The Impact of Vaccine Concerns on Racial/Ethnic Disparities in Influenza Vaccine Uptake Among Health Care Workers

Ojha, Rohit P.; Stallings-Smith, Sericea; Flynn, Patricia M.; Adderson, Elisabeth E.; Offutt-Powell, Tabatha N.; Gaur, Aditya H.

doi:10.2105/ajph.2015.302736

Cited by 27 publications

(24 citation statements)

References 46 publications

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“…22 The fact that 13% of the women in our cohort were vaccinated during pregnancy, and that 39% of our sample reported that they intended to be vaccinated with influenza vaccine in future pregnancies is reflective of an ingrained (anti)immunization continuum. 46,47 These findings are mirrored in other studies that have examined challenges with vaccine uptake among racially and ethnically diverse minority communities. 48,49 Our findings reinforce the notion that maternal immunization is not likely to shift without effective, repeated messaging that normalizes vaccination as a women's and infant health protection issue.…”

Section: Discussionsupporting

confidence: 56%

A randomized trial of maternal influenza immunization decision-making: A test of persuasive messaging models

Frew

Kriss

Chamberlain

et al. 2016

Human Vaccines & Immunotherapeutics

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Objective: We sought to examine the effectiveness of persuasive communication interventions on influenza vaccination uptake among black/African American pregnant women in Atlanta, Georgia. Methods: We recruited black/African American pregnant women ages 18 to 50 y from Atlanta, GA to participate in a prospective, randomized controlled trial of influenza immunization messaging conducted from January to April 2013. Eligible participants were randomized to 3 study arms. We conducted followup questionnaires on influenza immunization at 30-days post-partum with all groups. Chi-square and t tests evaluated group differences, and outcome intention-to-treat assessment utilized log-binomial regression models. Results: Of the 106 enrolled, 95 women completed the study (90% retention), of which 31 were randomly assigned to affective messaging intervention ("Pregnant Pause" video), 30 to cognitive messaging intervention ("Vaccines for a Healthy Pregnancy" video), and 34 to a comparison condition (receipt of the Influenza Vaccine Information Statement). The three groups were balanced on baseline demographic characteristics and reported health behaviors. At baseline, most women (63%, n D 60) reported no receipt of seasonal influenza immunization during the previous 5 y. They expressed a low likelihood (2.1 § 2.8 on 0-10 scale) of obtaining influenza immunization during their current pregnancy. At 30-days postpartum follow-up, influenza immunization was low among all participants (7-13%) demonstrating no effect after a single exposure to either affective messaging (RR D 1.10; 95% CI: 0.30-4.01) or cognitive messaging interventions (RR D 0.57; 95% CI: 0.11-2.88). Women cited various reasons for not obtaining maternal influenza immunizations. These included concern about vaccine harm (47%, n D 40), low perceived influenza infection risk (31%, n D 26), and a history of immunization nonreceipt (24%, n D 20). Conclusion: The findings reflect the limitations associated with a single exposure to varying maternal influenza immunization message approaches on vaccine behavior. For this population, repeated influenza immunization exposures may be warranted with alterations in message format, content, and relevance for coverage improvement.

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Section: Discussionsupporting

confidence: 56%

A randomized trial of maternal influenza immunization decision-making: A test of persuasive messaging models

Frew

Kriss

Chamberlain

et al. 2016

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

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“…One US study reported no difference in pandemic influenza A(H1N1) vaccine uptake by ethnicity 41 while another study reported lower rates of vaccination in non-Hispanic Black than non-Hispanic White HCWs. 42 Higher levels of concern about vaccine safety and effectiveness coupled with lower concern about the seriousness of influenza disease were found to mediate this finding. 42 Limitations of our study include volunteer bias, with a higher uptake of the influenza vaccine in our participants than reported for HCWs in Canada.…”

Section: Discussionmentioning

confidence: 91%

“…Earlier findings of ethnicity's association with vaccine uptake have been contradictory. One US study reported no difference in pandemic influenza A(H1N1) vaccine uptake by ethnicity while another study reported lower rates of vaccination in non‐Hispanic Black than non‐Hispanic White HCWs . Higher levels of concern about vaccine safety and effectiveness coupled with lower concern about the seriousness of influenza disease were found to mediate this finding …”

Section: Discussionmentioning

confidence: 99%

Factors associated with influenza vaccination among healthcare workers in acute care hospitals in Canada

