Challenges in building a successful influenza vaccine program, a 2-year journey

 

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Challenges in building a successful influenza vaccine program, a 2-year journey

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Li Ping
Tan
Aima Farhana Abdul Haris AimaFarhana.AbdulHaris@davita.com Davita Malaysia Clinical Kuala Lumpur Malaysia -
Mohammad Ashraf Rafiza MohammadAshraf.Rafiza@davita.com Davita Malaysia Clinical Kuala Lumpur Malaysia -
Gunavathy Subramaniam Gunavathy.Subramaniam@davita.com Davita Malaysia Clinical Kuala Lumpur Malaysia -
Nur Izzati MOhd Darali NurIzzati.MohdDarail@davita.com Davita Malaysia Clinical Kuala Lumpur Malaysia -
Jeyasutha Sukumar Jeyasutha.Sukumar@davita.com Davita Malaysia Clinical Kuala Lumpur Malaysia -
Mohana Regunathan Mohana.Regunathan@davita.com Davita Malaysia Clinical Kuala Lumpur Malaysia -
Nurul Hawa Salim NurulHawa.Salim@davita.com Davita Malaysia Clinical Kuala Lumpur Malaysia -
Ahmad Safuan Shamsul Bahari AhmadSafuan.SamshulBahari@davita.com Davita Malaysia Clinical Kuala Lumpur Malaysia -
Vickneswari Raja Gobar Vikneswari Raja Gobar Davita Malaysia Clinical Kuala Lumpur Malaysia -
Nor Majidah Mustaffa Kamal NorMajidah.MustaffaKamal1@davita.com Davita Malaysia Operations Kuala Lumpur Malaysia -
Chris, Pao Kuen Koh PaoKuen.Koh@davita.com Davita Malaysia HQ Kuala Lumpur Malaysia -
Li Ping Tan liping.tan@davita.com Davita Malaysia Clinical Kuala Lumpur Malaysia *
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Influenza vaccination has historically not been a part of vaccination strategies in Malaysia, both in the general population as well as in the dialysis cohorts. This is despite rising recognition that influenza infections have played a role in increasing hospitalizations. 

Our organization in 2024 started a campaign to drive influenza vaccination across our 44 dialysis clinics spread throughout Malaysia. However, the success was muted. At the end of 2025, only a total of 16% of the dialysis population had been vaccinated. This was far below a pre-set target of 50%.

A survey carried out using random sampling among patients identified a number of reasons for the low penetration rate. These were (1) Cost (Malaysia does not reimburse the influenza vaccine; therefore, all vaccinations are out-of-pocket) (2) poor awareness and knowledge of vaccine benefits (3) distrust towards vaccines 

For 2025, a more ambitious goal was planned (85%). To target this goal, we devised the following: 


A multistep program was designed to address the barriers identified above. These were as follows

1.    Reduced vaccination cost by 40% compared to average market prices

2.    Vaccination pamphlets detailing benefits of vaccination and risks of going without

3.    Scheduled vaccination counselling by dialysis unit nurses to each patient as well as patient levels CME sessions by nursing educators on a 3-monthly basis

4.    Targeted counselling by nursing educators on patients who have declined vaccination after having been approached 3 times

5.    Purchased stocks of vaccines to be placed in dialysis units proactively rather than reactively

6.    Vaccination activity to be done surrounding Dr rounds for maximal impact. 

vaccinationTHe above represent our improved vaccination activity recorded from the months of January through September of 2025. Vaccination rates notably picked up after May 2025. The activity which made the most impact was linking the vaccination to the Dr rounds. Nephrologists in MAlaysia do rounds on their patients on a 3 monthly basis; AThe rounds done in April/May 2025 were instrumental in driving increasing vaccination activity. This was supplemented by consistent nursing educational acitivites towards the patients. 


In a vaccine resistant population, the key impact driving the takeup of vaccinations was a structured program comprised of consistent education and awareness activities which laid the foundation of acceptance to the vaccine followed by physician driven vaccination. This was able to drive vaccinations from a base level of 16% in 2024 to 55.6% in 2025. 

Kewords