Influenza vaccination in the elderly: 1. Determinants of acceptance.

In the autumn of 1982 routine annual influenza vaccination was offered, by reminder letters and follow-up telephone calls, to 273 independent elderly individuals registered at a community health clinic in Hamilton, Ont. The demographic and geographic characteristics and the health beliefs of those who either accepted or did not accept the vaccine were compared. Among those who received reminder letters there were no significant differences in the rates of vaccine acceptance according to age, sex, household composition or ease of access to the clinic. The patients who reported having previously experienced side effects from the vaccine and perceived a lack of efficacy of the vaccine were more likely not to accept it this time. Both a lack of effort by health care providers (to promote vaccination) and patient behaviour appeared to contribute to pre-existing low levels of influenza vaccination coverage. Although physicians' efforts to inform patients about the vaccination clinics resulted in a tripling of the overall rate of acceptance of the vaccine, there remained a "hard core" of almost half the patients who were unwilling to receive the vaccine, apparently because they perceived its risks to outweigh its benefits.