Acceptance of Pandemic 2009 Influenza A (H1N1) Vaccine in a Minority Population: Determinants and Potential Points of Intervention

Abstract

OBJECTIVE: We sought to understand pandemic 2009 influenza A (H1N1) vaccine acceptance in a minority community including correlates of vaccine hesitancy and refusal. We identified intervention points to increase H1N1 vaccine coverage. PATIENTS AND METHODS: Minority parents and caregivers of children ≤18 years participated in a cross-sectional survey. Statistical analyses included bivariate correlations, exploratory factor analyses, internal-consistency assessment, and logistic regressions. RESULTS: The sample (N = 223) included mostly lower-income (71% [n = 159]) and black (66% [n = 147]) participants. Potential and actual receipt of pediatric H1N1 vaccination was low (36% [n = 80]). Pediatric H1N1 vaccine acceptance was associated with lack of insurance (odds ratio [OR]: 3.04 [95% confidence interval (CI): 1.26–7.37]), perceived H1NI pediatric susceptibility (OR: 1.66 [95% Cl: 1.41–1.95]), child vaccination prioritization in family (OR: 3.34 [95% CI: 1.33–8.38]), believing that H1N1 is a greater community concern than other diseases (OR: 1.77 [95% CI: 1.01–3.09]), believing that other methods of containment (eg, hand-washing, masks) are not as effective as the H1N1 vaccine (OR: 1.73 [95% CI: 1.06–2.83]), and a desire to promote influenza vaccination in the community (OR: 2.35 [95% CI: 1.53–3.61]). CONCLUSIONS: We found low acceptance of the H1N1 vaccine in our study population. Perceived influenza susceptibility, concern about H1N1 disease, and confidence in vaccinations as preventive methods were associated with vaccine acceptance. Physician support for HIN1 vaccination will aid in increasing immunization coverage for this population, and health departments are perceived as ideal community locations for vaccine administration.

Influenza vaccination acceptance among diverse pregnant women and its impact on infant immunization

“…As previous research with minority women has demonstrated, inherent in vaccine decision-making is distrust of information sources, particularly if immunization messages are disseminated by the government. 12 Our results indicate that for minority women, a community-developed approach to vaccine messaging based on formative research with the target population, is a promising approach to the promotion of vaccine acceptance and cultivating maternal intent to immunize infants. By utilizing "culture-centered" forms of communication with messages created by community members, source distrust may be effectively overcome.…”

“…The survey included 82 items, which were informed by the Integrated Behavioral model, formative interviews with community members, and prior behavioral research on influenza immunization among minority communities. 11,12,59 Key behavioral assessments included history of seasonal influenza immunization, willingness to pay for vaccine, and intention to immunize infant. We determined that the Flesch-Kincaid reading score of 7.4 of the final survey in either language met the acceptable criteria of 6-8th grade reading level for our target population.…”

“…Common perceptions such as the vaccine giving influenza (14%), a lack of concern about influenza severity (12.6%), perceptions of vaccine ineffectiveness (11.7%), and a lack of health insurance and inability to handle immunization cost (6.8%) have been cited as significant barriers to immunization during pregnancy. [9][10][11][12] Suboptimal coverage among pregnant women in the United States is also driven by sociodemographic disparities in immunization. Disparities in vaccination coverage for pregnant women are evident among those without higher Studies indicate that racial and ethnic minorities may be less likely to receive 12 and less aware of 13 vaccines such as human papillomavirus virus vaccine (HPV) and the 2009 pandemic (H1N1) influenza vaccine.…”

“…[9][10][11][12] Suboptimal coverage among pregnant women in the United States is also driven by sociodemographic disparities in immunization. Disparities in vaccination coverage for pregnant women are evident among those without higher Studies indicate that racial and ethnic minorities may be less likely to receive 12 and less aware of 13 vaccines such as human papillomavirus virus vaccine (HPV) and the 2009 pandemic (H1N1) influenza vaccine. Black/African American and Hispanic pregnant women and younger infants have historically experienced higher morbidity, mortality, and hospitalizations due to influenza.…”

Determinants of Parental Acceptance of the H1N1 Vaccine

“…Bhat-Schelbert et al, 2012; Leask et al, 2006; Poltorak et al, 2005, and Frew et al, 2011). In descriptive analysis, there was no significant difference between people with and without insurance in accepting vaccines for their children (42% vs. 37%, p = .293).…”