Influenza vaccination in patients with asthma: why is the uptake so low?

Helen Keenan, John Campbell, Philip H Evans

Patients with asthma are particularly susceptible to serious complications from influenza. The Chief Medical Officer recommends annual influenza vaccination for adult patients with asthma. The uptake of influenza vaccination by patients with asthma is only 40% and, unlike other high-risk groups, has failed to increase in recent years. To investigate the contribution of sociodemographic factors, asthma morbidity, and health beliefs to influenza vaccination uptake in patients with asthma. Cross-sectional questionnaire study. Single urban British general practice, Exeter, UK. A questionnaire survey was sent to adult patients with asthma. Participants were aged 16-65 years, were receiving beta(2) agonists and inhaled steroids, and had been invited for influenza vaccination in September 2003. Data were examined using univariate analysis and logistic regression. A total of 136/204 (66.7%) patients responded to the survey. Influenza vaccination uptake in the study population was 40%. Younger patients were less likely to have undergone vaccination than older patients. There was no difference in vaccination uptake rates between groups of patients defined by other sociodemographic factors. Asthma morbidity was similar in vaccinated and non-vaccinated groups of patients. Vaccinated individuals had a greater belief in the efficacy of the vaccination and medical advice regarding the vaccination, and felt more susceptible to influenza and its complications when compared with non-vaccinated individuals. A fear of side-effects was associated with declining the invitation for vaccination. These health beliefs were the only independent predictors of uptake of influenza vaccination among this group of patients with asthma. Improving vaccination uptake in patients with asthma is unlikely unless individual health beliefs are taken into account.