Determinants of influenza vaccination among high-risk Black and White adults

Vaccine. 2017 Dec 18;35(51):7154-7159. doi: 10.1016/j.vaccine.2017.10.083. Epub 2017 Nov 7.

Abstract

Background: Adults with chronic conditions are at much greater risk of influenza-related morbidity and mortality, yet flu vaccine uptake remains suboptimal. Research focused on the high-risk population has been limited, particularly related to racial disparities in vaccination. We explore a broad range of demographic, racial, and psychosocial factors to identify predictors of vaccination among high-risk adults, with a focus on identify differences between Black and White adults.

Methods: We conducted an online survey in March 2015, utilizing international research firm GfK's KnowledgePanel, for a nationally representative sample of Black and White adults (≥18, USA) and limited analysis adults with high-risk of influenza-related complications. Using two-way ANOVA, we assessed demographic, racial, and psychosocial predictors across vaccine uptake in the past five years and across racial group.

Results: 424 (52.2%) Black and 388 (47.8%) White respondents with high-risk complications completed the survey. 383 (47.3%) reported vaccination annually, 99 (12.2%) most years, 104 (12.9%) once/twice, and 223 (27.6%) never.ANOVA confirmed significant differences in vaccine behavior for most demographic predictors (except education), all racial factors (including racial fairness, experiences of discrimination, etc.), and most psychosocial factors (including vaccine attitudes, trust in the vaccine, etc.). ANOVA confirmed significant differences for most factors by race. We observed significant interaction effects between race and vaccine behavior for subjective social status, access to medical care, knowledge of vaccine recommendations, vaccine attitudes, perceived side effect risks, descriptive norms, subjective norms, flu vaccine hesitancy, and flu vaccine confidence, thus implying racial differences in the connection between vaccine uptake and key demographic, racial, and psychosocial factors.

Conclusions: This study provides a novel examination of flu vaccine behavior among high-risk Blacks and Whites that identified factors influencing vaccine uptake.We found significant differences by race. Health care professionals can use this information to more effectively target high-risk adults during flu season.

Keywords: African Americans; Chronic conditions; High-risk population; Influenza vaccination; Racial disparities; United States.

MeSH terms

  • Adolescent
  • Adult
  • Black or African American*
  • Chronic Disease / epidemiology
  • Chronic Disease / prevention & control
  • Cross-Sectional Studies
  • Demography
  • Female
  • Health Knowledge, Attitudes, Practice
  • Healthcare Disparities / ethnology*
  • Healthcare Disparities / statistics & numerical data
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Influenza Vaccines / administration & dosage
  • Influenza Vaccines / adverse effects
  • Influenza Vaccines / immunology*
  • Influenza, Human / epidemiology
  • Influenza, Human / ethnology
  • Influenza, Human / prevention & control*
  • Male
  • Middle Aged
  • Risk Factors
  • Seasons
  • Surveys and Questionnaires
  • United States / epidemiology
  • Vaccination / adverse effects
  • Vaccination / psychology
  • Vaccination / statistics & numerical data*
  • White People*
  • Young Adult

Substances

  • Influenza Vaccines