Socioeconomic status, demographics, beliefs and A(H1N1) vaccine uptake in the United States

Vaccine. 2011 Jul 18;29(32):5284-9. doi: 10.1016/j.vaccine.2011.05.014. Epub 2011 May 27.


Early vaccination against influenza viruses is a cost-effective solution to prevent contagion and reduce influenza-related morbidity and mortality. In the face of pandemic viruses, such as the A(H1N1), adequate rates of vaccine uptake play a critical role in containing the spread and effects of the disease. In order to understand the reasons underlying the relatively low 2009-2010 A(H1N1) vaccination rates, we conducted an online survey of 1569 respondents drawn from a nationally representative sample of United States (U.S.) adults age 18, and older. Because prior research suggests that vaccination rates are especially low among some U.S. population subgroups, we oversampled participants from minority ethnic/racial groups and those living under the Federal Poverty Level. Our results show that A(H1N1) vaccine uptake is associated with sociodemographic factors, A(H1N1)-related beliefs and seasonal vaccination. That is, A(H1N1) vaccination is strongly associated with age, urbanicity, perceiving the A(H1N1) vaccine as safe and seasonal flu vaccine uptake. Perceptions of safety and season flu vaccination show the strongest associations with A(H1N1) uptake. The reasons people gave to decline vaccination varied by respondents' sociodemographic group. For example, Black participants were the most likely ethnic/racial group to reported having tried to get the vaccine but found it unavailable. Together, these findings suggest some clear pointers towards strategic public health communication efforts calling for communication campaigns towards audiences segmented by social class, race/ethnicity and beliefs, often what advertisers call "psychodemographics".

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Culture
  • Demography
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Healthcare Disparities
  • Humans
  • Influenza A Virus, H1N1 Subtype / immunology*
  • Influenza Vaccines / economics
  • Influenza Vaccines / immunology*
  • Male
  • Middle Aged
  • Patient Compliance
  • Racial Groups
  • Social Class
  • Surveys and Questionnaires
  • United States
  • Vaccination / statistics & numerical data*


  • Influenza Vaccines