382692286 Literature Review

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Nov 24, 2024

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1 Covid Vaccine and Flu Vaccine and Hong Kong Policy Student's Name Institutional Affiliation Course Code and Name Instructor Due Date

2 Covid Vaccine and Flu Vaccine and Hong Kong Policy The Center for Health Protection (2022) provides healthcare recommendations to Hong Kong and their recent guidelines advocate for the simultaneous vaccination for seasonal flu and Covid-19. The healthcare body confirmed that the government has introduced a health policy that offers free seasonal influenza vaccination (SIV) to the residents regardless of their Covid-19 status. The Center for Health Protection (2022) reports that the government urged people to get SIV because it could help mitigate any suffering that can be caused by healthcare complications. Behrouzi et al. (2020) support this policy as evidenced by their study on the positive impacts of SIV on the cardiovascular health of patients with Covid-19. The main purpose of their research was to show the elevated risks for cardiovascular disease when one is suffering from viral respiratory infections. Behrouzi et al. (2020) report that many medical researchers have confirmed that SIV reduces the risks of cardiovascular events in patients with heart failure. Therefore, Behrouzi et al. (2020) and the Center for Health Protection (2022) conclude that SIV has the potential of addressing complications that may arise with Covid-19 infection. Paget et al. (2020) report that there is extensive literature confirming that the flu vaccine alongside the ongoing Covid-19 vaccination can have health and economic benefits. The scholars recommend that vaccination for both influenza and Covid-19 should be promoted as a central public health intervention. The evidence collected from literature reviews and reports shows that managing influenza can have a positive impact on the management of COvid-19. Moreover, Paget et al. 2020) report that having a health policy that embraces both Covid-19 and flu vaccination can help in reducing the overload on health services and healthcare practitioners. Jehi et al. (2020) validate these claims through their predictive model which shows that flu vaccines have a positive influence on the reduction of Covid-19 infection risk. Their model

3 confirmed that amongst 11,672 patients, those who had pneumococcal polysaccharide or influenza vaccine were at reduced risk of developing complications from COvid-19. Kwok et al. (2021) on the influenza vaccine uptake and Covid-19 vaccination intention. The main purpose of this study was to assess nurses' flu vaccination attitudes and practices and the subsequent intention to receive Covid-19 vaccination. 1205 eligible participants were selected for this study. The main findings confirm that the influenza flu vaccine uptake and the proportion intending to take Covid-19 vaccination were 49 percent and 63 percent respectively (Kwok et al., 2021). The results of the study confirm that while the Covid vaccine is available, only two-thirds of the professionals were ready and willing to get vaccinated. Comparatively, a significant proportion of the nurses were vaccinated against influenza. The main reason for the latter status is the fact that many nurses worked in settings with elevated risks for infection and transmission. Wang et al. (2021) conduct a study to assess vaccine hesitancy among the working class in Hong Kong. The main purpose of their research was to provide an overview of the trends in response to the willingness to accept the Covid-19 vaccine. In their study, Wang et al. (2021) measure the acceptance of Covid-19 vaccination alongside personal health behaviors and occupations. The 2047 participants in the study showed that the willingness to get vaccinated against the novel disease was high in the first wave but the value was reduced in the progressive waves. Wang et al. (2021) report that in the first wave, 43 percent of the participants were willing to get vaccinated but the number reduced to 35 percent in the latest phenomenon. Hong Kong has a health policy that advocated for the vaccination of all vulnerable individuals. These healthcare programs provide affordable options but the participants cited factors such as vaccine safety as reasons for unwillingness. Therefore, Wang et al. (2021) conclude that the uncertainty

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4 about the vaccine’s safety could jeopardize any efforts at establishing effective vaccination programs in Hong Kong. Chan et al. (2022) assess how the Covid-19 pandemic has influenced SIV behaviors. The main purpose of this study was to assess influenza uptake patterns in Hong Kong nurses before and during the pandemic. The scholars utilize a cross-sectional survey to collect insight from a sample of 1323 nurses. Six trends are identified to illustrate the changes in vaccination uptake : (a) resistance throughout, (b) negative change, (c) decreased tendency, (d) increased tendency (e) positive change, and (f) adherence throughout (Chan et al., 2022). The results of their study showed that there was no significant change in the vaccination uptake patterns from 2019 to 2020 – the rates increased from 41 percent to 42 percent. 4 percent of the participants were positive changers and they mainly comprised nurses above the age of 50 years. This cohort was more likely inclined to anticipate the potential complications from flu and Covid-19. Negative changes comprised 3 percent of the participants and their main opinions focused on the unlikelihood of seasonal influenza outbreaks during the pandemic. 26 and 43 percent of the sample were adherent and resistant to SIV respectively, notwithstanding the ongoing pandemic. Therefore, Chan et al. (2022) conclude that, unlike other regions, Hong Kong has not witnessed increased vaccination uptake despite the impending dangers of seasonal influenza and Covid-19. Chan et al. (2021) assess vaccine hesitancy in Hong Kong. The scholar begins their study by noting that the World Health Organization identified vaccine hesitancy as one of the most detrimental factors to global health. The scholars note that previous encounters with diseases such as Covid-19 have proven that the general population is hesitant to get vaccinated. Chan et al. (2021) report that in 2009, only 34 percent of the healthcare workers in Hong Kong received the H1N1 vaccine. In 2005, Hong Kong faced a significant flu season which was a consequence

