Table 4.
Association between knowledge, attitudes, and practices and odds of influenza vaccination among those infrequently vaccinated over time, 2016─2018.
| Characteristics* |
Total observations^ n (%) |
Influenza vaccination status, 2016─2018 |
Odds of being vaccinated vs. unvaccinated |
||
|---|---|---|---|---|---|
|
Unvaccinated n (row %) |
Vaccinated n (row %) |
cOR (95% CI) | aOR (95% CI)# | ||
| All | 1803 | 1411 (78.3) | 392 (21.7) | – | – |
| Perceived influenza susceptibility | |||||
| Not susceptible | 1339 (74.3) | 1067 (79.7) | 272 (20.3) | Ref | Ref |
| Susceptible | 423 (23.5) | 303 (71.6) | 120 (28.4) | 1.54 (1.20, 1.98) | 1.61 (1.25, 2.07) |
| Unknown | 41 (2.3) | 41 (100.0) | 0 (0.0) | – | – |
| Perceived vaccine effectiveness | |||||
| Not effective | 917 (50.9) | 749 (81.7) | 168 (18.3) | Ref | Ref |
| Effective | 845 (46.9) | 621 (73.5) | 224 (26.5) | 1.58 (1.25, 1.98) | 1.62 (1.29, 2.05) |
| Unknown | 41 (2.3) | 41 (100.0) | 0 (0.0) | – | – |
| Knowledge of influenza and vaccine | |||||
| No knowledge | 266 (14.8) | 210 (78.9) | 56 (21.1) | Ref | Ref |
| Some knowledge | 1493 (82.8) | 1157 (77.5) | 336 (22.5) | 1.09 (0.78, 1.53) | 1.11 (0.79, 1.56) |
| Unknown | 44 (2.4) | 44 (100.0) | 0 (0.0) | – | – |
| Concerns about vaccination safety or pain from vaccination | |||||
| No concerns | 1033 (57.3) | 786 (76.1) | 247 (23.9) | Ref | Ref |
| Some concerns | 726 (40.3) | 581 (80.0) | 145 (20.0) | 0.80 (0.64, 1.01) | 0.77 (0.61, 0.98) |
| Unknown | 44 (2.4) | 44 (100.0) | 0 (0.0) | – | – |
| Emotional benefits of vaccination | |||||
| No emotional benefits | 716 (39.7) | 593 (82.8) | 123 (17.2) | Ref | Ref |
| Some emotional benefits | 1045 (58.0) | 776 (74.3) | 269 (25.7) | 1.65 (1.29, 2.12) | 1.68 (1.31, 2.17) |
| Unknown | 42 (2.3) | 42 (100.0) | 0 (0.0) | – | – |
| Barriers to vaccination like inconvenient times or places for vaccination | |||||
| No barriers | 1143 (63.4) | 885 (77.4) | 258 (22.6) | Ref | Ref |
| Some barriers | 616 (34.2) | 483 (78.4) | 133 (21.6) | 0.95 (0.75, 1.19) | 0.93 (0.74, 1.18) |
| Unknown | 44 (2.4) | 43 (97.7) | 1 (2.3) | – | – |
| Supervisor recommendation vaccination | |||||
| No | 969 (53.7) | 761 (78.5) | 208 (21.5) | Ref | Ref |
| Yes | 793 (44.0) | 609 (76.8) | 184 (23.2) | 1.10 (0.88, 1.37) | 1.11 (0.89, 1.39) |
| Unknown | 41 (2.3) | 41 (100.0) | 0 (0.0) | – | – |
Abbreviations: aOR, adjusted odds ratio; CI, confidence interval; cOR, crude odds ratio; HCP, healthcare personnel.
Perceived influenza susceptibility: If you are unable to or don’t get an influenza vaccination, what do you think your chance of getting the flu this season will be?
Perceived vaccine effectiveness: How effective do you think the influenza vaccine is in preventing you from getting sick with influenza?
Knowledge of influenza and vaccine was a composite of three questions: (i) Agree or disagree with the following statement: People with influenza can transmit the virus only after their symptoms appear; (ii) Agree or disagree with the following statement: The influenza vaccine could give me influenza; and (iii) Agree or disagree with the following statement: People can spread influenza virus even when they are feeling well.
Concerns about vaccination was a composite of two questions: (i) Agree or disagree with the following statement: Influenza vaccination is safe; and (ii) Agree or disagree with the following statement: The influenza shot is painful.
Emotional benefits of vaccination were a composite of two questions: (i) Agree or disagree with the following statement: If I don’t get an influenza vaccination and end up getting sick with influenza, I’d be mad at myself for not getting the vaccine; and (ii) Agree or disagree with the following statement: If I don’t get an influenza vaccination, I will regret it.
Barriers to vaccination was a composite of two questions: (i) Agree or disagree with the following statement: I usually do not have time to get vaccinated with the influenza vaccine; and (ii) Agree or disagree with the following statement: There is not a convenient place for me to get vaccinated with the influenza vaccine.
Supervisor recommendation vaccination: Agree or disagree with the following statement: A supervisor or other leader at my workplace has recommended that I get an annual influenza vaccination.
* Collected each survey year in the start of season survey. Perceived vaccination protection for self and patient were excluded because they were only captured at enrollment.
Only people classified as infrequently vaccinated (vaccinated self-reported receiving 1─4 influenza vaccinations from 2011 to 2018) and surveyed all three years from 2016 to 2018 (with multiple observations per person, n = 601 people) are included in this analysis.
Adjusted for HCP hospital of employment, age, sex, preexisting medical condition, occupation, and providing patient care for > 10 years.