Using the health belief model to identify barriers to seasonal influenza
vaccination among Australian adults in 2019
Abstract
Background: Tens of thousands of Australians become ill with influenza
annually, causing thousands of severe infections that require
hospitalisation. However, only 40% of adults receive the annual
influenza vaccine. We surveyed Australian adults to provide up-to-date
data on the predictors and barriers of seasonal influenza vaccination.
Methods: We administered an online survey to a nationally representative
sample of Australian adults. We designed survey questions using the
constructs of the health belief model. Using simple and multivariable
Poisson regression, we identified attitudes and beliefs associated with
influenza vaccination in 2019. Results: Among 1,444 respondents, 51.7%
self-reported influenza vaccination in 2019. We estimated vaccine
coverage to be 44% for adults under 45, 46% for adults aged 45 to 64,
and 77% for adults aged 65 and over. The strongest individual
predictors of self-reported vaccination were believing the vaccine is
effective at preventing influenza (APR = 3.71; 95% CI = 2.87-4.80),
followed by recalling their doctor recommending the vaccine (APR = 2.70;
95%CI = 2.31-3.16). Common perceived barriers that predicted
self-reported vaccination included believing the vaccine could give you
influenza (APR = 0.59; 95% CI = 0.52-0.67), believing the vaccine can
make you ill afterwards (APR = 0.68; 95% CI = 0.62-0.74), and
preferring to develop immunity “naturally” (APR = 0.38; 95% CI =
0.32-0.45). Conclusion: Although vaccine uptake in 2019 appears to be
higher than previous years, there are perceived barriers which may limit
uptake among Australians. Tailored interventions are needed to combat
widespread influenza vaccine hesitancy, particularly among high risk
grou