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Title: Acceptance and feasibility of school-based seasonal influenza vaccination in Singapore: A qualitative study
Authors: Offeddu, Vittoria 
Low, Mabel Sheau Fong 
Surendran, Shilpa 
Kembhavi, Gayatri 
Tam, Clarence C 
Keywords: Influenza
Influenza vaccine
School-based vaccination
Issue Date: Dec-2019
Publisher: Elsevier
Citation: Offeddu, Vittoria, Low, Mabel Sheau Fong, Surendran, Shilpa, Kembhavi, Gayatri, Tam, Clarence C (2019-12). Acceptance and feasibility of school-based seasonal influenza vaccination in Singapore: A qualitative study. Vaccine. ScholarBank@NUS Repository.
Rights: Attribution-NonCommercial-NoDerivatives 4.0 International
Abstract: Introduction: Influenza is a major cause of disease in children. School-based seasonal influenza vaccination can be a cost-effective tool to improve vaccine uptake among children, and can bring substantial health and economic benefits to the broader community. The acceptance and feasibility of school-based influenza vaccination are likely to be highly context-specific, but limited data exist from tropical settings with year-round influenza transmission. We conducted a qualitative study to assess acceptability and feasibility of a school-based seasonal influenza vaccination programme in Singapore. Methods: We conducted qualitative in-depth interviews with key stakeholders, including healthcare professionals, representatives of relevant ministries, preschool principals and parents to understand their perspectives on a proposed school-based seasonal influenza vaccination programme. Interviews were transcribed verbatim and analysed using thematic analysis. Results: We conducted 40 interviews. Although preschool-aged children are currently the recommended age group for vaccination, stakeholders suggested introducing the programme in primary and/or secondary schools, where existing vaccination infrastructure would facilitate delivery. However, more comprehensive evidence on the local influenza burden and transmission patterns among children is required to develop an evidence-based, locally relevant rationale for a school-based vaccination programme and effectively engage policy-makers, school staff, and parents. Extensive, age-appropriate public education and awareness campaigns would increase the acceptability of the programme among stakeholders. Stakeholders indicated that an opt-out programme with free or subsidised vaccination would be the most likely to achieve high vaccine coverage and make access to vaccination more equitable. Conclusions: Overall, participants were supportive of a free or subsidised school-based influenza vaccination programme in primary and/or secondary schools, although children in this age group are not currently a recommended group for vaccination. However, a better informed, evidence-based rationale to estimate the programme’s impact in Singapore is currently lacking. Extensive, age-appropriate public education and awareness campaigns will help ensure full support across key stakeholder groups.
Source Title: Vaccine
ISSN: 0264410X
DOI: 10.1016/j.vaccine.2019.12.020
Rights: Attribution-NonCommercial-NoDerivatives 4.0 International
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