A qualitative study of lay beliefs about influenza immunisation in older people.

M.R. Evans · Hayley Prout · Lindsay Prior · Lorna Tapper-Jones · Christopher Butler

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Vaccine Coverage and Hesitancy Risk Perception and Management Intramuscular injections and effects

Abstract

BACKGROUND: Although influenza immunisation is now recommended for all people aged 65 years and over in the UK, many people in that age group still remain unimmunised. AIM: To investigate lay beliefs about influenza and influenza vaccine in older people to identify appropriate ways of promoting vaccine uptake. DESIGN: Qualitative study using narrative interviews. SETTING: Urban and rural communities in South Wales. METHOD: Participants were 54 people aged 65 years and over who were interviewed in their own home. Of these, 11 were regularly immunised, 18 had consistently refused immunisation (refusers), 15 had defaulted (defaulters), five had never been offered immunisation, and five had recently been immunised for the first time. RESULTS: There was an overwhelming consensus among immunised and unimmunised individuals that they were not at risk from influenza. Even if they did catch influenza, they would not suffer from any serious consequences. Refusers and defaulters were more likely to believe that the influenza vaccine had serious side-effects, while the regularly immunised group were more likely to perceive the vaccine as effective. Multiple prompts from family, friends, or primary care staff were important triggers for receiving immunisation. CONCLUSION: Many older people did not feel vulnerable to influenza, regardless of their age, and this influenced their views on the need for immunisation. Both refusers and defaulters overstated adverse effects from influenza vaccine so this is a potential target for an intervention. Individual prompts, particularly from GPs, seemed to be the most significant motivators to attend for immunisation.

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References

1992Basics of Qualitative Research: Grounded Theory Procedures and Techniques.2000Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults11The names and affiliations of the Task Force members are listed on page v of this supplement and at http://www.thecommunityguide.org22Some of this material was published previously in: Shefer A, Briss P, Rodewald L, et al. Improving immunization coverage rates: an evidence-based review of the literature. Epidemiol Rev 1999;20:96–142.2003What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and veterans affairs practices 2001Parents' perspectives on the MMR immunisation: a focus group study.1997Why do healthy elderly people fail to comply with influenza vaccination?2004Managing controversy through consultation: a qualitative study of communication and trust around MMR vaccination decisions.2003Why do older people not get immunised against influenza?2003Physician and practice factors related to influenza vaccination among the elderly

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