along with perception and knowledge had no significant association with age, gender, ethnicity, previous history of influenza vaccination, smoking status, history of chronic illness or living with susceptible individuals. However, there had been a positive association between smoking status and influenza vaccination uptake, with smokers more likely to be vaccinated compared to non-smokers. In addition to this, Indian and Malay populations were more likely to be vaccinated compared to that of Chinese populations.
Keywords
Knowledge, Attitude, Perception, Practice, Undergraduate Students, Influenza Vaccination, Cross-sectional Study, Malaysia
References
[01] Influenza [Internet]. World Health Organization. 2020 [cited 2020 Dec 13]. Available from: https://www.who.int/immunization/diseases/influenza/en/
[02] Sam, J. (2015). The burden of human influenza in Malaysia. The Medical journal of Malaysia. 70. 127-30. https://www.researchgate.net/publication/280969254_The_burden_of_human_influenza_in_Malaysia
[03] Influenza (Seasonal) [Internet]. Who.int. 2020 [cited 2020 Dec 13]. Available from: https://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal)
[04] Zhou F, Shefer A, Wenger J, Messonnier M, Wang LY, Lopez A, Moore M, Murphy TV, Cortese M, Rodewald L. Economic evaluation of the routine childhood immunization program in the United States, 2009. Pediatrics. 2014 Apr; 133 (4): 577-85. doi: 10.1542/peds.2013-0698. Epub 2014 Mar 3. PMID: 24590750.
[05] Kim, T. H., Johnstone, J., & Loeb, M. (2011). Vaccine herd effect. Scandinavian journal of infectious diseases, 43 (9), 683–689. https://doi.org/10.3109/00365548.2011.582247
[06] Sugaya N. A review of the indirect protection of younger children and the elderly through a mass influenza vaccination program in Japan. Expert Rev Vaccines. 2014 Dec; 13 (12): 1563-70. doi: 10.1586/14760584.2014.951036. Epub 2014 Aug 20. PMID: 25138431.
[07] Andre, F. E., Booy, R., Bock, H. L., Clemens, J., Datta, S. K., John, T. J., Lee, B. W., Lolekha, S., Peltola, H., Ruff, T. A., Santosham, M., & Schmitt, H. J. (2008). Vaccination greatly reduces disease, disability, death and inequity worldwide. Bulletin of the World Health Organization, 86 (2), 140–146. https://doi.org/10.2471/blt.07.040089
[08] WHO – Influenza vaccination coverage and effectiveness – Homepage. https://www.euro.who.int/en/health-topics/communicable-diseases/influenza/vaccination/influenza-vaccination-coverage-and-effectiveness January 12, 2021.
[09] OECD (2021), Influenza vaccination rates (indicator). doi: 10.1787/e452582e-en (Accessed on 12 January 2021)
[10] CDC – Flu Vaccination Coverage, United States, 2019–20 Influenza Season– Homepage. https://www.cdc.gov/flu/fluvaxview/coverage-1920estimates.htm. January 12, 2021.
[11] Www1.health.gov.au. 2000. Department Of Health | Communicable Diseases Intelligence, Volume 24, Number 3 - 16 March 2000. [online] Available at: [Accessed 12 January 2021].
[12] Www1.health.gov.au. 2000. Department Of Health | Factors Influencing Vaccination Uptake. [online] Available at: [Accessed 12 January 2021].
[13] Thompson SC, Ogilvie EL, Veit FC, Crofts N. Juvenile offenders and hepatitis B: risk, vaccine uptake and vaccination status. Med J Aust 1998; 169: 306-309
[14] Hudu, Shuaibu & Harmal, Nabil & Osman, Malina & Sekawi, Zamberi. (2016). Influenza vaccination among Malaysian healthcare workers: a survey of coverage and attitudes. The Medical journal of Malaya. 71. 231-237.
[15] K. K. Lim, Y. Y. Chan, A. Noor Ani, J. Rohani, Z. A. Siti Norfadhilah, M. R. Santhi, Complete immunization coverage and its determinants among children in Malaysia: findings from the National Health and Morbidity Survey (NHMS) 2016, Public Health, Volume 153, 2017, Pages 52-57, ISSN 0033-3506, https://doi.org/10.1016/j.puhe.2017.08.001. (http://www.sciencedirect.com/science/article/pii/S0033350617302743)
[16] Psasir.upm.edu.my. 2021. Immunisation Status In Hospitalised Infants: Reasons For Incomplete Immunisation - Universiti Putra Malaysia Institutional Repository. [online] Available at: [Accessed 12 January 2021].