Hussain

McGeer

McNeil

et al. 2018

Influenza Resp Viruses

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BackgroundInfluenza vaccine coverage rates among healthcare workers (HCWs) in acute care facilities in Canada remain below national targets.ObjectiveTo determine factors associated with influenza vaccine uptake among HCWs.MethodsThis secondary analysis of a prospective cohort study included HCWs aged 18‐69 years, working ≥20 h/wk in a Canadian acute care hospital. Questionnaires were administered to participants in the fall of the season of participation (2011/12‐2013/14) which captured demographic/household characteristics, medical histories, occupational, behavioural and risk factors for influenza. Generalized estimating equation logistic regression was used to determine factors associated with vaccine uptake in the season of participation.ResultsThe adjusted odds ratio for influenza vaccination in the current season was highest for those vaccinated in 3 of 3 previous seasons (OR 156; 95% CI 98, 248) followed by those vaccinated in 2 of 3 and 1 of 3 previous seasons when compared with those not vaccinated. Compared with nurses, physicians (OR 4.2; 95% CI 1.4, 13.2) and support services staff (OR 1.8; 95% CI 1.3, 2.4) had higher odds ratios for vaccine uptake. Conversely, HCWs identifying as Black had lower odds of uptake compared with those with European ancestry (OR 0.44, 95% CI 0.26‐0.75) when adjusted for other factors in the model.ConclusionHealthcare workers differ in their annual uptake of influenza vaccine based on their past vaccination history, occupation and ethnicity. These findings indicate a need to determine whether there are other vaccine‐hesitant groups within healthcare settings and learn which approaches are successful in increasing their uptake of influenza vaccines.

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“…Not only were they more skeptical about the effectiveness of the vaccination, but they were also of the belief that harmful side effects would result if they were to receive the immunization [19,38]. Health care workers who were black and Hispanic were more concerned about the vaccine’s safety and efficacy profile than white health care workers [39]. A portion of the black population was hesitant to receive the vaccine because they did not trust the health care system due to previous poor experience [40].…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Disparities in Influenza Vaccination among Adults with Chronic Medical Conditions Vary by Age in the United States

Qiao

Brown

et al. 2017

PLoS ONE

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BackgroundPeople living with chronic health conditions exhibit higher risk for developing severe complications from influenza according to the Centers for Diseases Control and Prevention. Although racial and ethnic disparities in influenza vaccination have been documented, it has not been comprehensively determined whether similar disparities are present among the adult population with at least one such condition.ObjectiveTo study if racial and ethnic disparities in relation to influenza vaccination are present in adults suffering from at least one chronic condition and if such inequalities differ between age groups.MethodsThe Medical Expenditure Panel Survey (2011–2012) was used to study the adult population (age ≥18) who had at least one chronic health condition. Baseline differences in population traits across racial and ethnic groups were identified using a chi-square test. This was conducted among various age groups. In addition, survey logistic regression was utilized to produce odds ratios of receiving influenza vaccination annually between racial and ethnic groups.ResultsThe total sample consisted of 15,499 adults living with at least one chronic health condition. The numbers of non-Hispanic whites (whites), non-Hispanic blacks (blacks), and Hispanics were 8,658, 3,585, and 3,256, respectively. Whites (59.93%) were found to have a higher likelihood of self-reporting their receipt of the influenza vaccine in comparison to the black (48.54%) and Hispanic (48.65%) groups (P<0.001). When examining persons aged 50–64 years and ≥65 years, it was noted that the black (54.99%, 62.72%) and Hispanic (53.54%, 64.48%) population had lower rates of influenza vaccine coverage than the white population (59.22%, 77.89) (both P<0.0001). No significant differences between whites and the blacks or Hispanics were found among the groups among adults between 18 and 49 inclusive (P>0.05). After controlling for patient characteristics, the difference in influenza vaccine coverage between whites and the minority groups were no longer significant for adults aged 50–64 years. However, the difference were still statistically significant for those aged ≥65 years.ConclusionsIn the United States, there are significant disparities in influenza vaccination by race and ethnicity for adults over 65 years with at least one chronic health condition. Future research is needed to help develop more targeted interventions to address these issues and improve influenza vaccination rates.

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The Impact of Vaccine Concerns on Racial/Ethnic Disparities in Influenza Vaccine Uptake Among Health Care Workers

Cited by 27 publications

References 46 publications

A randomized trial of maternal influenza immunization decision-making: A test of persuasive messaging models

A randomized trial of maternal influenza immunization decision-making: A test of persuasive messaging models

Factors associated with influenza vaccination among healthcare workers in acute care hospitals in Canada

Racial and Ethnic Disparities in Influenza Vaccination among Adults with Chronic Medical Conditions Vary by Age in the United States

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