What shapes influenza attitudes and behaviors in Italy? Insights from a cross-sectional study

Seasonal influenza places a substantial burden on healthcare systems. Despite the effectiveness of annual vaccination in reducing morbidity, mortality, and costs, vaccination coverage remains suboptimal. This study explored influenza-related attitudes and vaccination behaviors among adults aged 18 and older through a web-based survey (n=1,821). Among participants, 36% were aged 65 or older and 52% reported chronic conditions. Multivariable analysis identified chronic conditions and high perceived influenza risk (OR 8.8; 95% CI 6.2-12.4) as significant predictors of disease severity perception, while reliance on non-institutional online sources was negatively associated. Key predictors of vaccination in the past five years included having children, higher income, healthcare employment or retirement status, presence of chronic illness, positive perceptions of healthcare quality, and favorable attitudes toward influenza (OR 6.7; 95% CI 3.9-11.2) and vaccination (OR 4.3; 95% CI 2.4-4.5). These findings underscore the urgency of tailored, evidence-based communication and improved access strategies to increase influenza vaccination coverage in Italy.