[17] Burden of Influenza [Internet]. Centers for Disease Control and Prevention. 2020 [cited 2020 Dec 13]. Available from: https://www.cdc.gov/flu/about/burden/index.html
[18] Sam I, Abdul-Murad A, Karunakaran R, Rampal S, Chan Y, Nathan A, Ariffin H. Clinical features of Malaysian children hospitalized with community-acquired seasonal influenza. International Journal of Infectious Diseases. 2010; 14: e36-e40. https://www.ijidonline.com/article/S1201-9712(10)00008-1/fulltext
[19] Khor C, Sam I, Hooi P, Quek K, Chan Y. Epidemiology and seasonality of respiratory viral infections in hospitalized children in Kuala Lumpur, Malaysia: a retrospective study of 27 years. BMC Pediatrics. 2012; 12 (1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337250/
[20] Z S, TR A, MA Y, FM K, R T, LS K, KA O, TS S. Seasonal influenza virus strains circulating in Malaysia from 2005 to 2009 [Internet]. PubMed. 2020 [cited 2020 Dec 13]. Available from: https://pubmed.ncbi.nlm.nih.gov/21329312/
[21] Sam I, Shaw R, Chan Y, Hooi P, Hurt A, Barr I. Seroprevalence of Seasonal and Pandemic Influenza A in Kuala Lumpur, Malaysia in 2008-2010. Journal of Medical Virology. 2013; 85 (8): 1420-1425.
[22] Anikeeva O, Braunack-Mayer A, Rogers W. Requiring influenza vaccination for health care workers. Am J Public Health. 2009; 99 (1): 24-29. doi: 10.2105/AJPH.2008.136440
[23] Rashwan H, Jafar MH, Hussaini HM, Isahak I, Young SM. Knowledge, Attitude and Vaccination Status for Influenza Among Dentistry Staff and Students of Universiti Kebangsaan Malaysia. Int J Infect Dis 2008; 12: e141.
[24] Matthew M. Loiacono, Salaheddin M. Mahmud, Ayman Chit, Robertus van Aalst, Jeffrey C. Kwong, Nicholas Mitsakakis, Luke Skinner, Edward Thommes, Hélène Bricout, Paul Grootendorst, Patient and practice level factors associated with seasonal influenza vaccine uptake among at-risk adults in England, 2011 to 2016: An age-stratified retrospective cohort study, Vaccine: X, Volume 4, 2020
[25] Gasparini R, Amicizia D, Lai PL, Bragazzi NL, Panatto D. Compounds with anti-influenza activity: present and future of strategies for the optimal treatment and management of influenza Part II: Future compounds against influenza virus. J PrevMed Hyg 2014; 55: 109-29.
[26] Gasparini R, Amicizia D, Lai PL, Panatto D. Influenza vaccination: from epidemiological aspects and advances in research to dissent and vaccination policies. J Prev Med Hyg 2016; 57: E1-E4.
[27] Barberis I, Myles P, Ault SK, Bragazzi NL, Martini M. History and evolution of influenza control through vaccination: from the first monovalent vaccine to universal vaccines. J Prev Med Hyg 2016; 57: E115-20.
[28] Klein S. L., Pekosz A., Passaretti C., Anker M., Olukoya P. (2010) Sex, Gender and Influenza. World Health Organization, Geneva, 1–58.
[29] Wilhelm M. Influenza in older patients: a call to action and recent updates for vaccinations. Am J Manag Care. 2018 Mar; 24 (2 Suppl): S15-S24. PMID: 29521514.
[30] Jun Jean Ong1, Sharmathi Dhanapal1, Yuki Julius We Yong Ng1, Wei Cheen Gan1 and Xin Yi Chan Knowledge, Attitudes And Practices Of Medical Students Regarding Influenza Vaccination, 2019.
[31] Cvjetkovic SJ, Jeremic VL, Tiosavljevic DV. Knowledge and attitudes toward vaccination: A survey of Serbian students. J Infect Public Health. 2017 Sep-Oct; 10 (5): 649-656. doi: 10.1016/j.jiph.2017.05.008. Epub 2017 Jun 29. PMID: 28669785.
