Compliance with influenza vaccination. Its relation with epidemiologic and sociopsychological factors
G. A. van Essen, M. M. Kuyvenhoven and R. A. de Melker
Department of General Practice/Family Medicine, University of Utrecht, The Netherlands.
OBJECTIVE: To identify patient characteristics that are associated with
compliance with influenza vaccination reminders in high-risk patients.
DESIGN: Registration of the vaccination of high-risk patients invited by
their family physicians. Factors that might be associated with compliance
were evaluated, eg, sex, age, insurance, diagnosis, seriousness, and
multiple indications. A questionnaire about sociopsychological factors was
sent to all noncompliant patients and a random sample of 25% of compliant
patients. SETTING: Four single and 3 partnership practices with 2142
high-risk patients in a total of 26,000 patients in the Netherlands. MAIN
OUTCOME MEASURES: (1) Compliance by at-risk group; odds ratios (ORs) for
epidemiologic and diagnosis-based factors, adjusted by multiple logistic
regression analysis; (2) adjusted ORs (adj ORs) for sociopsychological
factors; and (3) decisive reason whether to comply. RESULTS: Compliance was
86% (95% confidence interval [CI], 85%-88%), with little difference between
at-risk groups. The epidemiologic factors age older than 50 years (adj OR,
1.9; 95% CI, 1.5-2.5) and multiple indication (adj OR, 2.2; 95% CI,
1.3-3.6) were related to compliance, independent of at-risk group. Belief
in the absence of side effects (adj OR, 10.5; 95% CI, 5.5-20.2) and in the
efficacy of the vaccine (adj OR, 5.6; 95% CI, 3.0-10.2) were most
positively associated with compliance. Perceived susceptibility to
influenza also was associated (adj OR, 2.9; 95% CI, 1.5-5.8), but
perception of one's health was not. There was a negative association of
compliance in the interaction of age younger than 50 years and disbelief in
the possible complications of influenza (adj OR, 0.2; 95% CI, 0.0-0.5).
These factors and the family physician's invitation were decisive.
CONCLUSIONS: Information about the protection and the side effects of
vaccination and the complications of influenza should be directed to
patients younger than 50 years; no specific high-risk groups require
special information.
