title: Factors mediating seasonal and influenza A (H1N1) vaccine acceptance among ethnically diverse populations in the urban south.
abstract: OBJECTIVE
  We examined the acceptability of the influenza A (H1N1) and seasonal vaccinations immediately following government manufacture approval to gauge potential product uptake in minority communities. We studied correlates of vaccine acceptance including attitudes, beliefs, perceptions, and influenza immunization experiences, and sought to identify communication approaches to increase influenza vaccine coverage in community settings.
  
  
  METHODS
  Adults ≥18 years participated in a cross-sectional survey from September through December 2009. Venue-based sampling was used to recruit participants of racial and ethnic minorities.
  
  
  RESULTS
  The sample (N=503) included mostly lower income (81.9%, n=412) participants and African Americans (79.3%, n=399). Respondents expressed greater acceptability of the H1N1 vaccination compared to seasonal flu immunization (t=2.86, p=0.005) although H1N1 vaccine acceptability was moderately low (38%, n=191). Factors associated with acceptance of the H1N1 vaccine included positive attitudes about immunizations [OR=0.23, CI (0.16, 0.33)], community perceptions of H1N1 [OR=2.15, CI (1.57, 2.95)], and having had a flu shot in the past 5 years [OR=2.50, CI (1.52, 4.10). The factors associated with acceptance of the seasonal flu vaccine included positive attitudes about immunization [OR=0.43, CI (0.32, 0.59)], community perceptions of H1N1 [OR=1.53, CI (1.16, 2.01)], and having had the flu shot in the past 5 years [OR=3.53, CI (2.16, 5.78)]. Participants were most likely to be influenced to take a flu shot by physicians [OR=1.94, CI (1.31, 2.86)]. Persons who obtained influenza vaccinations indicated that Facebook (χ(2)=11.7, p=0.02) and Twitter (χ(2)=18.1, p=0.001) could be useful vaccine communication channels and that churches (χ(2)=21.5, p<0.001) and grocery stores (χ(2)=21.5, p<0.001) would be effective "flu shot stops" in their communities.
  
  
  CONCLUSIONS
  In this population, positive vaccine attitudes and community perceptions, along with previous flu vaccination, were associated with H1N1 and seasonal influenza vaccine acceptance. Increased immunization coverage in this community may be achieved through physician communication to dispel vaccine conspiracy beliefs and discussion about vaccine protection via social media and in other community venues.
authors.affiliation: Emory University School of Medicine, Department of Medicine, Division of Infectious Diseases, Atlanta, GA, USA. pfrew@emory.edu
authors.forename: Paula M
authors.initials: PM
authors.lastname: Frew
authors.forename: Julia E
authors.initials: JE
authors.lastname: Painter
authors.forename: Brooke
authors.initials: B
authors.lastname: Hixson
authors.forename: Carolyn
authors.initials: C
authors.lastname: Kulb
authors.forename: Kathryn
authors.initials: K
authors.lastname: Moore
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: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D014481:United States; D014505:Urban Population; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines