Abstract
Introduction Influenza poses a significant risk to patients receiving hemodialysis, while vaccination reduces the risk of hospitalization, cardiovascular events, and mortality. However, the influenza vaccine uptake rate is low in low- and middle-income countries. This study aimed to assess influenza vaccination coverage, knowledge, and intentions regarding influenza vaccination, as well as to identify sociodemographic and clinical factors associated with vaccination intention among patients undergoing hemodialysis in the Klang Valley, Malaysia. Materials and methods An observational cross-sectional study was conducted in three private and two public dialysis centers in Malaysia between August and December 2024. Data were collected from patients receiving hemodialysis using a structured questionnaire. There were twelve questions with dichotomous scoring (correct = 1, incorrect/unsure = 0). The scores were later categorized as poor (0-4), moderate (5-7), and good (8-12), with the cut-off points based on tertile distribution. Statistical analyses were performed to determine associations between variables related to knowledge of influenza and its vaccine, as well as predictors of influenza vaccination intention. Results Only 10.8% of 298 respondents had been vaccinated at least once in their lifetime, despite 90% being aware of influenza and its vaccine. Social media (31.5%) and television (23.5%) were the two primary sources of information. The influenza vaccination intention rate is only 40.3%, despite 74.2% of respondents having moderate to good levels of knowledge about the vaccine. Good knowledge level (aOR=6.58, 95% CI 3.145-13.889, p<0.001), female gender (aOR=1.721, 95% CI 1.108-2.915, p=0.043), Chinese ethnicity (aOR=2.443, 95% CI 1.273-4.689, p=0.007), and recommendation by healthcare providers (aOR=3.64, 95% CI 1.497-8.836, p=0.004) are significant predictors for influenza vaccination intention. Conclusions This study highlights the significant misconceptions about influenza and its vaccine among patients receiving hemodialysis in Malaysia. Targeted public health campaigns and healthcare professional engagements are crucial in improving vaccination intention rates in this vulnerable population. Addressing these knowledge gaps could reduce influenza-related complications and mortality among these patients.