Barriers to influenza immunization in a low-income urban population Original Research Article

Barriers to influenza immunization in a low-income urban population Original Research Article Pages 21-25 Katrina Armstrong, Michelle Berlin, J. Sanford Schwartz, Kathleen Propert, Peter A. Ubel Close Close preview | Purchase PDF (156 K) | Related articles | Related reference work articles AbstractAbstract | Figures/TablesFigures/Tables | ReferencesReferences Abstract Background: Athough influenza immunization significantly reduces mortality from influenza, over one third of elderly Americans are not immunized each year. Low rates of immunization are particularly concerning among African-American low-income populations. Preliminary interviews suggested that fear of undisclosed ingredients in the influenza vaccine may impede vaccine acceptance in this vulnerable population. Objectives: To assess the role of concern about vaccine contents and other factors in the use of influenza immunization among a predominantly African-American low-income urban population. Methods: Cross-sectional, health-system-population–based, telephone survey of a random sample of West Philadelphia residents aged ≥65 years. Results: Of 659 eligible individuals, 486 (73.8%) were successfully interviewed. Concern about undisclosed shot contents was reported by 132 (20%) respondents and was inversely associated with vaccine receipt (OR 0.49, 95% CI 0.26–0.91). This association was similar among African Americans and Caucasians. In addition, receipt of influenza vaccine was inversely associated with belief that immunization is inconvenient (OR 0.14, 95% CI 0.05–0.36), belief that immunization is painful (OR 0.21, 95% CI 0.08–0.54), and history of previous side effects (OR 0.33, 95% CI 0.18–0.60), and positively associated with physician recommendation (OR 3.22, 95% CI 1.76–5.93). Conclusions: In a low-income urban population, concern about undisclosed vaccine contents appears to impede acceptance of influenza immunization among both African Americans and Caucasians. Directly addressing this concern offers a new approach to increasing immunization in this vulnerable population. Article Outline • Introduction • Methods • Study design and population • Subject selection • Instrument development and data collection • Statistical analysis • Results • Discussion • Acknowledgements • References