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Differences in Adult Influenza Vaccine-Seeking Behavior: The Roles of Race and Attitudes

Groom, Holly C. MPH; Zhang, Fan PhD; Fisher, Allison Kennedy MPH; Wortley, Pascale M. MD

Journal of Public Health Management and Practice: March/April 2014 - Volume 20 - Issue 2 - p 246–250
doi: 10.1097/PHH.0b013e318298bd88
Original Articles

Background: Racial/ethnic disparities in influenza vaccination among adults are longstanding, and research suggests they result from multiple factors. Influenza vaccine-seeking behavior may be an important aspect to consider when evaluating disparities in vaccination coverage.

Objective: To determine whether there are differences between blacks and whites in influenza vaccine-seeking behavior among adults 65 years and older.

Methods: Data were analyzed from a national sample of 3138 adults 65 years and older collected through the adult module of the 2007 National Immunization Survey, a random digit dialing telephone survey, which included an oversample of non-Hispanic blacks. Analysis included influenza vaccination rate, location of vaccination, and whether vaccinated individuals specifically went to the location to receive the vaccine (vaccine seekers) by race. The relationship between attitudes about influenza vaccination and vaccine-seeking behavior by race was also examined.

Results: White adults 65 years and older were significantly more likely to receive influenza vaccine than blacks, during the 2006–2007 influenza season (68% ± 4% vs 54% ± 3%, respectively), and a significantly higher proportion of vaccinated whites reported seeking out the vaccine than vaccinated blacks (66% ± 4% vs 47% ± 4%, respectively). Blacks were less likely to be vaccine seekers, regardless of education or poverty levels. Among persons vaccinated in a doctor's office, 52% of whites specifically went there to get vaccinated, compared with 37% of blacks. Among persons who believe the vaccine is very effective, 66% ± 5% of whites versus 50% ± 6% of blacks were vaccine seekers.

Conclusions: This study points to the importance of improving our understanding of what factors, in addition to beliefs about vaccination, lead to vaccine seeking and reinforces the need for systematically offering vaccine.

The objective of this study was to determine whether there are differences between blacks and whites in influenza vaccine-seeking behavior among adults 65 years and older.

Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Health Research, Kaiser Permanente NW, Portland, OR.

Correspondence: Holly C. Groom, MPH, Center for Health Research, Kaiser Permanente Northwest, 3550 N, Interstate Avenue, Portland, OR 97217 (

This work was supported by the Centers for Disease Control and Prevention. No financial disclosures were made by the authors of this paper. The authors declare that there is no conflict of interest that would interfere with the findings of this analysis. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

The author contributions to the design of this study are as follows: Holly Groom and Pascale Wortley—development of research questions, study design, interpretation of analysis, manuscript development; Fan Zhang—statistical analysis, including polytomous regression analysis, interpretation of results, and preparation of methods section of manuscript; and Allison Kennedy—interpretation of data and preparation of manuscript.

© 2014 Lippincott Williams & Wilkins, Inc.