5 of H3n2 – a novel strain of influenza. The healthcare workers showed similar uptake rates implying that the same trends may be observed with covid-19. Chan et al. (2021) confirm that the same trends have been observed in the most recent pandemic, especially during the third wave. Chan et al. (2021) report that in one study, 43.4 percent of participants were hesitant to get vaccinated because of a lack of confidence in the efficacy of the new entities. 52 percent and 62.5 percent of the participants considered the reputation of the manufacturers and country of evidence critical factors in vaccine acceptance. Regardless, Chan et al. (2021) confirm that government recommendation was the key driver for vaccine uptake. Therefore, a lack of support and endorsement by the authorities was likely to yield lower rates. Chan et al. (2021) conclude by recommending healthcare institutions address vaccine hesitancy with urgency. They note that uptake rates can only increase if the responsible bodies leverage education, dissemination of evidence-based information, and intensive deployment of public health interventions that are geared towards vaccine uptake enhancement. Lin et al. (2022) assess the relationship between vaccine uptake (seasonal influenza vaccine and COVID-19 vaccine) and the quality of life amongst a sample of residents of Taiwan. The scholars utilize the Taiwan Social Change Survey data which is classified under stratified random sampling. Line et al. (2022) utilize a sample of 1425 individuals whose vaccination status for both conditions is assessed concerning the quality of life. The scholar's group the participants into two groups. One class has individuals older than 49 years while the other has people under the age of 50 years. For the latter group, those who were vaccinated for seasonal influenza and Coid-19 reported a higher quality of life than those who did not. This difference was a consequence of the physical well-being that resulted from immunity to the respective conditions. Mental health was not significantly associated with vaccination. Furthermore, there

6 was no significant association between quality of life and vaccination in individuals older than 50 years. Lin et al. (2022) conclude by illustrating that not having Covid-19 and seasonal flu vaccinations is linked to poor quality of life. Therefore, such information should be leveraged when advocating for vaccination.

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7 References Behrouzi, B., Araujo Campoverde, M. V., Liang, K., Talbot, H. K., Bogoch, I. I., McGeer, A., Fröbert, O., Loeb, M., Vardeny, O., Solomon, S. D., & Udell, J. A. (2020). Influenza vaccination to reduce cardiovascular morbidity and mortality in patients with COVID-19. Journal of the American College of Cardiology , 76 (15), 1777–1794. https://doi.org/10.1016/j.jacc.2020.08.028 Centre for Health Protection. (2022, November 1). Vaccination Subsidy Scheme - general public . Centre for Health Protection. https://www.chp.gov.hk/en/features/46107.html Chan, C. P., Wong, N. S., & Lee, S. S. (2022). The double-edged impacts of covid-19 epidemic on influenza vaccination uptake in nurses in Hong Kong. Infectious Diseases , 54 (11), 794–803. https://doi.org/10.1080/23744235.2022.2094461 Chan, P. K. S., Wong, M. C. S., & Wong, E. L. Y. (2021). Vaccine hesitancy and covid-19 vaccination in Hong Kong. Hong Kong Medical Journal , 27 (2), 90–91. https://doi.org/10.12809/hkmj215115 Jehi, L., Ji, X., Milinovich, A., Erzurum, S., Rubin, B. P., Gordon, S., Young, J. B., & Kattan, M. W. (2020). Individualizing risk prediction for positive coronavirus disease 2019 testing. Chest , 158 (4), 1364–1375. https://doi.org/10.1016/j.chest.2020.05.580 Kwok, K. O., Li, K.-K., WEI, W. I., Tang, A., Wong, S. Y., & Lee, S. S. (2021). Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: A survey. International Journal of Nursing Studies , 114 , 103854. https://doi.org/10.1016/j.ijnurstu.2020.103854 Lin, C.-Y., Fan, C.-W., Ahorsu, D. K., Lin, Y. C., Weng, H.-C., & Griffiths, M. D. (2022). Associations between vaccination and quality of life among Taiwan general population: A

8 comparison between covid-19 vaccines and flu vaccines. Human Vaccines & Immunotherapeutics , 18 (5). https://doi.org/10.1080/21645515.2022.2079344 Paget, J., Caini, S., Cowling, B., Esposito, S., Falsey, A. R., Gentile, A., Kyncl, J., MacIntyre, C., Pitman, R., & Lina, B. (2020). The impact of influenza vaccination on the COVID-19 pandemic? evidence and lessons for public health policies. Vaccine , 38 (42), 6485–6486. https://doi.org/10.1016/j.vaccine.2020.08.024

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