Personal experience a major driver in decision for or against flu vaccination

"One of the most important findings was that personal experiences mattered a lot, both for people who got an annual flu shot on a regular basis and for those who didn't," said Nowak, the director of the Center for Health and Risk Communication at the Grady College of Journalism and Mass Communication. "I think that is an important reminder that it is really hard to overcome personal experience with persuasive communications. A lot of time communicators think they can just educate someone or just persuade them to take action, but that isn't always the case. It may take a better product or a new and different personal experience."

According to the 2013 National Health Interview Survey, the most recent report used by the Centers for Disease Control and Prevention, 29.6 percent of adults ages 18 to 49 receive the flu vaccination. That number increases to 46.5 percent for adults ages 50 to 64 and 67.9 percent for adults over 68.

The researchers behind the study -- published in the June issue of Vaccine and presented at the National Adult and Influenza Immunization Summit in May -- wanted to know why those vaccination percentages weren't higher.

In a quest to answer that question, Nowak and Kelli Bursey at the Oak Ridge Institute for Science and Education analyzed 29 flu vaccine-related communication research reports sponsored by the CDC's National Center for Immunization and Respiratory Diseases between 2000 and 2013. They then identified seven reasons that led to people getting annual flu vaccinations and six reasons they did not get vaccinated for the flu.

They found that people get the flu vaccine because:

• They believe they are susceptible to getting the flu.

• They believe the vaccine matters and works.

• They are older or have a chronic health conditions.

• They have received a recommendation from a doctor, which makes a positive difference.

• They have experienced a bad flu or flu-like illness.

• They have been on the receiving end of active vaccination promotion, which makes a positive difference.

• They have convenient and easy access to the flu vaccine.

The main reasons people didn't get the flu vaccination are:

• They believe, often as a result of personal experience, that flu is a "manageable illness."

• They don't believe the flu vaccination recommendation applies to them.

• They do not believe flu vaccines are effective.

• They have a concern about getting the flu from the vaccine.

• They believe other measures are more effective.

• They have a negative personal experience with the vaccine.

"Overall, these studies consistently found that people need to see flu as real and serious health threat -- either through personal experience or communication messages and materials -- in order to get vaccinated," Nowak said. "They also consistently found that misperceptions, such as believing the vaccine causes the flu, remain and are sometimes held by health care providers."

The 29 studies analyzed and summarized as part of qualitative meta-analysis included participants that were health care workers, parents and people with chronic illnesses.

One of the biggest surprises in the research involved the perceptions of health care workers and their view about flu vaccinations.

"Some health care workers are aware they can contract the flu, but they didn't acknowledge they can transmit the flu," Nowak said. "They saw patients as the threat and not themselves, which created a barrier for them to get vaccinated."