Counselling, pamphlets boost influenza vaccine intake in SG

Use of educational pamphlets alone and individualized counselling (IC) both lead to improved uptake of influenza vaccination, reports a Singapore study, noting that IC is not superior to pamphlets alone in increasing uptake.

“Performing vaccination at the initial point of contact with the healthcare provider may improve actual uptake rates,” the researchers said.

This randomized controlled study was performed in two government polyclinics with 160 patients (aged ≥65 years) attending for doctor consultation and assigned them into intervention or pamphlets alone (control) groups. All participants received an educational pamphlet on influenza vaccination, while those in the intervention group received additional face-to-face counselling.

Pre- and postintervention questionnaires were completed to assess the participants’ knowledge of influenza and attitudes towards the vaccine. The researchers then carried out follow-up calls and verified electronic records at 3 months to determine the actual vaccine intake.

Of the participants, 16 (10 percent) in the intervention group and 20 (12.5 percent) in the control group completed influenza vaccination (p=0.48) at 3 months. [Singapore Med J 2023;64:98-104]

Male gender (adjusted odds ratio [aOR], 2.96, 95 percent confidence interval [CI], 1.23‒7.12) and willingness to receive vaccination immediately after intervention (aOR, 12.15, 95 percent CI, 4.42‒33.38) significantly correlated with vaccine uptake.

Notably, IC was more effective than pamphlet alone in improving knowledge (p<0.01), but overall knowledge scores did not translate to actual vaccine uptake rates (aOR, 1.10, 95 percent CI, 0.90‒1.3).

“Our study has found that the use of educational brochure was as effective as IC in improving influenza vaccination uptake among the community-dwelling older adults in Singapore,” the researchers said. “To date, there have been no other trials directly comparing IC with distribution of informational materials.”

In earlier studies, counselling in addition to pamphlets were found to be more effective than no intervention at all. [Health Educ Res 2017;32:455-464]

Education by community pharmacists also improved knowledge and vaccination uptake, as shown in a previous study. However, another research showed that patient education by staff alone fell short of increasing uptake compared with the addition of an enabling systemic workflow. [PR Health Sci J 2006;25:35-42; J Am Geriatr Soc 1994;42:1154-1119]

“In Singapore, the uptake of influenza vaccination among adults older than 50 years remains low,” the researchers said. “Only 15.2 percent had received vaccination per a National Health Surveillance Survey conducted in 2013.” [Epidemiol Infect 2017;145:775-786]

The Ministry of Health in Singapore stepped in to address this issue by introducing the National Adult Immunization Schedule in October 2017. The program sought to increase public awareness and uptake of important vaccines, according to the researchers.

“Concurrently, flexible payment options were introduced, which allowed the use of MediSave for the payment of influenza vaccination in target populations,” they added.

The World Health Organization recommends annual influenza vaccination for older adults, pregnant women, children aged 6‒59 months, persons with specific chronic medical conditions, and healthcare workers. [http://www.who.int/immunization/policy/position_papers/influenza/en/]