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Hum Vaccin Immunother. 2019 Mar 9. doi: 10.1080/21645515.2019.1588005. [Epub ahead of print]

Factors predicting influenza vaccination adherence among patients in dialysis: an Italian survey.

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a Department of Medicine , University of Udine , Udine , Italy.
b Azienda Sanitaria Universitaria Integrata di Udine , Udine , Italy.
c Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia" , University of Catania , Catania , Italy.
d Dipartimento Scienze della Salute , University of Genova , Genova , Italy.
e Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit , University of Padova , Padova , Italy.
f Dipartimento Scienze della Sanita' Pubblica , University of Turin , Torino , Italy.
g Citta' della Salute e della Scienza Torino , Torino , Piemonte , Italy.
h Dipartimento Scienze Mediche , University of Turin , Torino , Italy.
i Department of Medicine (DIMED), Nephrology , University of Padova , Padova , Italy.
j Department of Translational Research and New Technologies in Medicine and Surgery, Hygiene and Epidemiology Section , University of Pisa , Pisa , Italy.
k Department of Clinical and Experimental Medicine, Internal Medicine , University of Catania , Catania , Italy.
l Department of Diagnostic and Public Health , University of Verona , Verona , Italy.
m Department of Medical and Surgical Sciences and Advanced Technologies, Vascular Surgery and Organ Transplant Unit , University Hospital of Catania , Catania , Italy.



The aim of this study was to investigate knowledge and practices about influenza among patients on dialysis services of Italian hospitals at risk of severe influenza infection and vaccine and to identify predictive factors to vaccination adherence.


A cross-sectional observational study was carried out from January 2017 to July 2017 after the 2016/2017 influenza vaccination campaign. The questionnaire was administered to all patients treated in seven large Italian dialysis services. It consisted of influenza vaccination coverage, knowledge about influenza and its vaccination, perceived risk of influenza complications, recommendations on influenza uptake received by general practitioner (GP) and nephrologist.


Response rate was 90% (703/781). Patients' knowledge about influenza infection and vaccine were detected by nine closed questions: 35.6% of responders answered correctly to ≥ 6 sentences, 47.5% of them reported that "influenza vaccine can cause influenza" and 45.7% believed that "antibiotics are a correct strategy to treat influenza". Levels of perceived risks of hospitalisation and death were low in 39.3% and 16.5% of patients respectively. The adherence to the last seasonal influenza vaccination was 57.5%. The multivariate predictors of influenza vaccination uptake resulted: age ≥65, male, consulting TV/radio, asking information to GP and/or nephrologist.


The study reveals the low adherence to influenza vaccination and the subotpimal level of knowledge in dialysis patients. Different strategies, including a greater alliance among nephrologists and GPs to prevent influenza should be encouraged to improve the adherence to influenza vaccination in this at risk group.


Influenza vaccination; dialysis patients; influenza coverage

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