741. The Flu Vaccine: Why are our HIV-Infected Patients Saying NO?
Session: Poster Abstract Session: Vaccines: Improving Delivery
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • HIV_Flu_Decline_ID_Week_2016_Poster_FINAL.pdf (686.7 kB)
  • Background: HIV-infected persons are considered at high risk for developing influenza (flu)-related complications and are recommended to receive annual flu vaccination. Limited data exists, however, regarding reasons HIV-infected patients decline flu vaccine.  We surveyed all of our HIV-infected patients who declined the flu vaccine to better understand reasons for declination, in order to target future educational efforts.

    Methods: The HIV Community Program is a statewide, Ryan White funded multidisciplinary clinic caring for ~1600 HIV-infected persons.  All patients are offered vaccine at any clinic visit occurring during flu season.  As a quality improvement initiative, from 12/1/15–4/15/16 we asked adult (≥18y) patients declining flu vaccine to complete and sign a declination form.  The form included education specific to the importance of flu vaccination in persons living with HIV.  We performed chart review to assess demographics, insurance type, CD4, viral load, acceptance of any pneumococcal vaccine, and refusal of any other vaccine.

    Results: Declination forms were completed by 86 patients, the majority of whom were male, black and aged 45-64 y (Table).  The most common reasons for declining were “I just don’t want it” and concerns about getting sick from or side effects of the vaccine (Figure). There were no significant statistical differences amongst the most common reasons when correlated with demographics or insurance type.  The majority (80%) had received ≥1 pneumococcal vaccine, 4 of whom on the same day they declined flu vaccine. Four patients opted to accept flu vaccine after receiving the education.

     

    Characteristic

    %

    (n = 86)

    Sex

         Male

    71

    Age

         18-44

         45-64

         ≥65

    36

    63

    1

    Race/Ethnicity

         Non-Hispanic white

         Non-Hispanic black

         Hispanic

    24

    73

    1

    Insurance Type

         Private

         Medicare

        Medicaid

    15

    24

    67

    Most recent CD4

         <200

          >500

    8

    58

    Most recent viral load

        <20

    71

    Refused any other vaccine
        Yes

    13

    Conclusion: Reasons cited by HIV-infected persons for declining flu vaccine reflect those cited in other populations, including lack of perceived risk and fear of side effects/illness.  Given the increased risk of flu-related complications in HIV-infected persons, further public health emphasis on vaccinating this high risk group is needed.

    Loren Nunley, MD, MBA1, Karen Swanson, BSN, RN, CCRC, ACRN2, Susan Szabo, MD1,2 and Marci Drees, MD, MS1,3,4, (1)Medicine, Christiana Care Health System, Newark, DE, (2)HIV Community Program, Christiana Care Health System, Wilmington, DE, (3)Christiana Care Value Institute, Newark, DE, (4)Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA

    Disclosures:

    L. Nunley, None

    K. Swanson, None

    S. Szabo, None

    M. Drees, None

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