Compliance with influenza vaccination. Its relation with epidemiologic and sociopsychological factors.

Abstract

To identify patient characteristics that are associated with compliance with influenza vaccination reminders in high-risk patients. Registration of the vaccination of high-risk patients invited by their family physicians. Factors that might be associated with compliance were evaluated, eg, sex, age, insurance, diagnosis, seriousness, and multiple indications. A questionnaire about sociopsychological factors was sent to all noncompliant patients and a random sample of 25% of compliant patients. Four single and 3 partnership practices with 2142 high-risk patients in a total of 26,000 patients in the Netherlands. (1) Compliance by at-risk group; odds ratios (ORs) for epidemiologic and diagnosis-based factors, adjusted by multiple logistic regression analysis; (2) adjusted ORs (adj ORs) for sociopsychological factors; and (3) decisive reason whether to comply. Compliance was 86% (95% confidence interval [CI], 85%-88%), with little difference between at-risk groups. The epidemiologic factors age older than 50 years (adj OR, 1.9; 95% CI, 1.5-2.5) and multiple indication (adj OR, 2.2; 95% CI, 1.3-3.6) were related to compliance, independent of at-risk group. Belief in the absence of side effects (adj OR, 10.5; 95% CI, 5.5-20.2) and in the efficacy of the vaccine (adj OR, 5.6; 95% CI, 3.0-10.2) were most positively associated with compliance. Perceived susceptibility to influenza also was associated (adj OR, 2.9; 95% CI, 1.5-5.8), but perception of one's health was not. There was a negative association of compliance in the interaction of age younger than 50 years and disbelief in the possible complications of influenza (adj OR, 0.2; 95% CI, 0.0-0.5). These factors and the family physician's invitation were decisive. Information about the protection and the side effects of vaccination and the complications of influenza should be directed to patients younger than 50 years; no specific high-risk groups require special information.