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Flu shots not to be sneezed at

October 23, 2009

Two in five at-risk American adults who would benefit from vaccination against seasonal flu are missing out on the protective shots because they believe they do not need them and are not inclined to be vaccinated. And among those who say they do intend to take up the vaccine, nearly half get around to it, according to Dr. Katharine Harris from the RAND Corporation* in Arlington, USA, and her team. Their work (1) shows that asking simple questions about the intention to be protected against flu may be an effective way of identifying those patients who are likely to benefit from further information and discussion about the benefits of the vaccine, in order to increase its uptake. Their findings are published online this week in the Journal of General Internal Medicine, published by Springer.

Despite strong evidence that seasonal influenza vaccines are effective and safe, uptake of the vaccine among adults in the US falls short of targets. Dr. Harris and colleagues assessed whether asking unvaccinated individuals about their intentions to be vaccinated against seasonal flu predicted actual vaccination. They also looked at concerns about, and barriers to, vaccination as well as willingness to be vaccinated based on a recommendation by a health care provider.

The researchers analyzed data from two surveys covering over 1,500 American adults to measure the uptake of the vaccine and understand intentions and motivations for being vaccinated. The individuals surveyed fell into the high risk groups specifically recommended for vaccination by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.

Harris and team found that by midseason, over a third of adults for whom the influenza vaccine was specifically recommended had been vaccinated, and another 17 percent said they intended to do so by the end of the season. Just over half of those who intended to be vaccinated followed through. However, nearly 45 percent of adults surveyed did not intend to be vaccinated at midseason and almost all remained unvaccinated by the end of the season.

Adults who had no intention of being vaccinated were more likely to cite a perceived lack of need as the main reason for not being vaccinated. Nonetheless, a substantial proportion of these individuals expressed willingness to be vaccinated based on a strong recommendation from a health care provider. Those who intended to be vaccinated said that the main reason they had not yet taken up the vaccine was because they had not got around to it.

The authors conclude: "Making vaccination convenient to those who intend to be vaccinated by administering influenza vaccines onsite, or by offering practical advice about where and when to be vaccinated, might be effective in helping millions of additional adults to be vaccinated who would otherwise not be. Persuading the two in five adults recommended for seasonal influenza vaccine who are not inclined to be vaccinated is likely to pose a substantially greater challenge and will likely require changing patients' fundamental beliefs about the benefits and risks of the vaccine."

*The RAND Corporation is a nonprofit institution that helps improve policy and decision making through research and analysis.

Reference
1. Harris KM et al (2009). Do people who intend to get a flu shot actually get one? Journal of General Internal Medicine DOI 10.1007/s11606-009-1126-2

Springer