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2500-12-31
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WORKPLACE AVAILABILITY, RISK GROUP AND PERCEIVED BARRIERS PREDICTIVE OF 2016-17 INFLUENZA VACCINE UPTAKE IN THE UNITED STATES: A CROSS-SECTIONAL STUDY
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Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave, University of Arizona, Tucson, AZ, United States
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave, University of Arizona, Tucson, AZ, United States
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave, University of Arizona, Tucson, AZ, United States
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave, University of Arizona, Tucson, AZ, United States
Abstract
Background: Seasonal influenza, though mostly self-limited in the healthy adult, may lead to severe disease
and/or complications in subpopulations. Annual influenza vaccination is available in many countries
with coverage goals rarely being met. We conducted a cross-sectional study of influenza vaccine uptake
and explored socio-demographic, economic, and psychological factors that explained vaccine uptake.
Methods: The survey was administered via Amazon Mechanical Turk (MTurk) to United States residents
in January 2017, using the Qualtrics platform. Using principal axis factor analysis, we reduced the 25
items theory-based psychological determinants into the primary constructs they measure if/when internal
consistency was sufficient (Cronbach’s alpha >0.60). Logistic regression models were used to quantify
the association of socio-demographic, economic, and psychological factors with reported vaccine behavior
in the 2016–17 flu season.
Results: 1007 participants completed the survey, sex distribution was even, 67% had 25–44 years of age,
and 61% annual household income of $30–99 thousand United States dollars. About 25% had the flu shot
offered at their workplace and 20% reported belonging to a group for whom the flu shot is recommended.
Vaccine uptake was 31.5%. Eight predictors remained in the final adjusted model (R2 = 0.489), having the
vaccine offered at the workplace, belonging to a group for whom the vaccine is recommended, and higher
perceived barriers were the strongest predictors of vaccine uptake, increasing (and decreasing in the case
of barriers) the odds by >3-fold. Additionally, higher household income, higher perceived susceptibility
and higher perceived benefits also independently predicted vaccine uptake.
Discussion: We found evidence that perceived barriers significantly impaired vaccine uptake to the same
extent that having the vaccine offered at the workplace or belonging to a group for whom the vaccine is
recommended facilitated uptake. Ideally, a better understanding of drivers of vaccine hesitancy will
result in improved interventions to increase vaccine uptake.
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