Barriers to influenza immunization in a low-income urban population.


Journal Article

BACKGROUND:Although 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 > or =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.

Full Text

Duke Authors

Cited Authors

  • Armstrong, K; Berlin, M; Schwartz, JS; Propert, K; Ubel, PA

Published Date

  • January 2001

Published In

Volume / Issue

  • 20 / 1

Start / End Page

  • 21 - 25

PubMed ID

  • 11137770

Pubmed Central ID

  • 11137770

Electronic International Standard Serial Number (EISSN)

  • 1873-2607

International Standard Serial Number (ISSN)

  • 0749-3797

Digital Object Identifier (DOI)

  • 10.1016/s0749-3797(00)00263-4


  • eng