Acceptability of A/H1N1 vaccination during pandemic phase of influenza A/H1N1 in Hong Kong: population based cross sectional survey
BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4164 (Published 27 October 2009) Cite this as: BMJ 2009;339:b4164
All rapid responses
Lau et al highlight the importance of understanding H1N1 vaccine
acceptability1. The need to commence the vaccination programme in the UK
ahead of the predicted ‘second wave’ has resulted in scant opportunity to
research the views of target populations to the H1N1 vaccine. Lau et al
emphasise the variation between Governments, with some like the US
reluctant to embark on mass vaccination until vaccine trials are
completed. Professional opinion appears divided elsewhere, with the
President of the German College of General Practitioners and Family
Physicians considering the risks of the vaccine Pandemrix (used in both
Germany and the UK) to outweigh its benefits2.
Such opinions are not contained within national borders, and may
influence vaccine acceptability amongst target groups within the UK. This
may be particularly relevant to those who have recently migrated from, or
maintain strong links with, countries where official ambivalence to the
vaccine is more evident than in Britain. Internationally divergent
official opinion may feed ‘vaccine anxieties’ of some within UK-born
populations also3 .
We are undertaking a pilot, qualitative study comparing the views
regarding swine flu vaccination of a small sample of pregnant recent
migrants from Poland with an equivalent group of Scottish women. 2009 will
see approximately 600 babies born to Polish women in NHS Lothian maternity
units (one third of the Scottish total to women in this group)4 . Poland
is adopting a conservative ‘wait and see’ approach to vaccination which
conflicts with the more proactive UK approach. Recently-completed
qualitative research in Lothian shows Polish women actively participate in
both UK and Polish systems of antenatal care, moving between Scotland and
Poland for ultrasound scans, medicines and advice. Expectations derived
from Poland form the basis for their evaluation of care received in
Scotland.
Recognition of the considerable heterogeneity in the UK population
may help frontline staff to tailor information to address the concerns of
individuals.
Judith Sim, Senior Researcher
S Vittal Katikireddi, Specialty Registrar in Public Health
Dermot Gorman, Consultant in Public Health
Agata Ulanika, Honorary Clinical Researcher
1. Lau et al, 2009, Acceptability of A/H1N1 vaccination during
pandemic phase of influenza A/H1N1 in Hong Kong: population based cross
sectional survey BMJ;339 b4164
2. Stafford, N, 2009, Only 12% of Germans say they will have H1N1
vaccine after row blows up over safety of adjuvants BMJ 2009;339:b4335
3. Fairhead, J and M. Leach, 2007, Vaccine anxieties: global science,
child health and society. London: Earthscan, Science in Society Series
4. Fischbacher, C. 2009. Live births by country of mother. First
half of 2009. Figures from Information Services Division, Lothian,
Edinburgh.
Competing interests:
None declared
Competing interests: No competing interests
By the time the swine flu vaccine is available, a certain percentage
of the world population would have already had swine flu infection-
clinical or sub-clinical, documented or otherwise.Will administering swine
flu vaccine to those already immune to pandemic H1N1 virus, cause any
particular side effect ?
Competing interests:
None declared
Competing interests: No competing interests
An experience from a different country: Similar and differential factors for intention to take Influenza A(H1N1) vaccine
Although, a considerable amount of time have passed since WHO had
declared that Influenza A(H1N1) was at post-pandemic period (1), the
acceptability of Influenza A(H1N1)is still a divisive issue.
Differential factor:
For developing countries the cost of vaccines may be a barrier as you
found with your valuable study (2). In Turkey, although it was provided to
all citizens free of charge, the intention to receive vaccine remained
quite low(3). We found in our study which has been newly submitted to a
journal also showed similar low willingness rates of H1N1 vaccine uptake
(4).
Similar factor:
Like you declared at Introduction part of your article, previous
vaccination history of seasonal influenza was also an important factor
especiallly for university students under education in health related
faculties in our study.
I think that the public health professionals should focus on improving the
uptake of seasonal influenza vaccination to reach considerable rates of
Influenza A vaccine uptake during further possible Influenza A outbreaks
and the provision of Influenza A vaccines must be free of charge.
Thanks for your valuable study.
With best wishes,
Assoc.Prof.Nazim Ercument Beyhun
Ataturk University Medical Faculty
Head of Dep. of Public Health
1.WHO.H1N1 in post-pandemic period. Director-general's opening
statement at virtual press conference.2010.
2.Joseph T F Lau, Nelson C Y Yeung, K C Choi, Mabel Y M Cheng, H Y
Tsui, and Sian Griffiths.Acceptability of A/H1N1 vaccination during
pandemic phase of influenza A/H1N1 in Hong Kong: population based cross
sectional survey.BMJ 2009 339:b4164; doi:10.1136/bmj.b4164
3.Akan H, Gurol Y, Izbirak G, Ozdatli S, Yilmaz G, Vitrinel A, et al.
Knowledge and attitudes of university students toward pandemic influenza:
a cross-sectional study from Turkey. BMC Public Health 2010; 10:413.
4.Beyhun NE, Kosan Z, Aras A, Guraksin A, Ezmeci T.Willingness to
Receive Influenza A(H1N1)Vaccine and Its Determinants Among University
Students During 2009 Outbreak in Turkey. Public Health(in submission,
submission date:15.4.2011).
Competing interests: No competing interests