Factors influencing the decision to receive seasonal influenza vaccination among US corporate non-healthcare workers

ABSTRACT

Influenza causes significant mortality and morbidity in the United States (US). Employees are exposed to influenza at work and can spread it to others. The influenza vaccine is safe, effective, and prevents severe outcomes; however, coverage among US adults (50.2%) is below Healthy People 2030 target of 70%. These highlights need for more effective vaccination promotion interventions. Understanding predictors of vaccination acceptance could inform vaccine promotion messages, improve coverage, and reduce illness-related work absences. We aimed to identify factors influencing influenza vaccination among US non-healthcare workers. Using mixed-methods approach, we evaluated factors influencing influenza vaccination among employees in three US companies during April–June 2020. Survey questions were adapted from the WHO seasonal influenza survey. Most respondents (n = 454) were women (272, 59.9%), 20–39 years old (n = 250, 55.1%); white (n = 254, 56.0%); had a college degree (n = 431, 95.0%); and reported receiving influenza vaccine in preceding influenza season (n = 297, 65.4%). Logistic regression model was statistically significant, X (16, N = 450) = 31.6, p = .01. Education [(OR) = 0.3, 95%CI = 0.1–0.6)] and race (OR = 0.4, 95%CI = 0.2–0.8) were significant predictors of influenza vaccine acceptance among participants. The majority had favorable attitudes toward influenza vaccination and reported that physician recommendation would influence their vaccination decisions. Seven themes were identified in qualitative analysis: “Protecting others” (109, 24.0%), “Protecting self” (105, 23.1%), “Vaccine accessibility” (94, 20.7%), “Education/messaging” (71, 15.6%), “Policies/requirements” (15, 3.3%), “Reminders” (9, 2.0%), and “Incentives” (3, 0.7%). Our findings could facilitate the development of effective influenza vaccination promotion messages and programs for employers, and workplace vaccination programs for other diseases such as COVID-19, by public health authorities.

HIGHLIGHTS

• Influenza causes significant mortality and morbidity in the United States (US).

• The US working-age group (18–64-year-old) bears a huge burden of influenza annually.

• Influenza vaccination coverage in the working-age group is low.

• Physicians and employers can influence vaccine acceptance of working adults.

• Employers can consider practical steps, e.g., incentivizing, or offering vaccine onsite.

KEYWORDS:

• Influenza
• corporate employees
• vaccination
• health education

Acknowledgments

The authors thank the employees of the three companies that participated in this study. The findings and conclusions in this study are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Disclosure statement

Dr. Inci Yildirim reports personal fees from Merck outside the submitted work. The authors list no other conflicts of interest. Alessia Melegaro acknowledges funding from the European Research Council (ERC) under Horizon 2020 research and innovation program (Grant agreement No. 101003183).

Additional information

Funding

This study was supported by the Centers for Diseases Control and Prevention (grant number - 5U01CK000572-02)