Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt.
Hum Vaccin Immunother. 2023 Aug;19(2):2258627. doi: 10.1080/21645515.2023.2258627. Epub 2023 Oct 1.
Vaccine hesitancy is a significant public health issue globally. We aim to document the barriers toward seasonal influenza vaccine uptake among healthcare workers (HCWs) and pregnant women (PW) in Pakistan. We performed a concurrent mixed methods study in four cities (Karachi, Islamabad, Quetta, and Peshawar) across Pakistan from September to December 2021. The quantitative component consisted of independent cross-sectional surveys for PW and HCWs, and the qualitative component comprised of in-depth interviews (IDIs) and focus group discussions (FGDs) among HCWs. Simple linear regression was used to determine the association of sociodemographic variables with knowledge, attitudes, and practices. Overall, 750 PW and 420 HCWs were enrolled. Among the PW, 44% were willing to receive the vaccine if available free of cost. Only 44% of the HCWs were vaccinated; however, 86% intended to get vaccinated and were willing to recommend the vaccine to their patients. HCWs refused vaccine due to side-effects (65%), cost (57%), and allergies (36%). An education level of secondary school and above was predictive of higher attitude and knowledge scores while having received the COVID-19 vaccine was associated with higher practice scores for both PW and HCWs. Several themes emerged from the interviews: 1) HCWs' knowledge of influenza and its prevention, 2) HCWs' perception of motivators and barriers to influenza vaccine uptake and 3) HCWs' attitudes towrd vaccine promotion. We report low influenza vaccine coverage among HCWs and PW in Pakistan. Educational campaigns addressing misconceptions, and improving affordability and accessibility through government interventions, can improve vaccine uptake.
疫苗犹豫是全球范围内一个重大的公共卫生问题。本研究旨在记录在巴基斯坦，医护人员（HCWs）和孕妇（PW）对接种季节性流感疫苗的障碍。我们在 2021 年 9 月至 12 月期间在巴基斯坦的四个城市（卡拉奇、伊斯兰堡、奎达和白沙瓦）进行了一项同时进行的混合方法研究。定量部分包括对 PW 和 HCWs 进行独立的横断面调查，定性部分包括对 HCWs 进行深入访谈（IDIs）和焦点小组讨论（FGDs）。简单线性回归用于确定社会人口统计学变量与知识、态度和实践之间的关联。总体而言，共纳入了 750 名 PW 和 420 名 HCWs。在 PW 中，如果免费提供，44%的人愿意接种疫苗。只有 44%的 HCWs 接种了疫苗；然而，86%的 HCWs 打算接种疫苗并愿意向他们的患者推荐疫苗。HCWs 因副作用（65%）、费用（57%）和过敏（36%）拒绝接种疫苗。中学及以上的教育水平与较高的态度和知识评分相关，而接种 COVID-19 疫苗与 PW 和 HCWs 的较高实践评分相关。访谈中出现了几个主题：1）HCWs 对流感及其预防的知识，2）HCWs 对接种流感疫苗的动机和障碍的看法，3）HCWs 对接种疫苗的态度。我们报告了在巴基斯坦，HCWs 和 PW 中流感疫苗接种率较低。通过政府干预措施开展教育宣传活动，解决误解问题，提高可负担性和可及性，可提高疫苗接种率。
