Misconceptions Drive Flu Vaccine Hesitancy Among Rheumatology Patients

More than 40% of patients surveyed at a Canadian hospital’s outpatient specialty rheumatology clinics said they were either uncertain about getting or likely to refuse the inactivated influenza vaccine. The study, which was conducted in the months before the first case of COVID-19 in the country, was published online ahead of print in ACR Open Rheumatology.

“Most patients acknowledged that influenza-related disease could be severe,” wrote researchers. “However, misconceptions such as vaccines overloading the immune system, concerns about vaccine safety, and beliefs that healthy lifestyles and good hygiene are better ways to avoid vaccine-preventable diseases were common among patients likely to refuse or uncertain about inactivated influenza vaccine.”

The study included 282 outpatients with rheumatic disease at Montreal General Hospital, an affiliate of McGill University. Patients were surveyed on their likelihood of receiving the influenza vaccine and were grouped into 3 categories: likely to refuse, uncertain, or likely to accept. The surveys were conducted from November 2019 through January 2020; Canada’s first patient with COVID-19 was diagnosed January 27, 2020.

According to the study, 58.5% of patients said they were likely to get the influenza vaccine, 23.8% were likely to refuse, and 17.7% were uncertain. Patients who were uncertain about influenza vaccination tended to be younger and were more likely to be employed.

Predictors of vaccine refusal included distrust in pharmaceutical companies (researchers reported a 41.0 odds ratio), having never received influenza vaccination (36.6 odds ratio), and an unwillingness to take time off work to be vaccinated (6.8 odds ratio). Predictors of uncertainty were no previous influenza vaccination (18.9 odds ratio) and reluctance to pay for vaccination (2.8 odds ratio).

“Interventions and strategies that facilitate access to vaccination, strengthen confidence in public health decisions, and educate patients with rheumatic disease on influenza virus and the risks and benefits of inactivated influenza vaccine may enhance vaccine acceptance,” researchers wrote, “and increase inactivated influenza vaccine coverage rates in this population.”

—Jolynn Tumolo

Reference:
Valerio V, Hudson M, Wang M, et al. Influenza vaccine hesitancy and its determinants among rheumatology patients. ACR Open Rheumatology. Published online ahead of print, January 20, 2022.