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Compliance with influenza vaccination. Its relation with epidemiologic and sociopsychological factors
G A van Essen1, M M Kuyvenhoven, R A de Melker
1Department 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.