Prevalence of influenza vaccination in a high-risk population: impact of age and race.

Participants in a Nashville Davidson County survey were queried regarding influenza vaccination, with the goal of developing strategies to improve vaccination coverage in the county. The Metropolitan Public Health Department used a locally adapted version of the Behavioral Risk Factor Surveillance System in a random-digit-dialing phone survey with a sample of 7901 residents of Davidson County, Tennessee, about health-related behaviors. Out of 7233 fully completed surveys, data for 7016 were analyzed. Thirty-six percent of the respondents were male; 17% were aged 18-24, 40% were aged 25-44, 26% were aged 45-64, and 16% were aged 65 or older. Seventy-six percent were white. Forty-five percent reported a chronic illness, increasing their risk for complications from influenza; 11% had asthma, 7% diabetes, 25% hypercholesterolemia, and 28% hypertension. Predictors for receipt of influenza vaccine were older age, presence of a primary care provider, health insurance, and employment. Those with chronic diseases were more likely to be vaccinated when compared to the general population. Among those 65 and older, blacks were less likely to be vaccinated (OR = 0.57, CI = 0.43, 0.76). The substantial disparity in receipt of influenza vaccine reflects the lack of recommendations and policies for vaccination coverage and suggests the need for greater community-based efforts to improve the preventive health behaviors of healthcare professionals and the public. In addition, new vaccine delivery strategies and systematic vaccination marketing efforts may be needed to increase influenza vaccination rates in communities of color and other underserved populations.