Increasing Influenza Vaccination Uptake by Sending Reminders: A Representative Cross-Sectional Study on the Preferences of Italian Adults (Preprint)

Author:

Domnich AlexanderORCID,Grassi RiccardoORCID,Fallani ElettraORCID,Costantini GiuliaORCID,Panatto DonatellaORCID,Ogliastro Matilde,Salvatore MarcoORCID,Cambiaggi MauraORCID,Vasco AlessandroORCID,Orsi AndreaORCID,Icardi Giancarlo

Abstract

BACKGROUND

Seasonal influenza vaccination (SIV) is a well-recognized and cost-effective means to reduce the burden of influenza. However, SIV uptake is insufficient in most jurisdictions, including Italy. Evidence from countries that achieved high SIV coverage suggests that active invitation to get vaccinated may increase SIV uptake.

OBJECTIVE

The goal of this study was to explore experience and attitudes of Italian adults towards active invitation to receive SIV, triggered by different sources and delivered by different communication channels, and to assess projected benefits of this strategy.

METHODS

A cross-sectional survey on a large sample of Italian adults aged ≥18 years was conducted by using computer-assisted web interviewing. Representativeness of the adult Italian population in terms of principal socio-demographic characteristics was achieved through applying a two-stage probabilistic quota sampling.

RESULTS

Responses from 2513 subjects were analyzed. A total of 52.16% (95% CI 50.63%-54.57%) of individuals previously received invitations to undergo SIV and, compared with people who did not receive any reminder, were 3 times more likely (68.15% versus 22.17%) to be vaccinated in the last season with an adjusted odds ratio (aOR) of 6.47 (95% CI 5.35-7.83). Among other sources investigated, reminders sent by general practitioners (GPs) were perceived as more attractive and associated with the largest effect size. Analogously, more positive attitude towards SIV reminders sent by GPs were significantly (P<.001) associated with higher intentions to get the next season vaccination. As for communication channels, most participants preferred text/instant messaging (27.19%, 95% CI 25.45%-28.96%) or email (24.59%, 95% CI 22.92%-26.32%), suggesting an acceleration in the Italian digital transformation triggered by the COVID-19 pandemic. Notably, there was no statistically significant differences in terms of sex, age groups, education level and previous season vaccination between subjects preferring text messages or email, suggesting that both digital channels may have equal reachability of the principal target populations. Conversely, traditional postal letters or phone calls were preferred by only 16.99% (95% CI 15.54%-18.52%) and 8.60% (95% CI: 7.53%-9.76%) of respondents, respectively. The remaining 22.64% (95% CI: 21.02%-24.33%) did not want to receive any reminder.

CONCLUSIONS

Reminders sent by GPs via text/instant messages or email is a valuable option for increasing SIV uptake among Italian adults. Public health implications were discussed.

Publisher

JMIR Publications Inc.

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