Influenza vaccination. Knowledge, attitudes, and behavior among high-risk outpatients
K. L. Nichol, R. P. Lofgren and J. Gapinski
Department of Medicine, Veterans Affairs Medical Center, Minneapolis, MN 55417.
The Minneapolis and Pittsburgh Veterans Affairs Medical Centers conduct
virtually identical institution-wide influenza vaccination programs that
include annual educational and publicity mailings to all outpatients.
Despite these efforts, 40% to 50% of high-risk outpatients at both centers
fail to receive influenza vaccine each year. To assess differences between
high-risk vaccine recipients and nonrecipients, a self-administered
questionnaire was mailed to 500 randomly selected outpatients from each
site. The questionnaire asked about risk factors, vaccination status, and
knowledge and attitudes regarding influenza and "flu shots." Patient risk
characteristics and vaccination rates in Minneapolis and Pittsburgh were
similar with 75.6% and 76.3% reporting high-risk conditions and 65.6% and
56.1% of high-risk respondents reporting influenza vaccination,
respectively. High-risk vaccine recipients and nonrecipients had similar
knowledge but different attitudes about influenza and "flu shots." Using
stepwise logistic regression, factors positively associated with
vaccination behavior were: intention to follow physician or nurse
recommendations for "flu shots" (odds ratio [OR] = 7.09); previous
vaccination behavior (OR = 6.36); and physician or nurse recommendations
for a "flu shot" (OR = 4.29). Factors negatively associated with
vaccination behavior were difficulty in coming to the medical center (OR =
0.42) and previous side effects from the vaccine (OR = 0.19). These
findings suggest areas in need of additional emphasis if influenza
vaccination rates are to be improved.
