Research Article: Seasonal influenza: Knowledge, attitude and vaccine uptake among adults with chronic conditions in Italy

Date Published: May 1, 2019

Publisher: Public Library of Science

Author(s): Gaia Bertoldo, Annalisa Pesce, Angela Pepe, Concetta Paola Pelullo, Gabriella Di Giuseppe, Lamberto Manzoli.


This cross-sectional study aimed at evaluating the knowledge and attitudes concerning influenza vaccination in Southern Italy, and investigating the potential determinants of vaccine uptake. The sample consisted of 700 adults (mean age 58.7y) with chronic diseases attending four public specialty clinics in Italy. Overall, 64.7% of the participants were aware that influenza can be prevented with vaccines and that patients with chronic diseases are at higher risk of developing severe complications. Less than half of the sample (42.1%) received influenza vaccine in the last season, and 46.9% declared the will to receive influenza vaccination in the next season. The level of awareness was significantly lower among the elderly (> = 65y) and those with a higher self-reported health. A significantly higher likelihood of vaccination was observed among the elderly, the subjects with a higher knowledge about vaccine utility and safety, the participants with chronic respiratory diseases, and those who had taken more drugs. Future education programs and communication strategies are strongly needed in adults with chronic diseases to improve influenza vaccination knowledge and uptake.

Partial Text

It is well known that seasonal influenza is an acute respiratory illness caused by virus strains that annually undergo antigenic variations. Influenza is a major public health issue, having been associated with increased in all-cause mortality [1–2], significant economic costs due to work absenteeism and intensified healthcare service use [3]. The World Health Organization (WHO) estimates that annual influenza epidemics result in about 3 to 5 million cases of severe illness worldwide each year, and about 290.000 to 650.000 deaths [4]. The European Centre for Disease Prevention and Control estimates that up to 40,000 people in the European Union die prematurely each year due to causes associated with influenza [5].

In total, 700 of the 712 subjects agreed to participate in the study, with an overall response rate of 98.3%. Table 1 shows an overview of the respondents’ socio-demographic characteristics. The mean age of the participants was 58.7 years (18–92 years). Slightly more than half were females, and almost all were Italian. A total of 38.5% had completed a high school education, about 60% were married and only 30.6% were employed. Moreover, patients were mainly affected by diabetes (48.7%), cardiovascular disease (40.4%) and chronic respiratory disease (36.3%).

Annual influenza vaccination has been demonstrated to be effective in reducing morbidity and mortality among high-risk patients. The present study collected detailed data on the knowledge, attitudes and vaccine uptake among a sample of adults with chronic diseases. The current study’ findings can be compared with those in other studies despite the latter’s different samples and methodologies.