BACKGROUND:
In the United States, a major public health initiative is access and administration of the annual influenza vaccine. The role of health related quality of life (HRQOL) and social determinants in persons obtaining immunization against influenza remains unclear. The objective of this study was to assess HRQOL factors and social determinants associated with obtaining the influenza immunization within the past 12 months.
METHODS:
A cross-sectional data analysis was conducted on 123,641 survey participants, aged 18 years and older, using the 2014 Behavioral Risk Factor Surveillance Survey. A weighted multivariable logistic regression was used to assess associations between influenza immunization and health related quality of life.
RESULTS:
The social determinants of sexual orientation, race/ethnicity, income, age, education, marital, drinking and smoking status, and having health insurance were all found to be significantly associated with influenza immunization. Five domains of HRQOL were examined; general health, mental and physical health (14 or more unhealthy days), lifetime depression, and activity limitation. After adjusting for social determinants, compared to those who perceived to have excellent health, self-perceived very good health had 1.02 (95% CI: 0.96-1.09) times higher odds of getting the flu vaccine, self-perceived good health had 1.10 (95% CI: 1.03-1.18) times higher odds, and self-perceived fair/poor health had 1.27 (95% CI: 1.16-1.40) times higher odds of getting the flu vaccine. We found that participants with 14 unhealthy days of physical health had 1.05 (95% CI: 0.96-1.14) times higher odds of getting the flu vaccine compared to their counterparts. However, participants with 14 unhealthy days of mental health had 19% (aOR = 0.81; 95% CI: 0.74-0.89) lower odds of getting the flu vaccine compared to their counterparts. Furthermore, compared to those without depression, depressed participants had 1.29 (95% CI: 1.21-1.38) times higher odds of getting the flu vaccine. Compared to those who did not report to be limited in any activity because of physical, mental or emotional problems, those who were limited in any way had 1.13 (95% CI: 1.07-1.21) times higher odds of getting the flu vaccine.
CONCLUSIONS:
Influenza immunization is the primary prevention method against a potential influenza epidemic. The results of this study show a significant role of HRQOL and social determinants on influenza immunization. Further research is needed to evaluate potential disparities surrounding immunization against influenza to inform and improve current health promotion activities.