The CDC recommends annual influenza vaccination by the end of October if possible. Timing of vaccination is vital since people over 65 may be at risk for intraseason immunity waning. Traditionally, vaccinations occur in doctor’s offices, but other settings are increasing the availability and convenience of vaccines. The objective was to assess the association between timing and setting of influenza vaccination.
The 2015 Behavioral Risk Factor Surveillance System (BRFSS) telephone survey was used to identify adults in the US who reported a flu shot in the past year. Based on self-reported date of flu shot, the 2014-2015 flu season was included and divided into early (July-Oct) versus late (Nov-May) vaccination. Settings of vaccination included doctor’s office, clinic/hospital, store, and work. Covariates of interest were demographics, having a checkup within previous 1 year, insurance, obesity (BMI≥30), alcohol use, current smoking status, and comorbidities. Comorbidities (hypertension, high cholesterol, stroke, angina, heart attack, skin cancer, other cancer, arthritis, depression, kidney disease, diabetes, asthma, chronic obstructive pulmonary disease) were categorized as 0, 1-2, or 3+ present. Logistic regression, stratified by age ≥65, identified predictors of early vaccination.
A total of 130,615 patients were included. Patients vaccinated in doctor’s offices and stores tended to be older and have higher rates of comorbidities compared to those in clinics or at work. In age-stratified analyses, patients 18-64 had higher odds of early vaccination at clinics (odds ratio 1.11, 95% confidence interval 1.02-1.22), stores (OR 1.09, 95% CI 1.002-1.19), and work (OR 1.88, 95% CI 1.71-2.05) compared to doctor’s offices. Patients ≥65 had higher odds of early vaccination at stores (OR 1.17, 95% CI 1.07-1.27) and work (OR 1.67, 95% CI 1.33-2.09). Patients with certain traits (e.g. males, smokers, those with children) have lower odds of early vaccination.
Vaccination setting is associated with vaccination timing: non-traditional (store, work) settings increase the odds of receiving a flu shot before the end of October. Age plays a key role in when and where patients receive flu vaccinations. Vaccination programs in non-traditional settings should consider targeting the later flu season to increase participation.
M. Luther, None