The importance of confidence, complacency, and convenience for influenza vaccination among key risk groups in large urban areas of Peru

ABSTRACT

Influenza vaccination has been available under Peru’s national immunization program since 2008, but vaccination coverage has decreased lately. Surveys and focus groups were conducted among four risk groups (pregnant women, mothers of children aged <6 years, adults with risk factors, and adults aged ≥65 years) to identify factors affecting influenza vaccine hesitancy in Peru. The 3Cs model (Confidence, Complacency, and Convenience) was used as a conceptual framework for the study.

Most pregnant women and mothers of young children (70.0%), but less than half (46.3%) of older adults and adults with risk factors were vaccinated against influenza. Vaccine confidence and complacency were positively associated with educational level. Complacency was the most deficient of the 3Cs. Pregnant women and mothers were the most informed and least complacent among risk groups.

Focus groups revealed the misconceptions behind the high level of complacency observed, including the perception of influenza risk and the role assigned to vaccination in preventing the disease. Interviews with officials identified that most strategies are directed to vaccination availability and hence to convenience, with opportunities for strategies to improve vaccination uptake and community engagement.

The results highlight the importance of implementing in Peru communication strategies to increase perceptions of vaccine safety and effectiveness thus improving confidence and reducing complacency. The establishment of explicit incentives should also be considered to increase vaccination uptake, particularly to health personnel.

KEYWORDS:

• Influenza
• vaccination
• vaccine hesitancy
• Peru
• vaccination program
• complacency

Author contributions

Miguel Ángel González-Block, Blanca Estela Pelcastre-Villafuerte, Emilio Gutiérrez-Calderón, Sandra Patricia Díaz-Portillo, Juan Arroyo-Laguna, and Berenice Rodríguez-Zea contributed to project design, methods development, acquisition of data, and data interpretation. Elsa Sarti and Esteban Puentes-Rosas contributed to the design of the study and data interpretation. All authors helped to draft or revise the manuscript, and all authors reviewed and approved the final version.

Acknowledgments

Editorial assistance was provided by Dr. Surayya Taranum (4Clinics, Paris, France) and funded by Sanofi Pasteur.

Disclosure of potential conflicts of interest

This project was financially supported by Sanofi Pasteur. Elsa Sarti and Esteban Puentes-Rosas are employees of Sanofi Pasteur. Miguel Ángel González-Block, Blanca Estela Pelcastre-Villafuerte, Emilio Gutiérrez-Calderón, Sandra Patricia Díaz-Portillo, Juan Arroyo-Laguna, and Berenice Rodríguez-Zea have no relevant conflicts of interest to report.

Supplemental Material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

The study was funded by Sanofi Pasteur. Employees of Sanofi Pasteur participated in conceiving and designing the study, drafting, and editing the article, deciding to submit the article for publication, and approving the final, submitted version.