Flu vaccination prevalence in military health service beneficiaries newly recommended for vaccination

In August 2010, CDC's Advisory Committee on Immunization Practices published new influenza vaccination recommendations for the 2010-2011 influenza season that now include everyone six months or older among those recommended for vaccination. Previous guidelines recommended vaccination for select groups (persons age 50 or older and those with certain chronic conditions), so this season marked the first in which some groups (specifically, those without chronic conditions between ages 19 and 49) were recommended for vaccination.

Like many health care systems, TRICARE, the health care program for military service members, retirees, and their families, is dedicated to promoting flu vaccination. The TRICARE beneficiary population is different from other health system beneficiary populations in that all uniformed military personnel are required to be vaccinated, but dependents and retired personnel are not, requiring multiple strategies to promote widespread vaccination.

TRICARE was interested in capturing flu vaccination behaviors and attitudes of newly recommended beneficiaries in light of the new CDC guidelines as well as better understanding the practice and impact of physician vaccination recommendation. To do so, the TRICARE Management Activity analyzed data from a flu vaccination telephone survey of 5001 adult TRICARE beneficiaries, 26% (n=1284) of which were newly recommended for vaccination.

Survey results indicated statistically significant differences in vaccination prevalence between newly and previously recommended groups in certain beneficiary categories. While there were no statistically significant difference among newly and previously recommended active duty respondents (84.3% vs. 83.9%, respectively), differences were detected between newly vs. previously recommended retirees (27.2% vs. 53.2%), their dependents (28.6% vs. 50.2%), and active duty dependents (24.2% vs. 31.1%).

Newly recommended respondents were less likely to have a physician recommend vaccination and were more likely to believe that they did not need the vaccine compared with those who were previously recommended. Among newly recommended respondents who were yet unvaccinated, 45.3% said they intended to be vaccinated this season, and 57% said they would do so if their doctor recommended it. Additional data collection is planned for early spring 2011, and results comparing vaccination prevalence among this group early and late in the flu season will be presented.

Initial findings point to differences in perception and behavior between those newly and previously recommended for vaccination and may suggest potential benefit for interventions to increase compliance with CDC vaccination guidelines, especially among active duty dependents. Increasing physician recommendation appears to be a promising intervention approach.