Skip to main content
. 2007 Jun 12;84(4):615–631. doi: 10.1007/s11524-007-9197-z

TABLE 1.

Challenges faced in general and HTR populations with various approaches to raising routine influenza immunization levelsa

Objective Challenges in the general population Additional challenges in HTR populations
At the individual level
Change attitudes Philosophical beliefs Distrust of government and the health care system
Difficult to communicate importance of indirect protection (i.e., being vaccinated to protect others)
Misinformation (e.g., about contraindications, adverse events)
Increase motivation Need for yearly revaccination Immunization is low in priority among other health care issues
Educate target population High cost of mass education Difficult to locate and/or engage target population
Low educational level
Language barriers
At the provider level
Improve vaccination practices and attitudes Non-uniform vaccination recommendations Difficulty in record keeping
Legal/regulatory barriers to standing orders
Track and follow-up with patients Lack of provider motivation Lack of provider motivation
Poor record keeping Not easily accessible
Broaden the provider base Legal/regulatory barriers
Provide appropriate financial incentives Limited reimbursement for adults
At the structural level
Coordinate with vaccine manufacturers Balancing vaccine supply and demand
Inadequate communication from vaccine suppliers
Change social or professional norms Unclear lines of responsibility for adult vaccination
Preventive care not the norm; lack of provider advocacy
Mount community-based vaccination programs Liability issues Lack of coverage
Coordination of bordering jurisdictions Critical timing relative to influenza season
Provide convenient access May shift people away from more comprehensive sources of care Homelessness, transient (migrant)
Homebound (immobile)
Incarcerated
Difficult to locate target populations
Understand the dynamics of disease spread People at direct risk may not be the most important reservoirs

aChallenges outlined for the general population are not meant to be fully comprehensive and may also be applicable to HTR populations.

HHS Vulnerability Disclosure