title: National and state-specific estimates of place of influenza vaccination among adult populations - United States, 2011-12 influenza season.
abstract: BACKGROUND
  Annual influenza vaccination has been recommended for all persons ≥6 months since the 2010-11 season. New partnerships between public health agencies and medical and nonmedical vaccination providers have increased the number of vaccination providers and locations where vaccination services are delivered.
  
  
  METHODS
  Data from the 2011-12 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Point estimates of place of vaccination and 95% confidence intervals were calculated. Multivariable logistic regression and predictive marginal modeling were conducted to identify factors associated with vaccination settings.
  
  
  RESULTS
  Among adults vaccinated during the 2011-12 influenza season, a doctor's office was the most common place (38.4%) for receipt of influenza vaccination, with stores (e.g., supermarkets or drug stores) (20.1%) the next common, and workplaces (17.6%) the third common. Overall, reported vaccination in nonmedical settings by state ranged from 32.2% in California to 60.4% in Nevada, with a median of 45.8%. Characteristics significantly associated with an increased likelihood of receipt of vaccination in nonmedical settings were higher education, not having certain identified high-risk conditions, not having had a routine checkup in the previous 12 months, and not having a primary doctor for health care. Being a member of a racial/ethnic minority group, unemployed or not in the work force were significantly associated with a decreased likelihood of receipt of vaccination in nonmedical settings.
  
  
  CONCLUSIONS
  Doctor's offices were the most common medical setting for adult influenza vaccination; workplaces and stores were important nonmedical settings. Increasing access to vaccination services in medical and nonmedical settings should be considered as important strategies for improving vaccination coverage. These results also can help guide development of strategies for achieving Healthy People 2020 objectives for influenza vaccination of adult populations.
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States. Electronic address: lhp8@cdc.gov.
authors.forename: Peng-Jun
authors.initials: PJ
authors.lastname: Lu
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States.
authors.forename: Alissa
authors.initials: A
authors.lastname: O'Halloran
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States.
authors.forename: Helen
authors.initials: H
authors.lastname: Ding
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States.
authors.forename: Walter W
authors.initials: WW
authors.lastname: Williams
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States.
authors.forename: Carolyn B
authors.initials: CB
authors.lastname: Bridges
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333, United States.
authors.forename: Erin D
authors.initials: ED
authors.lastname: Kennedy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010594:Pharmacies; D010824:Physicians' Offices; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*; D017132:Workplace; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: Behavioral Risk Factor Surveillance System (BRFSS); Influenza vaccination; Medical setting; Nonmedical setting; Place of influenza vaccination
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