Department of Industrial Engineering and Management, Ben Gurion University of the Negev, Be'er Sheva, Israel.
Department of Industrial Engineering and Management, Ben Gurion University of the Negev, Be'er Sheva, Israel ; School of Management, Ono Academic College, Kiryat Ono, Israel.
Isr J Health Policy Res. 2014 Apr 25;3:13. doi: 10.1186/2045-4015-3-13. eCollection 2014.
Influenza vaccination is the most efficient and cost-effective method to prevent influenza. To increase vaccination coverage, health authorities use various intervention programs (IPs), such as cost subsidies or placing vaccination centers in malls to make vaccination more accessible. Nevertheless, vaccination coverage has been sub-optimal in most developed countries, including in Israel.
To determine possible drivers of individual vaccination uptake and to examine the effectiveness of different IPs in increasing vaccination, we analyzed a telephone survey of a representative sample of the Israeli population conducted in March 2011 (n = 470), and paper questionnaires at the work place and at homes during April-July 2011 to several sub-populations : soldiers (n = 81), medical staff (n = 107), ultra-orthodox Jews (n = 72), Israeli Arabs (n = 87) and students (n = 85).
The population can be stratified into three sub-groups: Acceptors, who receive vaccination regardless of IPs (22%), Conditional Acceptors, who are only vaccinated because of IP implementation (44%) and Non-Acceptors, who are not vaccinated despite IP implementation (34%). Our analysis shows that the risk perception towards influenza relative to vaccination is higher in the Acceptors than in the Conditional Acceptors, with the Non-Acceptors showing the lowest risk perception (P < 0.01). For Conditional Acceptors, physician recommendation is the most effective IP, regardless of the sub-population tested (P = 0.04). Students and low-income participants were more prone than any others to be persuaded to receive vaccination following IPs. In addition, financial incentives were more effective for ultra-religious orthodox Jews and students; vaccinations in more accessible areas were more effective for the ultra-religious orthodox, soldiers, and medical personnel; and TV and radio advertisements were more effective for people above 50 relative to other age groups.
Risk perception of influenza and vaccination governs the likelihood of successful implementation of IPs. Policy makers in Israel should invest efforts to increase the knowledge regarding influenza and vaccination, and should apply specific interventions customized to the preferences and diverse perceptions among the Israeli sub-populations.
流感疫苗接种是预防流感最有效和最具成本效益的方法。为了提高疫苗接种率，卫生当局使用各种干预方案（IP），例如成本补贴或在购物中心设立疫苗接种中心，以提高疫苗接种的可及性。然而，包括以色列在内的大多数发达国家的疫苗接种率一直不理想。
为了确定个体疫苗接种率的可能驱动因素，并研究不同干预方案在增加疫苗接种率方面的有效性，我们分析了 2011 年 3 月对以色列代表性人群进行的电话调查（n=470），以及 2011 年 4 月至 7 月在工作场所和家中对几个亚人群进行的纸质问卷：士兵（n=81）、医务人员（n=107）、极端正统派犹太人（n=72）、以色列阿拉伯人（n=87）和学生（n=85）。
人群可以分为三个亚组：无论 IP 如何，都会接种疫苗的接受者（22%）、仅因 IP 实施而接种疫苗的有条件接受者（44%）和不接种疫苗的不接受者（34%）。我们的分析表明，与疫苗接种相比，接受者对流感的风险感知高于有条件接受者，而不接受者的风险感知最低（P<0.01）。对于有条件接受者，医生的建议是最有效的干预方案，无论测试的亚人群如何（P=0.04）。学生和低收入参与者比其他任何人更容易在 IP 实施后接受疫苗接种。此外，对于极端正统派犹太人和学生来说，经济激励措施更为有效；在更方便的地区接种疫苗对极端正统派、士兵和医务人员更有效；电视和广播广告对 50 岁以上人群比对其他年龄段人群更有效。
流感和疫苗接种的风险感知决定了 IP 成功实施的可能性。以色列的政策制定者应努力提高人们对流感和疫苗接种的认识，并针对以色列不同亚人群的偏好和不同认知应用特定的干预措施。
