Yuan Jiehu, Li Lan, Dong Meihong, So Hau Chi, Cowing Benjamin J, Ip Dennis Kai Ming, Liao Qiuyan
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Centre for Digital Public Health in Emergencies, Institute for Risk and Disaster Reduction, University College London, London, UK.
Commun Med (Lond). 2024 Aug 16;4(1):165. doi: 10.1038/s43856-024-00585-w.
Seasonal influenza vaccine (SIV) greatly reduces disease burden among school-aged children, yet parental vaccine hesitancy remains a persistent challenge. Two types of SIV are available for children in Hong Kong and other locations: inactivated influenza vaccine (IIV), administered through intramuscular injection, and live attenuated influenza vaccine (LAIV), administered via nasal spray. We aimed to understand how vaccine hesitancy shaped parental preference for LAIV versus IIV, particularly amidst important public health events, such as the COVID-19 pandemic and the massive rollout of COVID-19 vaccination campaigns.
We employed a concurrent mixed-methods design. The quantitative part involves longitudinal surveys spanning three years, from pre-pandemic to post-pandemic periods, tracking parental vaccine hesitancy and preference for SIV types. The qualitative part involves 48 in-depth interviews, providing insights into parental preference for SIV types, underlying reasons, and related values.
Our quantitative analyses show an overall increase in parental vaccine hesitancy and preference for LAIV over IIV after the onset of the COVID-19 pandemic and especially after the rollout of the COVID-19 vaccination campaign. Further logistic regression modelling based on the cohort data shows that higher vaccine hesitancy, coupled with the COVID-19 vaccination campaign rollout, predicts a greater preference for LAIV over IIV. The qualitative analysis complements these results, highlighting that LAIV's non-invasive nature aligns with parental values of prioritizing natural immunity and concerns about overmedication, leading to a more acceptable attitude towards LAIV.
Leveraging the higher acceptability of LAIV compared to IIV among parents with high vaccine hesitancy could promote childhood vaccination uptake.
季节性流感疫苗（SIV）可大幅降低学龄儿童的疾病负担，但家长对疫苗的犹豫态度仍是一个长期挑战。在香港和其他地区，有两种类型的SIV可供儿童使用：通过肌肉注射接种的灭活流感疫苗（IIV）和通过鼻喷接种的减毒活流感疫苗（LAIV）。我们旨在了解疫苗犹豫如何影响家长对LAIV和IIV的偏好，特别是在重要的公共卫生事件期间，如COVID-19大流行和COVID-19疫苗接种运动的大规模开展。
我们采用了同步混合方法设计。定量部分包括从大流行前到流行后三年的纵向调查，跟踪家长对疫苗的犹豫态度和对SIV类型的偏好。定性部分包括48次深入访谈，深入了解家长对SIV类型的偏好、潜在原因和相关价值观。
我们的定量分析表明，在COVID-19大流行开始后，尤其是在COVID-19疫苗接种运动开展后，家长对疫苗的犹豫态度总体增加，且对LAIV的偏好超过IIV。基于队列数据的进一步逻辑回归模型显示，较高的疫苗犹豫态度，再加上COVID-19疫苗接种运动的开展，预示着对LAIV的偏好超过IIV。定性分析补充了这些结果，强调LAIV的非侵入性符合家长优先考虑自然免疫和担心过度用药的价值观，从而导致对LAIV的态度更易接受。
利用LAIV在疫苗犹豫程度高的家长中比IIV具有更高可接受性这一特点，可促进儿童疫苗接种率的提高。
