Elsevier

Vaccine

Volume 35, Issue 34, 3 August 2017, Pages 4346-4354
Vaccine

Knowledge of influenza vaccination recommendation and early vaccination uptake during the 2015–16 season among adults aged ≥18 years – United States

https://doi.org/10.1016/j.vaccine.2017.06.074Get rights and content

Highlights

  • 19.6% indicated knowing that influenza vaccination is recommended for persons ≥6 months.

  • 62.3% had awareness that there was a recommendation for influenza vaccination, but with incorrect age group.

  • Overall, 39.9% of adults aged ≥18 years reported having an influenza vaccination.

  • Effective strategies are needed to improve recommendation awareness and vaccination coverage.

Abstract

Background

Since 2010, the Advisory Committee on Immunization Practices (ACIP) has recommended that all persons aged ≥6 months receive annual influenza vaccination.

Methods

We analyzed data from the 2015 National Internet Flu Survey (NIFS), to assess knowledge and awareness of the influenza vaccination recommendation and early influenza vaccination coverage during the 2015–16 season among adults. Predictive marginals from a multivariable logistic regression model were used to identify factors independently associated with adults’ knowledge and awareness of the vaccination recommendation and early vaccine uptake during the 2015–16 influenza season.

Results

Among the 3301 respondents aged ≥18 years, 19.6% indicated knowing that influenza vaccination is recommended for all persons aged ≥6 months. Of respondents, 62.3% indicated awareness that there was a recommendation for influenza vaccination, but did not indicate correct knowledge of the recommended age group. Overall, 39.9% of adults aged ≥18 years reported having an influenza vaccination. Age 65 years and older, being female, having a college or higher education, not being in work force, having annual household income ≥$75,000, reporting having received an influenza vaccination early in the 2015–16 season, having children aged ≤17 years in the household, and having high-risk conditions were independently associated with a higher correct knowledge of the influenza vaccination recommendation.

Conclusions

Approximately 1 in 5 had correct knowledge of the recommendation that all persons aged ≥6 months should receive an influenza vaccination annually, with some socio-economic groups being even less aware. Clinic based education in combination with strategies known to increase uptake of recommended vaccines, such as patient reminder/recall systems and other healthcare system-based interventions are needed to improve vaccination, which could also improve awareness.

Introduction

Influenza is a major cause of morbidity and mortality among adults in the United States [1], [2], [3], [4]. Influenza illness burden among healthy adults 18–49 years is an important cause of outpatient medical visits and loss of workdays [5], [6]. Influenza vaccination has been shown to be a cost-effective tool for reducing morbidity and mortality associated with influenza among adults [5], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18].

Prior to 2010, the adult groups recommended for annual vaccination included persons 50 years and older, pregnant women, persons 18–49 years with medical conditions associated with higher risk of complications from influenza infection, healthcare personnel, and close contacts of high-risk persons [19]. Since the 2010–11 influenza season, the Advisory Committee on Immunization Practices (ACIP) has recommended annual influenza vaccination for all persons 6 months of age and older, including healthy adults 18–49 years who were not close contacts of persons at high-risk [1] Healthy adults aged 18–49 year was added to the recommendations in the 2010–11 season given the known significant morbidity and economic impact of influenza in working age adults [1]. In addition, the universal vaccination recommendation also eliminates the need to determine whether each person has one or more specific indications for vaccination and emphasizes the importance of preventing influenza among persons of all ages [1].

Influenza vaccination is the most effective strategy for preventing influenza and its complications; however, vaccination coverage has been suboptimal [1], [20], [21], [22]. Knowledge and awareness of the influenza vaccination recommendation might be related to vaccination coverage [20], [23], but information about levels of knowledge and association between knowledge and vaccination among adult population groups is limited.

Data from the 2015 National Internet Flu Survey (NIFS) were analyzed to assess knowledge and awareness of influenza vaccination recommendation and early vaccination during the 2015–16 season among adults aged ≥18 years in the United States.

Section snippets

Methods

The NIFS is an annual survey and collects information about early-season influenza vaccination, and knowledge, attitudes, behaviors, and barriers related to influenza and influenza vaccination in the non-institutionalized U.S. adult population. The 2015 NIFS was conducted for Centers for Diseases Control and Prevention (CDC) by RTI International and GfK Custom Research, LLC during October 29–November 11, 2015. The survey was conducted using a probability-based Internet panel, the GfK

Results

Sociodemographic and access-to-care characteristics of the study population are shown in Table 1.

Among all adults aged ≥18 years, only 19.6% indicated correct knowledge of the influenza vaccination recommendation (those who answered that “the vaccine is recommended for all persons age 6 months and older”) (Table 2). Among those indicating correct knowledge of the influenza vaccination recommendation, influenza vaccination coverage was 53.5%, significantly higher than those with incorrect answers

Discussion

Less than 1 in 5 adults in the United States had correct knowledge of the ACIP recommendation that all persons aged ≥6 months should receive an influenza vaccination annually, with some socio-economic groups being even less knowledgeable. However, more than 3 in 5 adults in the United States were aware that there is a recommendation for influenza vaccination, although they did not know the correct recommended age group. Less than half of adults reported vaccination by early November 2015. Since

Conflict of interest

All authors have no conflicts of interest to be stated.

Disclaimer

The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of CDC.

Acknowledgments

We thank James A. Singleton and Stacie M. Greby for their thoughtful review of the manuscript.

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