GSK, Philadelphia, PA, USA.
GSK, Philadelphia, PA, USA.
Vaccine. 2018 Nov 19;36(48):7276-7285. doi: 10.1016/j.vaccine.2018.10.027. Epub 2018 Oct 23.
Seasonal influenza results in substantial morbidity, mortality and socio-economic burden. The US Advisory Committee on Immunization Practices recommends vaccination of everyone over 6 months of age, but coverage remains substantially below the Healthy People 2020 target of 70% in most age groups. Influenza is different from other vaccine-preventable diseases in several ways that influence vaccine uptake. Although the incidence of most vaccine-preventable diseases is low, there is a perception that these diseases result in significant illness or death. In contrast, seasonal influenza has a relatively high incidence, but there is an incorrect perception of a lower disease severity. The vaccine effectiveness of seasonal influenza vaccines is less than other routine vaccines, varies from season to season between northern and southern hemispheres, and can be low in some seasons. It is also not well recognized that vaccination can attenuate the severity of influenza illness. Finally, the need for annual vaccination is perceived as a burden to busy people. Understanding these differences from the perspective of caregivers and vaccinees might help to improve influenza vaccine uptake. Presenting vaccine effectiveness in terms of clinical outcomes that have the most impact might help to overcome the perceptions that influenza is a non-serious disease and that the vaccine is not effective. The benefits of disease attenuation need to be emphasized in terms of reduced mortality, hospitalization, absenteeism and disruption to daily life. Innovative communication strategies should be adopted, including stronger recommendations from and to healthcare providers, continuous patient education, and social media initiatives employing more emotional and narrative approaches than traditionally used. Finally, access to seasonal influenza vaccination needs to be improved, and barriers such as cost and inconvenience removed. Multiple initiatives have already been successful. The remaining challenge is to translate individual successes into public health policies with corresponding funding and implementation.
季节性流感会导致大量发病、死亡和社会经济负担。美国免疫实施咨询委员会建议为所有 6 个月以上的人群接种疫苗，但大多数年龄段的覆盖率仍远低于“健康人民 2020”目标的 70%。流感在几个方面与其他可通过疫苗预防的疾病不同，这些差异影响了疫苗的接种率。虽然大多数可通过疫苗预防的疾病发病率较低，但人们普遍认为这些疾病会导致严重疾病或死亡。相比之下，季节性流感的发病率相对较高，但人们错误地认为其疾病严重程度较低。季节性流感疫苗的有效性低于其他常规疫苗，在北半球和南半球的不同季节之间存在差异，并且在某些季节可能较低。人们也没有充分认识到接种疫苗可以减轻流感的严重程度。最后，每年接种疫苗被认为是忙碌人群的负担。从照顾者和接种者的角度理解这些差异可能有助于提高流感疫苗的接种率。根据对临床结果最有影响的疫苗有效性进行表述，可能有助于克服流感不是一种严重疾病以及疫苗无效的看法。需要强调疾病减轻的好处，包括降低死亡率、住院率、缺勤率和对日常生活的干扰。应采用创新的沟通策略，包括加强医护人员的推荐和指导、持续的患者教育以及利用比传统方法更具情感和叙事性的社交媒体举措。最后，需要改善季节性流感疫苗的可及性，消除成本和不便等障碍。已经有多项举措取得了成功。剩下的挑战是将个别成功转化为具有相应资金和实施措施的公共卫生政策。
