Applying the health belief model as a framework for determinants of adult vaccination during the 2009 H1N1 pandemic in the United States

INTRODUCTION – The 2009 H1N1 pandemic shifted flu-associated morbidity and mortality to younger aged members of the population. This study examined decisions to be vaccinated against the 2009 H1N1 virus among adults 18 to 64 years of age. The Health Belief Model is used as the theoretical framework. METHODS – Data are from the National 2009 H1N1 Flu Survey (NHFS), conducted by the CDC National Center for Immunization and Respiratory Diseases and the National Center for Health Statistics. A logistic regression was conducted to determine factors influencing H1N1 vaccination. RESULTS – Most adults were not vaccinated. Previous seasonal flu vaccination was the strongest predictor of pandemic strain vaccination. Child in household, chronic medical condition, health care worker, and concern about the public health threat posed by the virus increased the odds of vaccination. Adults who perceived a higher personal risk of contracting the virus were less likely to be vaccinated. All background variables were statistically significant. DISCUSSION – Low rates of adult vaccination uptake during the pandemic are of concern. High personal risk perception did not result in vaccination, but rather the opposite. Promoting seasonal flu vaccine may help to encourage vaccination during a pandemic. Since the presence of child in household is important, vaccination efforts directed to facilitate adult vaccination in places where children are taken could further increase adult vaccinations. Efforts at vaccination need to target adults who are not in high risk groups, do not have children in the household, and do not receive the seasonal flu vaccine.