Vaccine Literacy, Covid-19 and influenza: a cross-sectional survey in Prato in the 2nd pandemic wave

Abstract   Covid-19 is a pandemic and an infodemic, with contrasting information regarding risk and preventive measures, including vaccination. This study aims to assess Vaccine Literacy (VL) of a sample of workers in the province of Prato (Tuscany, Italy) in the second wave of the Covid-19 pandemic (November-December 2020) and to analyze the relationship between VL and attitudes about Covid-19 and flu vaccination. A cross-sectional design was adopted. Sociodemographic characteristics, health information, vaccination behaviour for past and current flu season and intention to get vaccinated against Covid-19 were collected. A multivariate logistic regression was performed to identify predictors of getting a Covid-19/flu vaccination. The Italian Health Literacy tool on Vaccination (HLVa-IT) tool was used to measure VL. A total of 117 questionnaires were analyzed. Among them, 64.9% intended to get Covid-19 vaccine. The mean VL was 3.18 ± 0.43 (functional 2.87 ± 0.72; interactive-critical 3.36 ± 0.45) out of 4. Having more than one comorbidity was a negative predictor of intention to get Covid-19 vaccine (OR: 0.21 95%CI: 0.04 - 0.91). Regarding the flu vaccine, being vaccinated in the previous season was the only positive predictor of being vaccinated in the current season (OR = 24.25 95%CI 7.96 - 87.73). The study was conducted before the authorization of Covid-19 vaccines: little information about them may have contributed to VL not being related to the intention to get vaccination. The negative role of comorbidities could be due to fear of adverse effects on fragile health status. For flu vaccination, VL may have exerted a lower impact because of the positive experience with the flu vaccine in terms of safety and effectiveness in the previous seasons. Key messages • The introduction of new vaccines should be supported by effective communication. • Better knowledge of current vaccines and not just routine administration is desirable for greater personal empowerment.


Introduction:
Knowing predictors for adherence to governmental recommendations is fundamental to guiding health communication in pandemic situations. This study investigated whether political stringency was associated with students' adherence to the COVID-19 governmental measures in the Nordic countries (Denmark, Finland, Norway, Iceland, and Sweden) and the United Kingdom (UK).

Methods:
We used data from a cross-sectional online survey, from university students in all Nordic countries and the UK (N = 10.345), in May 2020. Data on socio-demography, study information, living arrangements, health behaviors, stress, knowledge, and concern about COVID-19 infection supplemented with measures on political stringency from the Oxford Covid-19 Government Response Tracker were utilised. Multiple linear regression analysis methods were applied. Results: Around 66% reported that they followed governmental measures. Our model explained only 10% of the variation of adherence. The main predictors for adherence were older age, female sex, and being worried about the COVID-19 infection. More days since lockdown and political stringency were also associated with adherence to governmental recommendations in all countries. Sweden had the lowest willingness to adhere to governmental recommendations even though the strength of the association between political stringency and adherence was similar to other countries.

Conclusions:
Political stringency and congruent communication are important in ensuring adherence to governmental recommendations during the first wave of the COVID-19 pandemic.

Key messages:
Political stringency is important to ensure adherence to governmental recommendations. Congruent communication is important to ensure adherence to governmental recommendations. The introduction of new vaccines should be supported by effective communication.
Better knowledge of current vaccines and not just routine administration is desirable for greater personal empowerment.

Background:
The National Institute of health (ISS), within the G20 Health Working Group, launched at March 2021 an innovative training Laboratorium, to strengthen the capacity and competencies of the Public Health Workforce (PHW) on prevention, preparedness and response to health crises. It was recognised in the G20 Declarations of Ministers of Health and Leaders and it was aimed to the development of training tools suitable for distance learning. ISS proposed the design of e-Learning courses based on an integration of WHO's Competency-Based Education (CBE) and Problem Based Learning (PBL) models.

Objectives:
Describe the design of a pilot e-Learning course based on CBE-PBL models, focused on Epidemic Intelligence (EI).

Results:
The pilot e-Learning course ''Use of Epidemic Intelligence systems with a particular focus on event-based surveillance for pandemic preparedness'' will be delivered by ISS e-Learning platform https://www.eduiss.it. By the end of the course participants will be able to evaluate the potential use/ applicability of EI systems, focusing on event-based surveillance for preparedness and early warning at country/institutional level. CBE is the basis for articulating the outcomes and identifying the required competencies and PBL for creating learning activities associated to learning outcomes. Interactive tools (exercise, web pages, quiz and other activities) are associated to learning objectives. The course is offered to public health professionals free of charge, in English language. About 16 hours are required to complete all the activities and receive attendance certification.

Conclusions:
Continuously updated training of PHW is a hallmark to better face health challenges. In our proposal, the learning methodology integrates CBE vision with PBL approach, adapting both to e-Learning context.