title: Influenza Vaccination: A Cross-Sectional Survey of Knowledge, Attitude and Practices among the Lebanese Adult Population.
abstract: BACKGROUND
  Influenza is a common preventable infectious disease associated with high mortality and morbidity. Vaccination is the most cost-effective measure to prevent influenza, yet the vaccine uptake is known to be low. No previous studies have assessed the rate of seasonal influenza vaccination use among the Lebanese population, nor examined the knowledge and attitudes towards the influenza vaccine.
  
  
  METHODS
  A cross-sectional survey was performed in 30 pharmacies randomly selected across Lebanon. A 19-item questionnaire was used to record influenza vaccination status, knowledge and attitudes towards the influenza vaccine among the Lebanese general population.
  
  
  RESULTS
  The survey response rate was 93%. Among the 640 study participants, the overall 2014-2015 seasonal influenza vaccination rate was 27.6%. The majority of participants (72.4%) reported irregular uptake of the vaccine. Results of the multivariate analysis revealed that elderly people (OR = 2.25, CI = 1.08-4.71), with higher education (OR = 1.42, CI = 1.09-1.84), higher physical activity (OR significantly higher than 1 for all categories), and chronic respiratory disease (OR = 3.24, CI = 1.58-6.62) were more regularly vaccinated, while those who visit the doctor "only when needed" (OR = 0.55, CI = 0.34-0.88) and those who consume more than seven drinks/week (OR = 0.24, CI = 0.09-0.65) were less regularly vaccinated. When introducing knowledge and attitude variables to the model, "thinking that the vaccine was not needed" was the only correlate that demonstrated a significant inverse association with regular influenza vaccination (OR = 0.15; p = 0.017).
  
  
  CONCLUSIONS
  Suboptimal vaccination rates exist among the Lebanese ambulatory adult population. Clear misinformation on the importance of regular influenza immunization is also highlighted. This evidence underscores a compelling need to raise public awareness regarding the efficacy of the influenza vaccine.
authors.affiliation: Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, PO Box: 36-Byblos, Lebanon. Ghada.khoury@lau.edu.lb.
authors.forename: Ghada
authors.initials: G
authors.lastname: El Khoury
authors.affiliation: Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, PO Box: 36-Byblos, Lebanon. pascale.salameh@lau.edu.lb.
authors.forename: Pascale
authors.initials: P
authors.lastname: Salameh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000517:prevention & control*; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: Lebanon; immunization; influenza; vaccination