Influenza vaccination concerns among older blacks: a randomized controlled trial

Am J Prev Med. 2009 May;36(5):429-434.e6. doi: 10.1016/j.amepre.2009.01.025. Epub 2009 Mar 6.


Context: Vaccination can decrease the morbidity and mortality caused by influenza, yet vaccination rates remain low, especially among minority groups. Previous studies have found that important barriers to vaccination include the fear of adverse reactions and concern that the vaccine causes influenza.

Background: This research aimed to assess the effects of messages designed to address concerns about the safety and effectiveness of vaccination among blacks aged >or=50 years.

Design: In a randomized controlled trial conducted in 2007 with pre-exposure and post-exposure measurements, participants were randomly assigned to read either the vaccine safety messages (VSM) developed for the study (treatment condition) or the vaccine information statement (VIS) currently given to those getting the vaccine (control condition).

Setting/participants: A total of 108 participants participated in the study. Data were collected in either participants' residences, community settings, or university conference rooms.

Main outcome measures: Influenza vaccine-related beliefs and intention to receive vaccination were assessed.

Results: Data analysis in 2007 and 2008 found that the randomization hypotheses of equal groups were retained. Participants exposed to the VSM showed greater improvement in post-exposure beliefs about how the vaccine works (p=0.0006) and the transmission of the flu (p=0.0034) as well as greater post-exposure disagreement with the belief that the vaccine causes influenza (p=0.0411).

Conclusions: The VSM affected beliefs about vaccine safety and effectiveness to a greater degree than did the VIS. These findings show that VSM are effective in changing beliefs empirically linked with influenza vaccination and vaccination disparities. The dissemination of VSM to older blacks may increase vaccination rates and reduce vaccination disparities.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • African Americans*
  • Aged
  • Aged, 80 and over
  • Attitude to Health
  • Female
  • Healthcare Disparities
  • Humans
  • Influenza Vaccines* / administration & dosage
  • Influenza Vaccines* / adverse effects
  • Influenza, Human / ethnology
  • Influenza, Human / prevention & control
  • Male
  • Middle Aged
  • Missouri
  • Patient Education as Topic*


  • Influenza Vaccines