title: Acceptance of pandemic 2009 influenza A (H1N1) vaccine in a minority population: determinants and potential points of intervention.
abstract: OBJECTIVE
  We sought to understand pandemic 2009 influenza A (H1N1) vaccine acceptance in a minority community including correlates of vaccine hesitancy and refusal. We identified intervention points to increase H1N1 vaccine coverage.
  
  
  METHODS
  Minority parents and caregivers of children ≤ 18 years participated in a cross-sectional survey. Statistical analyses included bivariate correlations, exploratory factor analyses, internal-consistency assessment, and logistic regressions.
  
  
  RESULTS
  The sample (N = 223) included mostly lower-income (71% [n = 159]) and black (66% [n = 147]) participants. Potential and actual receipt of pediatric H1N1 vaccination was low (36% [n = 80]). Pediatric H1N1 vaccine acceptance was associated with lack of insurance (odds ratio [OR]: 3.04 [95% confidence interval (CI): 1.26-7.37]), perceived H1NI pediatric susceptibility (OR: 1.66 [95% Cl: 1.41-1.95]), child vaccination prioritization in family (OR: 3.34 [95% CI: 1.33-8.38]), believing that H1N1 is a greater community concern than other diseases (OR: 1.77 [95% CI: 1.01-3.09]), believing that other methods of containment (eg, hand-washing, masks) are not as effective as the H1N1 vaccine (OR: 1.73 [95% CI: 1.06-2.83]), and a desire to promote influenza vaccination in the community (OR: 2.35 [95% CI: 1.53-3.61]).
  
  
  CONCLUSIONS
  We found low acceptance of the H1N1 vaccine in our study population. Perceived influenza susceptibility, concern about H1N1 disease, and confidence in vaccinations as preventive methods were associated with vaccine acceptance. Physician support for HIN1 vaccination will aid in increasing immunization coverage for this population, and health departments are perceived as ideal community locations for vaccine administration.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA. pfrew@emory.edu
authors.forename: Paula M
authors.initials: PM
authors.lastname: Frew
authors.forename: Brooke
authors.initials: B
authors.lastname: Hixson
authors.forename: Carlos
authors.initials: C
authors.lastname: del Rio
authors.forename: Alejandra
authors.initials: A
authors.lastname: Esteves-Jaramillo
authors.forename: Saad B
authors.initials: SB
authors.lastname: Omer
mesh_terms: D000328:Adult; D001294:Attitude to Health / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000009:adverse effects; D007251:Influenza, Human / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D008913:Minority Groups / Q000706:statistics & numerical data*; D016017:Odds Ratio; D058873:Pandemics / Q000517:prevention & control*; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D016312:Treatment Refusal / Q000208:ethnology / Q000706:statistics & numerical data; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D007252:Influenza Vaccines