title: The Impact of Vaccine Concerns on Racial/Ethnic Disparities in Influenza Vaccine Uptake Among Health Care Workers.
abstract: OBJECTIVE
  We explored whether collective concerns about the safety, effectiveness, and necessity of influenza vaccines mediate racial/ethnic disparities in vaccine uptake among health care workers (HCWs).
  
  
  METHODS
  We used a self-administered Web-based survey to assess race/ethnicity (exposure), concerns about influenza vaccination (mediator; categorized through latent class analysis), and influenza vaccine uptake (outcome) for the 2012 to 2013 influenza season among HCWs at St. Jude Children's Research Hospital in Memphis, Tennessee. We used mediation analysis to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the total, direct, and indirect effects of race/ethnicity on influenza vaccine uptake.
  
  
  RESULTS
  Non-Hispanic Blacks had lower influenza vaccine uptake than non-Hispanic Whites (total effect: PR = 0.87; 95% CI = 0.75, 0.99), largely mediated by high concern about influenza vaccines (natural indirect effect: PR = 0.89; 95% CI = 0.84, 0.94; controlled direct effect: PR = 0.98; 95% CI = 0.85, 1.1). Hispanic and Asian HCWs had modestly lower uptake than non-Hispanic Whites, also mediated by high concern about influenza vaccines.
  
  
  CONCLUSIONS
  Racial/ethnic disparities among HCWs could be attenuated if concerns about the safety, effectiveness, and necessity of influenza vaccines were reduced.
authors.affiliation: Rohit P. Ojha and Sericea Stallings-Smith are with the Department of Epidemiology and Cancer Control, and Patricia M. Flynn, Elisabeth E. Adderson, and Aditya H. Gaur are with the Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. Tabatha N. Offutt-Powell is with the Data and Informatics Section, Division of Public Health, Delaware State Health Services, Dover.
authors.forename: Rohit P
authors.initials: RP
authors.lastname: Ojha
authors.affiliation: Rohit P. Ojha and Sericea Stallings-Smith are with the Department of Epidemiology and Cancer Control, and Patricia M. Flynn, Elisabeth E. Adderson, and Aditya H. Gaur are with the Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. Tabatha N. Offutt-Powell is with the Data and Informatics Section, Division of Public Health, Delaware State Health Services, Dover.
authors.forename: Sericea
authors.initials: S
authors.lastname: Stallings-Smith
authors.affiliation: Rohit P. Ojha and Sericea Stallings-Smith are with the Department of Epidemiology and Cancer Control, and Patricia M. Flynn, Elisabeth E. Adderson, and Aditya H. Gaur are with the Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. Tabatha N. Offutt-Powell is with the Data and Informatics Section, Division of Public Health, Delaware State Health Services, Dover.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Flynn
authors.affiliation: Rohit P. Ojha and Sericea Stallings-Smith are with the Department of Epidemiology and Cancer Control, and Patricia M. Flynn, Elisabeth E. Adderson, and Aditya H. Gaur are with the Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. Tabatha N. Offutt-Powell is with the Data and Informatics Section, Division of Public Health, Delaware State Health Services, Dover.
authors.forename: Elisabeth E
authors.initials: EE
authors.lastname: Adderson
authors.affiliation: Rohit P. Ojha and Sericea Stallings-Smith are with the Department of Epidemiology and Cancer Control, and Patricia M. Flynn, Elisabeth E. Adderson, and Aditya H. Gaur are with the Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. Tabatha N. Offutt-Powell is with the Data and Informatics Section, Division of Public Health, Delaware State Health Services, Dover.
authors.forename: Tabatha N
authors.initials: TN
authors.lastname: Offutt-Powell
authors.affiliation: Rohit P. Ojha and Sericea Stallings-Smith are with the Department of Epidemiology and Cancer Control, and Patricia M. Flynn, Elisabeth E. Adderson, and Aditya H. Gaur are with the Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN. Tabatha N. Offutt-Powell is with the Data and Informatics Section, Division of Public Health, Delaware State Health Services, Dover.
authors.forename: Aditya H
authors.initials: AH
authors.lastname: Gaur
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D000367:Age Factors; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006282:Health Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D044469:Racial Groups / Q000523:psychology / Q000706:statistics & numerical data*; D012737:Sex Factors; D013714:Tennessee; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines