Factors associated with influenza vaccination acceptance in Mexican healthcare workers: A multicenter cross-sectional study.

Adherence of healthcare workers (HCWs) to influenza vaccination is far from optimal despite its being the most effective intervention for preventing influenza. In order to evaluate factors associated with influenza vaccination acceptance among Mexican HCWs during the 2017-2018 influenza season, a multicenter cross-sectional study spanning public and private hospitals was conducted. Participants were consecutively invited to answer a self-administered questionnaire. A total of 1513 out of 1553 questionnaires were evaluated. The median age of the participants was 32 (26-44) years and 65.8% were women. Nurses and physicians comprised 53.0% of the surveyed population. Total self-reported adherence to influenza vaccination among HCWs during the 2017-2018 season was 63.5% and varied across participating hospitals (P < 0.001). Factors positively associated with influenza vaccination were incremental doses of influenza vaccine received within the last 5 years (aOR = 1.94, 95% CI = 1.78-2.10), City 3 (aOR = 1.62, 95% CI = 1.19-2.20) and City 1 (aOR = 1.39, 95% CI = 1.02-1.91), whereas factors negatively associated were lack of a previous dose of influenza vaccine (aOR = 0.03, 95% CI = 0.01-0.08) and unawareness of the vaccination campaign (aOR = 0.57, 95% CI = 0.44-0.72). Lack of information and poor communication were barriers identified by both vaccinated and unvaccinated personnel. This study concluded that adherence to influenza vaccination in Mexican HCWs is suboptimal and that the factors associated with receipt of influenza vaccine are similar to those reported in other studies.

Risk Factors for Mortality in Hospitalized Patients with COVID-19: An Overview in a Mexican Population.

BACKGROUND: Currently, Mexico ranks third worldwide in mortality due to coronavirus disease pandemic 2019 (COVID-19) and reliable information is scarce, with the available data focused on epidemiological characteristics. This study aimed to identify the risk factors associated with mortality and outcomes in hospitalized Mexican patients with COVID-19. METHODS: We prospectively assessed patients admitted to a COVID-19 reference center in southeast Mexico between March 28 and June 30, 2020. Mortality was defined as survivors or non-survivors and univariate and multivariate logistic regression analyses were performed to explore the association of the clinical characteristics and laboratory parameters with mortality. RESULTS: We included 200 patients with a mean age of 55 years, 69% were men and 72% had at least one chronic comorbidity. Eighty-six patients required invasive mechanical ventilation (IMV) with an overall mortality rate of 82.5%. Only 51% of the patients with IMV were admitted to the intensive care unit (ICU), with a survival rate of 27.3%, but only 7.2% for patients without ICU admissions (p=0.014). The multivariate analysis found that a neutrophil-to-lymphocyte ratio ≥9 (odds ratio [OR], 4.64; 95% confidence interval [CI], 2.05-10.53) albumin <3.5 g/dL (OR, 3.76; 95% CI, 1.56-9.07), lactate dehydrogenase (LDH) level ≥725 U/L (OR, 5.45; 95% CI, 2.36-12.57), and IMV (OR, 64.7; 95% CI, 15.20-275.39) were independent risk factors associated with mortality. CONCLUSION: Neutrophil-to-lymphocyte ratio, LDH, albumin, and IMV were independent risk factors for mortality in Mexican patients with COVID-19. Also, the availability of ICU resources is invaluable for better outcomes in critically ill patients. Our results could provide clinical information for timely decision-making in low-and-middle income countries to overcome the pandemic.