Gender Differences in Rural Adolescents' Reasons for Refusal or Acceptance of Influenza Vaccination

Background: Influenza is a leading vaccine preventable disease in the US. Vaccinating school-age children against influenza may indirectly protect vulnerable populations. However, little is known about adolescents' attitudes toward influenza vaccination, and whether such attitudes vary by gender.

Methods: Participants were recruited from two counties participating in a school-based influenza vaccination intervention in rural Georgia (N=341). Data were collected from surveys distributed to middle- and high-school students in participating counties prior to intervention implementation. Possible reasons for getting or not getting an influenza vaccination in the past year were presented. Participants rated the extent to which each reason influenced their vaccination decision. MANCOVA was used to compare differences in reasons for past year vaccination/non-vaccination by gender, controlling for age.

Results: Approximately 22.6% reported receiving an influenza vaccine last year, 69.8% reported not vaccinating, and 7.6% were unsure. Males and females were equally likely to report influenza vaccination. Females were more likely to report having control over getting an influenza vaccination (p=0.003). Among participants who received an influenza vaccination, the most common reason was a doctor's recommendation. Males were more likely than females to vaccinate based on a friend/family recommendation (p=0.040). Among adolescents who did not receive a vaccination, the most common reason was disliking needles. Females were more likely to report disliking needles (p=0.020) and cost (p=0.050) as barriers.

Conclusions: Findings suggest that there may be gender differences in reasons for influenza vaccine acceptance. Future influenza vaccination efforts geared toward rural adolescents may benefit from taking gender differences into account.