Time and Education Are Key in Improving Flu Vaccine Uptake in Older Patients


All over the United States, outpatient clinics and emergency rooms are inundated with patients who report fever, chills, and cough all winter.

All over the United States, outpatient clinics and emergency rooms are inundated with patients who report fever, chills, and cough all winter. These are symptoms of 2 vaccine-preventable illness: pneumococcal infection and influenza. Patients can also be coinfected with these infectious agents, and they pose a great risk to the elderly population. Sadly, vaccine uptake of both the influenza and pneumococcal vaccines in older patients continues to be suboptimal—less than 65%.

Elderly patients who follow the CDC recommendations make arrangements to have an annual influenza vaccine and 2 pneumococcal shots. Researchers in Detroit, MI employed a vaccine up-take framework to delve into older patients' decision-making process. The study examines how sociocultural factors, health system infrastructure, and social networks affect vaccination rates, and also addresses individuals’ experiences, perceptions and beliefs

The researchers invited adults aged 65 or older who lived in urban and suburban communities in the Detroit Metropolitan Area to focus group discussions. They populated 8 discussion groups in all.

Participants indicated that trusting the health system and their providers was pivotal in making the decision to be vaccinated. However, participants were disappointed with constraints on their providers' time. The researchers suggested that providers need to prioritize patient needs—including immunizations—to increase efficiency. Electronic reminders, like e-mail, are also valuable tools for maximizing time.

An overriding theme in the discussion was participants' desire to advocate for themselves. This meant having a chance to ask questions, and also having a responsive complaint system in place at their providers' organizations. The message here is that providers must educate elderly patients, and provide enough information about immunizations so they can make reasonable decisions.

Emphasizing that people know themselves, and know how to take care of themselves, is important. Showing them the means to do it may increase vaccination rates in populations that need it.

This article appears in the January 2017 issue of Human Vaccines & Immunotherapeutics.


Kaljee LM, Kilgoe P, Prentiss T, et al. “You need to be an advocate for yourself”: Factors associated with decision-making regarding influenza and pneumococcal vaccine use among US older adults from within a large metropolitan health system. Human Vaccines

Immunotherapeutics. 13:1, 206-212.

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