title: Influence of family on acceptance of influenza vaccination among Japanese patients.
abstract: BACKGROUND
  Influenza is a major cause of morbidity and mortality in Japan and worldwide, especially for people of >65 years old and those with high-risk medical conditions. Although the influenza vaccine is effective in reducing the morbidity and mortality, the vaccine coverage rate has not increased adequately in Japan, compared with western countries.
  
  
  OBJECTIVE
  Our aim was to assess whether medical and personal characteristics are associated with receiving influenza vaccination in Japanese patients.
  
  
  METHODS
  Out-patients of a city hospital were recruited for a case-control study between November 1998 and February 1999. Cases were 98 out-patients aged 18 years or older who received influenza vaccination. Controls were 112 non-vaccinated out-patients matched with cases for primary physician and date of clinic visit. The candidates were interviewed by telephone and asked to respond to a 26-item questionnaire. The data were analysed using multiple logistic regression models.
  
  
  RESULTS
  The factors associated with the acceptance of influenza vaccination were: (i) recommendation by a family member and/or a close friend [odds ratio (OR) 17.74; 95% confidence interval (CI) 1.95-161.77]; (ii) belief in influenza vaccine efficacy (OR 10.55; 95% CI 3.42-32.49); (iii) having a family member and/or friends who had been vaccinated before (OR 6.44; 95% CI 2.37-17.50); (iv) physician's recommendation (OR 4.03; 95% CI 1.42-11.37); and (v) knowledge about the influenza vaccine (OR 3.06; 95% CI 1.02-9.20). Fear of adverse reactions (OR 0.21; 95% CI 0.07-0.66) was the sole factor associated with non-acceptance of influenza vaccine.
  
  
  CONCLUSIONS
  Patients in Japan are likely to be greatly influenced by their family members or close friends in their decision of whether to accept influenza vaccination, unlike US patients who make health care decisions on their own. When implementing an influenza vaccination programme, this effect of cultural background observed in Japan should be taken into account in other countries.
authors.affiliation: Department of General Medicine and Clinical Epidemiology, School of Public Health, Kyoto University Graduate School of Medicine and Kyoto Hoken-Kai Kamigyo Hospital, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Takahashi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Noguchi
authors.forename: Mahbubur
authors.initials: M
authors.lastname: Rahman
authors.forename: Takuro
authors.initials: T
authors.lastname: Shimbo
authors.forename: Masashi
authors.initials: M
authors.lastname: Goto
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Matsui
authors.forename: Atsushi
authors.initials: A
authors.lastname: Asai
authors.forename: Motoki
authors.initials: M
authors.lastname: Onishi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Koyama
authors.forename: Izumi
authors.initials: I
authors.lastname: Sawada
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshinaka
authors.forename: Tsuguya
authors.initials: T
authors.lastname: Fukui
mesh_terms: D000328:Adult; D001294:Attitude to Health; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005190:Family; D005260:Female; D006801:Humans; D007252:Influenza Vaccines; D007564:Japan; D016015:Logistic Models; D008297:Male; D010342:Patient Acceptance of Health Care; D012944:Social Support; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
chemical_list: D007252:Influenza Vaccines