TABLE 2 : Knowledge of Influenza Vaccine Vaccination Status
Q1 : Vaccine Effectiveness Number Correct 111 11
Q2 : Severity of Influenza ( Hospitalization / Mortality )
Q3 : Vaccine Indications ( Elderly & Chronic Conditions )
Q4 : Disease Severity after Vaccination
Q5 : Herd Immunity
Q6 : Side Effects
Yes ( N = 149 ) No ( N = 29 ) P value
% Correct 74 % 39 % Number Correct 142 26 % Correct 95 % 93 % Number Correct 140 22 % Correct 94 % 81 % Number Correct 97 8 % Correct 68 % 28 % Number Correct 56 5 % Correct 38 % 17 % Mean 1.87 1.83 SEM 0.09 0.22
< 0.001 *
0.635
0.044 *
< 0.001 *
For questions 1-5 ( Q1-5 ), number and percentage of participants who answered each knowledge-based question correctly with chi square or Fisher ’ s exact test comparing the vaccinated and unvaccinated groups and resultant p values . For question 6 ( Q6 ), mean number of correct side effects listed by the participants , and standard error of mean ( SEM ) with independent sample t-test comparing the two groups and the resultant p value . The asterisk symbol (*) = p value is statistically significant ( p < 0.05 ).
0.053
0.841
RECOMMENDATIONS FROM PATIENTS
Participants were also asked to provide recommendations to increase vaccination rates . Participant recommendations included counseling the patients on the risks and benefits of the vaccine , offering the vaccine to patients in clinic , increasing healthcare access , and reducing the cost of the vaccine . Other less common responses included advertising the vaccine and sending reminders .
DISCUSSION KNOWLEDGE GAP
In this study , the patients who received or planned to receive the influenza vaccine knew more about the vaccine ’ s effectiveness and vaccine indications , including the importance of vaccinating elderly patients and those with chronic conditions . The most common reason for declining vaccination was the lack of awareness , which further suggests that knowledge disparities and misconceptions may play an important role in shaping patient ’ s beliefs about influenza vaccination . Thus , the knowledge gap may be an important contributor to the low vaccination rates .
Lack of knowledge was also found to be a barrier to vaccination in other studies . 6-9
However , no differences existed in terms of the understanding of influenza severity , including the potential for hospitalization and mortality in this study . Perhaps patients understood influenza could lead to severe infections and death . However , they may not have believed in the effectiveness of the vaccine and chose to decline vaccination .
REASONS FOR DECLINING VACCINATION
In addition to the lack of awareness , the fear of side effects and lack of perceived need and motivation were common reasons for declining vaccination . The notion that the vaccine is unnecessary has been shown by other studies to be a common response . 6 , 7 , 13 , 14 However , in our research , the fear of side effects was cited as a more common reason compared to other studies . 6 , 7 , 13 Another study conducted at WVU had similar findings , 10 suggesting that the Morgantown community may have more concerns about the potential side effects of the vaccine than other areas .
DISSEMINATING HEALTH INFORMATION
A recent study has also shown that perceptions and attitudes factor into the decision to vaccinate . 13 The knowledge gap may play an important role by shaping patient ’ s perceptions and beliefs . It is imperative for healthcare providers to disseminate the benefits of the vaccine , including its effectiveness to reduce the chances of contracting influenza . In addition , it is important for healthcare workers to discuss the risks of the vaccine as suggested by the participants in this study .
SOCIAL NETWORKING
Patients who received or intended to receive the vaccine were also more likely to have family and close friends who were vaccinated in the same influenza season . Social networking of family and friends and the communication of pro-vaccine attitudes and beliefs likely create a positive vaccine culture . The networking between friends has also been reported to be a primary motivator for influenza vaccination . 10
STUDY LIMITATIONS
This study did have several limitations . Firstly , the sample size was small . The lack of incentive to complete the questionnaire and survey fatigue could have been potential reasons . Also , the cover letter and survey were handed to the patients without active recruitment . Inconsistent distribution of the survey may have also contributed to the low response rate .
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