Wong Voon Son, Teh Yu Hao, Leong Pooi Pooi, Tay Li Lian, Ahmad Miswan Norazinizah, Ng Teck Han, Kang Waye Hann
Department of Medicine, M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, MYS.
Department of Preclinical Science, M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, MYS.
Cureus. 2025 Jul 23;17(7):e88564. doi: 10.7759/cureus.88564. eCollection 2025 Jul.
Introduction Influenza poses a significant risk to patients receiving hemodialysis, while vaccination reduces the risk of hospitalization, cardiovascular events, and mortality. However, the influenza vaccine uptake rate is low in low- and middle-income countries. This study aimed to assess influenza vaccination coverage, knowledge, and intentions regarding influenza vaccination, as well as to identify sociodemographic and clinical factors associated with vaccination intention among patients undergoing hemodialysis in the Klang Valley, Malaysia. Materials and methods An observational cross-sectional study was conducted in three private and two public dialysis centers in Malaysia between August and December 2024. Data were collected from patients receiving hemodialysis using a structured questionnaire. There were twelve questions with dichotomous scoring (correct = 1, incorrect/unsure = 0). The scores were later categorized as poor (0-4), moderate (5-7), and good (8-12), with the cut-off points based on tertile distribution. Statistical analyses were performed to determine associations between variables related to knowledge of influenza and its vaccine, as well as predictors of influenza vaccination intention. Results Only 10.8% of 298 respondents had been vaccinated at least once in their lifetime, despite 90% being aware of influenza and its vaccine. Social media (31.5%) and television (23.5%) were the two primary sources of information. The influenza vaccination intention rate is only 40.3%, despite 74.2% of respondents having moderate to good levels of knowledge about the vaccine. Good knowledge level (aOR=6.58, 95% CI 3.145-13.889, p<0.001), female gender (aOR=1.721, 95% CI 1.108-2.915, p=0.043), Chinese ethnicity (aOR=2.443, 95% CI 1.273-4.689, p=0.007), and recommendation by healthcare providers (aOR=3.64, 95% CI 1.497-8.836, p=0.004) are significant predictors for influenza vaccination intention. Conclusions This study highlights the significant misconceptions about influenza and its vaccine among patients receiving hemodialysis in Malaysia. Targeted public health campaigns and healthcare professional engagements are crucial in improving vaccination intention rates in this vulnerable population. Addressing these knowledge gaps could reduce influenza-related complications and mortality among these patients.
引言
流感对接受血液透析的患者构成重大风险，而接种疫苗可降低住院风险、心血管事件风险和死亡率。然而，低收入和中等收入国家的流感疫苗接种率较低。本研究旨在评估马来西亚巴生谷地区接受血液透析患者的流感疫苗接种覆盖率、对流感疫苗接种的知识和意愿，并确定与接种意愿相关的社会人口统计学和临床因素。
材料与方法
2024年8月至12月期间，在马来西亚的三家私立和两家公立透析中心进行了一项观察性横断面研究。使用结构化问卷从接受血液透析的患者中收集数据。有12个采用二分法评分的问题（正确=1，错误/不确定=0）。随后，分数被分为差（0-4分）、中（5-7分）和好（8-12分）三类，截断点基于三分位数分布。进行统计分析以确定与流感及其疫苗知识相关的变量之间的关联，以及流感疫苗接种意愿的预测因素。
结果
在298名受访者中，只有10.8%的人一生中至少接种过一次疫苗，尽管90%的人知道流感及其疫苗。社交媒体（31.5%）和电视（23.5%）是两个主要信息来源。尽管74.2%的受访者对疫苗有中等至良好的了解，但流感疫苗接种意愿率仅为40.3%。良好的知识水平（调整后比值比[aOR]=6.58，95%置信区间[CI]3.145-13.889，p<0.001）、女性（aOR=1.721，95%CI 1.108-2.915，p=0.043）、华裔（aOR=2.443，95%CI 1.273-4.689，p=0.007）以及医护人员的建议（aOR=3.64，95%CI 1.497-8.836，p=0.004）是流感疫苗接种意愿的重要预测因素。
结论
本研究凸显了马来西亚接受血液透析患者对流感及其疫苗存在重大误解。有针对性的公共卫生宣传活动和与医护人员的互动对于提高这一弱势群体的疫苗接种意愿率至关重要。填补这些知识空白可以减少这些患者中与流感相关的并发症和死亡率。
