Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 8;12(8):898.
doi: 10.3390/vaccines12080898.

Increasing Influenza Vaccination Rates among Patients with Type 2 Diabetes Mellitus in Chongqing, China: A Cross-Sectional Analysis Using Behavioral and Social Drivers Tools

Zhourong Li  1   2 , Luzhao Feng  3 , Jiang Long  1   4 , Yu Xiong  1   4 , Tingting Li  1   4 , Binshan Jiang  3 , Shuang Yang  2 , Lin Fu  2 , Zumin Shi  5 , Yong Zhao  2 , Li Qi  1   4   6
Affiliations

Increasing Influenza Vaccination Rates among Patients with Type 2 Diabetes Mellitus in Chongqing, China: A Cross-Sectional Analysis Using Behavioral and Social Drivers Tools

Zhourong Li et al. Vaccines (Basel). .

Abstract

Background: Influenza vaccination is essential for type 2 diabetes mellitus (T2DM) patients due to their higher risks of severe complications and mortality from influenza. This study investigated the willingness of T2DM patients in Chongqing, China, to receive the influenza vaccination during the 2023/2024 season, using behavioral and social drivers (BeSD) tools to improve vaccination uptake in this high-risk group.

Methods: A multi-stage sampling method was used to select participants, and face-to-face surveys were conducted in community health centers between March 1 and May 1, 2023. Binary logistic regression was used to analyze the factors influencing vaccination willingness, and standardized scores identified barriers and drivers.

Results: Among 1672 T2DM patients, 11.7% had been vaccinated during the 2022/2023 season, and 59.6% were willing to receive the vaccination in the 2023/2024 season. Higher willingness was associated with ethnic minorities (odds ratio [OR], 3.18, 95% confidence interval [CI]: 1.58-6.39), being unemployed individuals (OR 2.69, 95% CI: 1.60-4.52), higher monthly household income per capita (OR 2.72, 95% CI: 1.65-4.50), having diabetes complications (OR 1.76, 95% CI: 1.23-2.51), sufficient vaccine knowledge (OR 1.87, 95% CI: 1.48-2.37), and previous vaccination (OR 7.75, 95% CI: 4.83-12.44). Concerning BeSDs, fear of infecting friends or family members and trust in vaccine efficacy were the predominant drivers, while high vaccine costs were the greatest barrier.

Conclusions: Future strategies should focus on improving vaccine knowledge, supporting healthcare workers and peer recommendations, and enhancing vaccination policies. Key interventions such as health education among high-risk groups, such as unemployed individuals, advocacy campaigns, pay-it-forward strategies, and policies for free vaccination could improve coverage in Chongqing.

Keywords: behavioral and social drivers; influenza vaccination willingness; type 2 diabetes mellitus patients.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Sampling flowchart of participants in Chongqing, China.
Figure 2
Figure 2
Drivers of influenza vaccination among the participants with T2DM in Chongqing (n = 989). Note: * The average score of each item; T2DM, type 2 diabetes mellitus; IV, influenza vaccine.
Figure 3
Figure 3
Barriers to influenza vaccination among the participants with T2DM in Chongqing (n = 683). Note: * The average score of each item; T2DM, type 2 diabetes mellitus; IV, influenza vaccine.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Jing Y., Hong T., Bi Y., Hu D., Chen G., Li J., Zhang Y., Zhang R., Ji L., Zhu D. Prevalence, treatment patterns and control rates of metabolic syndrome in a Chinese diabetic population: China Cardiometabolic Registries 3B study. J. Diabetes Investig. 2018;9:789–798. doi: 10.1111/jdi.12785. - DOI - PMC - PubMed
    1. Ruiz P.L.D., Bakken I.J., Håberg S.E., Tapia G., Hauge S.H., Birkeland K.I., Gulseth H.L., Stene L.C. Higher frequency of hospitalization but lower relative mortality for pandemic influenza in people with type 2 diabetes. J. Intern. Med. 2020;287:78–86. doi: 10.1111/joim.12984. - DOI - PubMed
    1. Goeijenbier M., van Sloten T., Slobbe L., Mathieu C., van Genderen P., Beyer W.E., Osterhaus A.D. Benefits of flu vaccination for persons with diabetes mellitus: A review. Vaccine. 2017;35:5095–5101. doi: 10.1016/j.vaccine.2017.07.095. - DOI - PubMed
    1. World Health Organization Influenza (Seasonal) 2023. [(accessed on 8 March 2024)]. Available online: https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)
    1. National Immunization Advisory Committee (NIAC) Technical Working Group (TWG) Influenza Vaccination TWG Technical guidelines for seasonal influenza vaccination in China (2022–2023) Zhonghua Liu Xing Bing Xue Za Zhi. 2022;43:1515–1544. - PubMed

LinkOut - more resources