However , the importance of distributing surveys to all patients was reiterated at two months into the study . Perhaps the response rate would have been higher if an active and consistent enrollment process were implemented .
Secondly , volunteer bias and non-response bias may have also been at play , as research has shown that those who participate in surveys are more educated and from a higher socioeconomic background compared with those who do not participate . 15 When this bias occurs , the study could have inadvertently excluded patients who had a limited understanding of the vaccine , thereby resulting in bias toward the null . Perhaps , the knowledge gap between the two groups could have been more significant if more unvaccinated patients who had limited knowledge of the vaccine participated .
Thirdly , no mechanism existed to prevent patients from completing multiple questionnaires , besides instructions to complete only one survey in the cover letter . However , it was unlikely that a significant number of participants completed more than one survey given the small sample size . Fourthly , we could not distinguish between the patients who were vaccinated and those who planned to receive the vaccine . Lastly , the small sample makes it challenging to generalize the findings . Despite these limitations , a knowledge gap was found between the vaccinated and unvaccinated groups in our study .
CONCLUSIONS
This study demonstrates that a knowledge disparity existed between the patients who received or planned to receive the influenza vaccine and those who declined , emphasizing the importance of counseling patients on the benefits and risks of the influenza vaccine . In addition , social networking may be useful to raise awareness and foster pro-vaccine attitudes and perceptions , creating a positive vaccine culture .
REFERENCES
1 . CDC . Estimating Seasonal Influenza- Associated Deaths in the United States . 2018 ; www . cdc . gov / flu / about / disease / us _ flu-related _ deaths . htm . Accessed 7 / 24 , 2018 .
2 . Girard MP , Tam JS , Assossou OM , Kieny MP . The 2009 A ( H1N1 ) influenza virus pandemic : A review . Vaccine . Jul 12 2010 ; 28 ( 31 ): 4895-4902 .
3 . CDC . Estimated Influenza Illnesses , Medical Visits , Hospitalizations , and Deaths Averted by Vaccination in the United States . 2017 ; www . cdc . gov / flu / about / disease / 2015-16 . htm . Accessed 7 / 24 , 2018 .
4 . CDC . 2016-17 Influenza Season Vaccination Coverage Report . 2017 ; www . cdc . gov / flu / fluvaxview / reportshtml / reporti1617 / reporti / index . html . Accessed 7 / 24 , 2018 .
Sue Irwin , Managing Partner Medical Billing Authority , LLC
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West Virginia Medical Journal • June 2021 • 31