Losing ground at the wrong time: trends in self-reported influenza vaccination uptake in Switzerland, Swiss Health Survey 2007–2017

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Abstract

We studied time trends in seasonal influenza vaccination and associations with socioeconomic and health-related determinants in Switzerland, overall and in people aged ≥65 years.

Design

Three cross-sectional surveys.

Participants

Individuals who participated in the Swiss Health Surveys 2007, 2012 and 2017. We calculated the proportion reporting influenza vaccination in the last 12 months, and performed multivariable logistic regression analyses.

Results

We included 51 582 individuals in this analysis. The median age was 49 years (IQR 25–64), and 27 518 were women (53.3%). The proportion of reporting a history of influenza vaccination overall was 31.9% (95% CI 31.4 to 32.4); and dropped from 34.5% in 2007 to 28.8% in 2017. The uptake of vaccination within the past 12 months was 16% in 2007 and similar in 2012 and 2017 (around 14%). In people with chronic disease, uptake dropped from 43.8% in 2007 to 37.1% in 2012 and to 31.6% in 2017 (p<0.001). In people aged ≥65 years, uptake dropped from 47.8% in 2007 to 38.5% in 2012 to 36.2% in 2017 (p<0.001). In logistic regression, self-reported vaccination coverage decreased in the 65–75 years old (adjusted OR (aOR) 0.56, 95% CI 0.48 to 0.66 between 2007 and 2012; aOR 0.89, 95% CI 0.77 to 1.03 between 2012 and 2017). Uptake was positively associated with the ≥65 age group, living in French-speaking and urban areas, history of smoking, bad self-reported health status, private/semiprivate health insurance, having a medical profession and having any underlying chronic disease.

Conclusion

Influenza vaccination coverage was low in older and chronically ill persons. Significant efforts are required in preparing for the influenza season 2020/2021 to reduce the double burden of COVID-19 and seasonal influenza. These efforts should include campaigns but also novel approaches using social media.

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  1. SciScore for 10.1101/2020.06.05.20123026: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablePregnancy was recorded as current pregnancy among women 15 to 49 years old.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    We visualized changes in the frequency of vaccination uptake, and geographical distributions of the population that reported vaccination for influenza at the cantonal level using ArcGIS version 10.5 (Redlands, CA, USA).
    ArcGIS
    suggested: (ArcGIS for Desktop Basic, RRID:SCR_011081)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has several limitations. Influenza vaccination status is self-reported in the Swiss Health Survey, and the reliability of the data unclear. For example, vaccination coverage could be lower if social desirability bias led to an overestimation of uptake. Conversely, incomplete recall of vaccinations could bias coverage downwards. Individuals younger than 15 years are excluded from the survey, but coverage in this age group is probably even lower than in the 15 to 19-year-olds. A strength of our analysis is the fact that the survey is a nationwide and representative, and repeated every five years using the same methodology. Also, the analyses were weighted and adjusted for a range of potential confounders, which did not substantially change the results. In conclusion, we need to increase influenza vaccination uptake, particularly in the elderly and chronically ill, who are also the risk groups most heavily affected by COVID-19. These efforts should include classic information campaigns, but novel approaches using social media should also be considered (29, 30). Recommendations by health care professionals are essential to improve influenza vaccination coverage, such as client reminder/recall and standing orders (31). The preparation of influenza season 2020/21 must start now to address the double burden of COVID-19 and seasonal influenza.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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