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Factors Contributing to Influenza Vaccine Hesitancy Identified

November 25, 2019

Insurance, health care, and employment status play a role in vaccine hesitancy among adults in the United States, according to new research.

“Understanding barriers to influenza vaccination can help the development of interventions to reduce influenza vaccine hesitancy, increase vaccination, and reduce influenza burden,” the researchers wrote.

To conduct their study, the researchers analyzed responses to “Overall, how hesitant are you about flu vaccinations?” from the 2018 National Internet Flu Survey. Respondents were adults aged 18 years or older.

Associations between sociodemographic characteristics, attitudes, beliefs about influenza vaccination, and influenza vaccination hesitancy were analyzed via logistic regression.

Results showed that 38.5% of respondents were hesitant about influenza vaccination and that the following factors were associated with vaccination hesitancy:

  • Being female
  • Age 18 to 49 years
  • non-Hispanic black
  • Having high school or less education
  • Being unemployed
  • Having income $35,000 or less
  • Having not visited a doctor
  • Not having a usual place for health care
  • Not receiving a recommendation for influenza vaccination
  • Not having health insurance
  • Having concerns about serious vaccine adverse effects
  • Never having received influenza vaccination
  • Believing the influenza vaccine is unsafe
  • Believing the influenza vaccine last season was not effective
  • Not receiving influenza vaccination this season

“Influenza vaccination hesitancy varied widely by socio-demographic characteristics, attitudes, and beliefs about influenza vaccine,” the researchers concluded. “This information may assist to develop targeted interventions to reduce hesitancy and thus improve influenza vaccination acceptance.”

—Amanda Balbi


Srivastav A, Lu PJ, Santibanez T, et al. Influenza vaccination hesitancy among adults, united states, 2018 national internet flu survey. Paper presented at: American Public Health Association 2019 Annual Meeting and Expo; November 2-6, 2019; Philadelphia, PA. Accessed November 4, 2019.

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