A New Methodology for Estimating Seasonal Influenza Vaccination Rates in the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS)

Seasonal influenza infections and related comorbidities account for thousands of deaths in the United States. Effective and safe vaccines for seasonal influenza have been developed and promise to substantially reduce the mortality and morbidity burden of influenza viruses, yet millions go unvaccinated every year. Important in understanding influenza vaccination behavior within the United States are accurate and reliable data. Currently, limitations in the measures of influenza vaccination that are included in national health surveys may hinder the accuracy of seasonal estimations. To date, various methodological adjustments have been proposed to improve the accuracy of seasonal vaccination estimates; however, there is no systematic review or evaluation of these methods. This research examines the effectiveness of existing methodologies, when applied to data from the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS), and also introduces a new method of estimating seasonal influenza vaccination rates for both surveys.