Where U.S. adults reported receiving the annual influenza vaccine: A BRFSS analysis

New Orleans, LA – November 13, 2018

Patrick Maloney, PhD Epidemiology student presented his research findings, “Where U.S. adults reported receiving the annual influenza vaccine: A BRFSS analysis”, at the American Public Health Association Annual Meeting in San Diego November 10-14.

Despite significant morbidity and mortality, the rates of annual influenza vaccination remain far below desired levels. Few studies have explored the locations where individuals are seeking vaccination, despite the fact that locations that offer the influenza vaccine have expanded and diversified. This study examined the influence of demographics, health care coverage, and high-risk conditions on vaccination location. Methods: Data from the 1999-2015 Behavioral Risk Factor Surveillance System (BRFSS) were used to establish relative trends over time of the locations where influenza vaccination was reportedly received by U.S. adults. Data from the 2015 BRFSS were used to assess the relationship between demographic factors, health care coverage, and high-risk conditions and vaccination location. Vaccination locations were dichotomized into traditional (i.e. doctor’s offices, health departments, hospitals etc.) and non-traditional (i.e. store, workplace, school, etc.) locations. Multivariable logistic regression was used to examine this relationship. All analyses were stratified by age group. Results: Overall, the percentage of U.S. adults receiving the influenza vaccine at traditional locations has decreased from 70% in 1999 to 57% in 2015. Conversely, the percentage of U.S. adults receiving vaccinations at the non-traditional location has increased from 30% in 1999 to 43% in 2015. Stratified multivariable analysis revealed that vaccination at non-traditional locations was linked to individuals without a primary doctor, who have not seen a doctor within the last year, who are white, who have higher levels of income and education, who are employed, and who do not have high-risk conditions. These results are consistent across the stratified age groups. Insurance status and access to care (the individual reporting that he or she had not been able to see a doctor within the last year due to cost) were insignificantly associated with vaccination at a non-traditional location across age groups. Male sex was significantly associated with vaccination at a non-traditional location in the 18-49 age group, but not in other age groups. Conclusions: Although vaccination at non-traditional locations has become more frequently used and more readily available, a significant disparity exists between those who get vaccinated at traditional locations and those who use non-traditional locations. These results indicate that the traditional setting remains essential for reaching certain populations, particularly for minority and low-income populations and persons with high-risk conditions. Efforts should be made by non-traditional locations to reach underserved populations. 

Patrick Maloney is an Epidemiology PhD student in Epidemiology program at the LSU Health Sciences Center School of Public Health.