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Clinical Decisionmaking

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Side effects and effectiveness determine whether healthy adults will get a flu shot

Influenza outbreaks that appear each winter cause U.S. workers to lose about 15 million working days a year. Immunizing healthy adults has been associated with 43 percent fewer days of sick leave due to upper respiratory illness (URI), 44 percent fewer visits to doctors' offices, and an estimated cost savings of $46.85 per person vaccinated.

To keep more workers on the job, many employers offer employees free influenza vaccines each fall. Two studies by Rutgers University researchers suggest which employees are likely to take them up on their offer. They found that healthy adult workers were more likely to be immunized against influenza if they had received a flu shot the previous year, believed it would be effective in preventing the flu, and expected it to have minimal side effects. Having suffered from a bad bout of the flu the previous year had no effect on a person's decision about getting a flu shot in the current year.

Employers might boost flu vaccine use rates by publicizing that the vaccine is effective, only rarely has minor side effects, and "everyone is doing it." Employers also need to make getting the flu shot convenient, note Gretchen B. Chapman, Ph.D., and Elliot J. Coups, B.A. Their research, which was supported by the Agency for Healthcare Research and Quality (HS09519), included interviews with 79 university employees and questionnaires completed by 435 corporate employees.

The researchers found that only 22 percent of those who said that the flu shot was not very effective accepted the vaccine in the first study, compared with 61 percent of those who said it was moderately or very effective. The analogous percentages for the second study were 5 percent and 64 percent. Also in the first study, 8 percent of those who said that a reaction to the shot was moderately or very likely accepted the vaccine compared with 61 percent of those who said a reaction was not at all or only slightly likely. In the second study, these percentages were 20 percent and 57 percent. Also in study 2, 85 percent of those who had gotten a flu shot the previous year had a shot in the current year compared with 17 percent of those who had not had a shot the previous year.

See "Predictors of influenza vaccine acceptance among healthy adults," by Dr. Chapman and Mr. Coups, in Preventive Medicine 29, pp. 249-262, 1999.

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