Purpose: To determine whether patients' demographic, medical, and personal characteristics, including attitudes and beliefs about vaccination, health, and medical providers, are associated with acceptance of influenza vaccine.
Patients and methods: Nine hundred sixty-five patients attending a university hospital-based general medicine clinic during the fall influenza vaccination period, including 624 patients for whom influenza vaccine was indicated, were observed in a prospective cohort study. In addition, 58 patients who refused influenza vaccine and an equal number who accepted it were interviewed over the telephone to examine their beliefs and behaviors in greater detail.
Results: Seventy-five percent of patients for whom influenza vaccine was indicated received it. Prospectively assessed patient characteristics that were significantly associated with nonvaccination included not believing vaccine prevents "flu" (relative risk [RR] 5.3), never received pneumococcal vaccine (RR 3.5), not vaccinated against influenza the previous year (RR 3.5), never vaccinated against influenza (RR 2.3), and felt sick after previous influenza vaccination (RR 2.3). Demographic characteristics and medical diagnoses were not significantly related to vaccination. Almost one half of 58 interviewed subjects who refused influenza vaccine cited fear of a reaction. Among retrospectively determined attitudes and beliefs significantly associated with refusal of influenza vaccine were not believing the vaccine works well (odds ratio [OR] 11.6), concern about a reaction (OR 9.3), and perception that the medical provider had not recommended it (OR 5.8).
Conclusion: Demographic characteristics of patients and their medical diagnoses were not associated with acceptance of influenza vaccination. Among patients who were not vaccinated, doubts about the efficacy of influenza vaccine and fear of its side effects were common, and their perceptions of the medical provider's recommendation of vaccine appeared to be an important factor in the decision whether to accept it.