[32] Rogers, C. J., Bahr, K. O. & Benjamin, S. M. Attitudes and barriers associated with seasonal influenza vaccination uptake among public health students; a cross-sectional study. BMC Public Health 18, 1131 (2018). https://doi.org/10.1186/s12889-018-6041-1.
[33] Ryan KA, Filipp SL, Gurka MJ, Zirulnik A, Thompson LA. Understanding influenza vaccine perspectives and hesitancy in university students to promote increased vaccine uptake. Heliyon. 2019 Oct 12; 5 (10): e02604. doi: 10.1016/j.heliyon.2019.e02604. PMID: 31667418; PMCID: PMC6812243.)
[34] Costantino C, Vitale F. Influenza vaccination in high-risk groups: a revision of existing guidelines and rationale for an evidence-based preventive strategy. J Prev Med Hyg. 2016; 57 (1): E13-E18.
[35] ECDC Technical Report. Seasonal influenza vaccination in Europe: overview of vaccination recommendations and coverage rates in the EU Member States for the 2012-13 influenza season. Available online at: http://ecdc.europa.eu/en/publications/Publications/Seasonal-influenza-vaccination-Europe-2012-13.pdf [Accessed 08/02/2016]. [Ref list]
[36] Riccò M, Cattani S, Casagranda F, Gualerzi G, Signorelli C. Knowledge, attitudes, beliefs and practices of Occupational Physicians towards seasonal influenza vaccination: a cross-sectional study from North-Eastern Italy. J Prev Med Hyg. 2017; 58 (2): E141-E154.
[37] Abalkhail, M. S., Alzahrany, M. S., Alghamdi, K. A., Alsoliman, M. A., Alzahrani, M. A., Almosned, B. S., Gosadi, I. M., & Tharkar, S. (2017). Uptake of influenza vaccination, awareness and its associated barriers among medical students of a University Hospital in Central Saudi Arabia. Journal of infection and public health, 10 (5), 644–648. https://doi.org/10.1016/j.jiph.2017.05.001
[38] Khazaeipour, Z., Ranjbarnovin, N., & Hoseini, N. (2010). Influenza immunization rates, knowledge, attitudes and practices of health care workers in Iran. Journal of infection in developing countries, 4 (10), 636–644. https://doi.org/10.3855/jidc.1152
[39] Rashid, Z. Z., Jasme, H., Liang, H. J., Yusof, M. M., Sharani, Z. Z., Mohamad, M., Ismail, Z., Sulong, A., & Jalil, N. A. (2015). INFLUENZA VACCINATION UPTAKE AMONG HEALTHCARE WORKERS AT A MALAYSIAN TEACHING HOSPITAL. The Southeast Asian journal of tropical medicine and public health, 46 (2), 215–225.
[40] Park, Jung & Lee, Soo & Lee, Ji & Kyungdo, Han & Kim, Ji & Yoon, Jin & Park, Suk & Kim, Yang-Hyun & Cho, Kyung-Hwan. (2018). The Association between Smoking Status and Influenza Vaccination Coverage Rate in Korean Adults: Analysis of the 2010–2012 Korea National Health and Nutrition Examination Survey. Korean Journal of Family Medicine. 39. 90. 10.4082/kjfm.2018.39.2.90.
[41] Zhiqi Zhang. 2018. Knowledge, Attitudes and Practices Towards Seasonal Influenza and Vaccine among Private High School Students in Connecticut. In Proceedings of the 2018 2nd International Conference on Computational Biology and Bioinformatics (ICCBB 2018). Association for Computing Machinery, New York, NY, USA, 12–17. DOI: https://doi.org/10.1145/3290818.3290829
[42] Abu Hammour, W., & Al-Saleh, S. (2019). Knowledge, attitudes, and practice of healthcare workers toward influenza vaccination at Al Jalila Children's Specialty Hospital (AJCH), Dubai, UAE. International journal of pediatrics & adolescent medicine, 6 (1), 16–20. https://doi.org/10.1016/j.ijpam.2019.01.001
[43] Ermenlieva NM, Tsankova GS, Todorova TT. Seasonal influenza vaccination: knowledge, attitude and practice in Varna, Bulgaria. Ther Adv Vaccines Immunother. 2019; 7: 2515135519868152. Published 2019 Sep 25. doi: 10.1177/2515135519868152.
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