Examining Influenza Vaccination Patterns Among Young Adults with Asthma: Insights into Knowledge, Attitudes, and Practices

Figures & data

Table 1 Sociodemographic Characteristics of the Enrolled Participants (n=397)

		Median (95% Cl) or Frequency (%)
Age		32 (30–34)
Gender	Female	263 (66.4%)
	Male	134 (33.6%)
Marital Status	Married	288 (72.9%)
	Other	107 (27.1%)
Educational level	High school or less	209 (52.6%)
	Diploma or higher	188 (47.4%)
Monthly income	Equal to or less than 1000 JDs	171 (44.9%)
	More than 1000 JDs	210 (55.1%)
Asthma duration		10.00 (10–15)
Previous asthma hospitalization		155 (39.3%)
Are you a smoker?	No	273 (68.9%)
	Former smoker	46 (11.6%)
	Yes	77 (19.4%)
Are you exposed to passive smoking?	No	155 (39.5%)
	Yes	237 (60.5%)
Asthma control	Well-controlled	35 (8.8%)
	Partially controlled	107 (27%)
	Uncontrolled	254 (64%)

Abbreviations: Cl, Confidence level; JDs, Jordanian Dinar.

Table 2 Patients’ Responses to Asthma, Flu, and Vaccine Knowledge Items (n=397)

		Frequency (%)
Asthma Knowledge
Asthma is an infectious disease	No*	355 (89.4%)
	I do not know	22 (5.5%)
	Yes	20 (5%)
Asthma is a hereditary disease	No	131 (33%)
	I do not know	39 (9.8%)
	Yes*	227 (57.2%)
Patients may experience flare-ups/exacerbations	No	8 (2%)
	I do not know	23 (5.8%)
	Yes*	366 (92.2%)
Asthma is a chronic disease	No	35 (8.8%)
	I do not know	40 (10.1%)
	Yes*	322 (81.1%)
Do you know the spirometry test?	No	190 (47.9%)
	I do not know	32 (8.1%)
	Yes	175 (44.1%)
Do you know how to properly use the peak flow meter?	No	270 (68%)
	I do not know	42 (10.6%)
	Yes	85 (21.4%)
Does cold weather trigger asthma symptoms?	No	59 (14.9%)
	I do not know	35 (8.8%)
	Yes*	303 (76.3%)
Does smoking trigger asthma symptoms?	No	14 (3.5%)
	I do not know	12 (3%)
	Yes*	371 (93.5%)
Does exposure to pets trigger asthma symptoms?	No	53 (13.4%)
	I do not know	28 (7.1%)
	Yes*	316 (79.6%)
Does perfume trigger asthma symptoms?	No	33 (8.3%)
	I do not know	7 (1.8%)
	Yes*	357 (89.9%)
Do dust/air pollution trigger asthma symptoms?	No	15 (3.8%)
	I do not know	5 (1.3%)
	Yes*	377 (95%)
Does pollen trigger asthma symptoms?	No	35 (8.8%)
	I do not know	42 (10.6%)
	Yes*	320 (80.6%)
Does allergic rhinitis make asthma symptoms worse?	No	23 (5.8%)
	I do not know	35 (8.8%)
	Yes*	339 (85.4%)
Does sinusitis make asthma symptoms worse?	No	16 (4%)
	I do not know	49 (12.3%)
	Yes*	332 (83.6%)
Does influenza make asthma symptoms worse?	No	22 (5.5%)
	I do not know	19 (4.8%)
	Yes*	356 (89.7%)
Does tonsillitis make asthma symptoms worse?	No	47 (11.8%)
	I do not know	86 (21.7%)
	Yes*	264 (66.5%)
Do you know how to correctly use asthma inhalers?	No	12 (3%)
	I do not know	14 (3.5%)
	Yes	371 (93.5%)
Does aspirin worsen asthma symptoms?	No	135 (34%)
	I do not know	168 (42.3%)
	Yes*	94 (23.7%)
Do NSAIDs (Brufen, Voltaren) worsen asthma symptoms?	No	129 (32.5%)
	I do not know	178 (44.8%)
	Yes*	90 (22.7%)
Influenza Knowledge
Influenza is the same as the common cold	No	119 (30%)
	I do not know	66 (16.6%)
	Yes*	212 (53.4%)
Influenza is caused by bacteria	No*	135 (34%)
	I do not know	89 (22.4%)
	Yes	173 (43.6%)
Influenza can spread from one person to another	No	6 (1.5%)
	I do not know	6 (1.5%)
	Yes*	385 (97%)
Antibiotics can be used to treat flu	No*	82 (20.7%)
	I do not know	60 (15.1%)
	Yes	255 (64.2%)
Influenza Vaccine Knowledge
Is there a vaccine against the flu?	No	52 (13.1%)
	I do not know	48 (12.1%)
	Yes*	297 (74.8%)
Do you know the difference between triple and quadruple influenza vaccines?	No	219 (55.4%)
	I do not know	127 (32.2%)
	Yes	49 (12.4%)
When is the appropriate time to take the influenza vaccine?	1–3 (January- march)	67 (17.1%)
	11–12 (November- December)	45 (11.5%)
	9–10 (September- October)*	213 (54.5%)
	I do not know	66 (16.9%)
Does the vaccine have side effects?	No	137 (34.8%)
	I do not know	119 (30.2%)
	Yes*	138 (35%)
Knowledge score Median (95% Cl)		17 (15–20)

Note: *Indicates the correct answer.

Abbreviation: Cl, Confidence level.

