Determinants of healthcare provider recommendations for influenza vaccinations

• Black adults were more likely to receive provider recommendations for flu vaccines than White adults.
• ACIP priority groups were more likely to receive provider recommendations for flu vaccines than non-priority groups.
• Differences in provider recommendation rates can explain higher flu vaccine uptake for ACIP priority groups.
• Differences in rates of receipt of provider recommendations cannot explain lower flu vaccine uptake among Black adults.

ObjectiveInvestigate determinants of receiving healthcare provider (HCP) recommendations for seasonal and H1N1 influenza vaccinations.MethodsUsing a United States national sample of adults 18 + from the National 2009 H1N1 Flu Survey, multivariate regression models estimated the likelihood of receiving a HCP recommendation. Covariates included demographics, socioeconomic status, and Advisory Committee on Immunization Practices (ACIP) priority groups.ResultsAdults age 55–64 and 65 + were more likely to report a HCP recommendation when compared to adults age 18–34 (OR: 1.483, 95%CI: 1.237–1.778 and OR: 1.738, 95%CI: 1.427–2.116, respectively). Chronically ill adults had 58.0% (95%CI: 1.414–1.765) higher odds of receiving a HCP recommendation than non-chronically ill adults. Patients visiting a doctor once and twice had 28.7% (95%CI: 0.618–0.821) and 17.1% (95%CI: 0.721–0.952) lower odds of receiving a HCP recommendation when compared to adults visiting their doctor at least four times. And, compared to Non-Hispanic Whites, Non-Hispanic Blacks had 28.4% (95%CI: 1.064–1.549) higher odds of receiving a recommendation.ConclusionsACIP priority groups experienced higher rates of recommendations compared to non-ACIP groups. Racial differences in HCP recommendations cannot explain racial disparities in flu vaccination rates.