Determinants of influenza vaccine uptake and perceived barriers among public university employees

Direct and indirect costs of seasonal influenza in the U.S. are estimated in the billions of dollars annually. Although the influenza vaccine reduces morbidity and mortality, uptake rates remain sub-optimal among U.S. adults. The purpose of this study is to examine characteristics associated with vaccine uptake, including demographics, hand hygiene behaviors, and perceived barriers among employees in a public Midwestern university.

A mixed methods survey was distributed randomly to 1600 employees during the 2011-12 influenza season.  Questions pertained to demographics, vaccine status, hand hygiene behaviors and included an open-ended question to elicit perceptions regarding the decision not to obtain the influenza vaccine.

Approximately 23% of employees who received the survey completed it; 94.5% (342) of respondents answered the questions about influenza vaccine status.  Analyses indicated that adults 18-49 were the least likely to report vaccination uptake. Results of multi-logistic regression indicated that the odds of influenza vaccine uptake increased with age. A total of 59.6% reported not receiving an influenza vaccination for the current season.  Of these, qualitative thematic analysis using cross comparative analysis revealed ten major decision-making themes that were perceived barriers to vaccine uptake.

Practical implications of this study address how to increase vaccine uptake among healthy adults in light of universal influenza vaccine recommendations.  They include the use of workplace venues to offer clearer communication about specific benefits and limitations of influenza immunizations, provided together with information on other strategies for protection against the flu and colds, such as proactive hand hygiene behaviors and respiratory etiquette.