Table 3 Participants’ Responses to Influenza Vaccine Attitude Items. (n=397)

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
I believe that I must receive the influenza vaccination	9 (2.3%)	69 (17.5%)	84 (21.3%)	151 (38.2%)	82 (20.8%)
It is easy to reach the pharmacy /hospital to receive the influenza vaccination	8 (2%)	28 (7.1%)	59 (14.9%)	225 (57%)	75 (19%)
My physician believes that I should receive the influenza vaccine	3 (0.8%)	26 (6.6%)	182 (46.2%)	135 (34.3%)	48 (12.2%)
Influenza vaccination prevents infection by the influenza virus	4 (1%)	39 (9.9%)	81 (20.6%)	169 (43%)	100 (25.4%)
The influenza vaccination may cause complications/troubles for me*	75 (19.1%)	84 (21.4%)	103 (26.3%)	102 (26%)	28 (7.1%)
I believe that I get sick because of the influenza shot*	83 (21.1%)	127 (32.3%)	98 (24.9%)	68 (17.3%)	17 (4.3%)
I am worried about the chances of contracting the influenza because of the influenza vaccine*	84 (21.4%)	127 (32.3%)	90 (22.9%)	74 (18.8%)	18 (4.6%)
Catching the influenza is not a problem for me*	92 (23.4%)	154 (39.2%)	29 (7.4%)	73 (18.6%)	45 (11.5%)
Attitude score Median (95% Cl)	28 (25–32)

Note: *Reversed-coded statements.

Abbreviation: Cl, Confidence Level.

Table 4 Patients’ Responses to Different Asthma Practice Items. (n=397)

	Never	Rarely	Sometimes	Usually	Always
	Frequency (%)	Frequency (%)	Frequency (%)	Frequency (%)	Frequency (%)
How often do you avoid smoking/exposure to smoking?	45 (11.5%)	49 (12.5%)	49 (12.5%)	127 (32.3%)	123 (31.3%)
How often do you avoid exposure to pets?	25 (6.4%)	31 (7.9%)	38 (9.7%)	69 (17.6%)	230 (58.5%)
How often do you avoid exposure to cold weather?	8 (2%)	46 (11.7%)	84 (21.4%)	160 (40.7%)	95 (24.2%)
How often do you avoid exposure to perfumes?	14 (3.6%)	37 (9.4%)	61 (15.5%)	115 (29.3%)	166 (42.2%)
How often do you avoid exposure to dust/air pollution?	8 (2%)	18 (4.6%)	46 (11.7%)	133 (33.8%)	188 (47.8%)
How often do you change your beddings weekly?	7 (1.8%)	24 (6.1%)	106 (27.1%)	115 (29.4%)	139 (35.5%)
How often do you avoid taking aspirin or NSAIDs?	62 (15.9%)	60 (15.3%)	70 (17.9%)	73 (18.7%)	126 (32.2%)
Do you perform a spirometry test on every visit to the physician?	72 (18.4%)	87 (22.3%)	161 (41.2%)	51 (13%)	20 (5.1%)
Do you perform a spirometry test each time your physician recommends doing so?	45 (11.5%)	49 (12.5%)	49 (12.5%)	32 (8.2%)	188 (48.1%)
How often do you use a flow meter at home?	25 (6.4%)	31 (7.9%)	38 (9.7%)	28 (7.2%)	17 (4.4%)
How often do you use an air dehumidifier?	8 (2%)	46 (11.7%)	84 (21.4%)	22 (5.7%)	19 (4.9%)
Practice score Median (95% Cl)	37 (33–41)

Abbreviation: Cl, Confidence Level.

Table 5 Patients’ Responses to Influenza Vaccine Practice Items (n=397)

		Frequency (%)
How often did you receive an influenza vaccine?	Never	168 (42.4%)
	Once	69 (17.4%)
	More than once	82 (20.7%)
	Annually	77 (19.4%)
What type of vaccine did you receive?	Trivalent	38 (16.7%)
	Quadrivalent	27 (11.9%)
	I do not know	162 (71.4%)
What was the severity of the side effects?	Mild	128 (61.8%)
	Moderate	58 (28%)
	Severe	21 (10.1%)
Reported side effects due to the influenza vaccine
Fever		73 (31.9%)
Redness		127 (55.5%)
Fatigue		43 (18.8%)
Headache		67 (29.3%)
Nausea		22 (9.6%)
Do you intend to take the influenza vaccine this year?	No	82 (20.6%)
	Not sure	112 (28.2%)
	Yes	203 (51.1)

Table 6 Multinomial Regression Model Between Different Sociodemographic Characteristics and the Intention to Vaccinate Against Flu This Year (n=397)

		No vs Yes				Not sure vs Yes
		RRR	95% Confidence Interval for RRR				95% Confidence Interval for RRR
			Lower Bound	Upper Bound	p-value	RRR	Lower Bound	Upper Bound	p-value
Age		0.978	0.959	0.997	0.021	0.985	0.968	1.002	0.079
Knowledge		0.916	0.847	0.990	0.028	0.902	0.839	0.970	0.005
Gender	Female	0.585	0.323	1.059	0.077	0.774	0.453	1.324	0.350
	Male	(REF)	(REF)	(REF)	(REF)	(REF)	(REF)	(REF)	(REF)
Monthly income	≤.1000 JDs	1.078	0.600	1.939	0.801	1.989	1.187	3.332	0.009
	>1000 JDs	(REF)	(REF)	(REF)	(REF)	(REF)	(REF)	(REF)	(REF)
Control status	Well-controlled	0.761	0.292	1.984	0.577	0.193	0.053	0.698	0.012
	Partial controlled	1.098	0.580	2.079	0.774	0.821	0.462	1.459	0.502
	Uncontrolled	(REF)	(REF)	(REF)	(REF)	(REF)	(REF)	(REF)	(REF)

Abbreviations: RRR, Relative Risk Ratio; REF, Reference group; JDs, Jordanian Dinar.

Figure 1 Reasons for non-vaccination.