Factors Contributing to Suboptimal Vaccination Against Influenza: Results of a Nationwide Telephone Survey of Persons with Cardiovascular Disease

Vaccination against influenza averts cardiovascular events and is recommended for all patients with coronary heart disease. Because data were unavailable regarding vaccination rates among such patients' household contacts, we sought to estimate the rate of influenza vaccination in persons with cardiovascular disease and their contacts. In 2004, we conducted a random, nationwide telephone survey of 1,202 adults (age, > or = 18 yr) to ascertain knowledge, attitudes, and behaviors regarding influenza vaccination. Of the interviewees, 134 (11.1%) had histories of heart disease or stroke. Of these 134, 57% were men, and 45% were > or = 65 years of age. Overall, 57% were inoculated against influenza in 2003-2004, and 68% intended the same during 2004-2005. Vaccination rates increased with age: 48% (ages, 18-49 yr), 68% (ages, 50-64 yr), and 75% (age, > or = 65 yr). Forty of 69 respondents (58%) reported that their spouses were vaccinated, and 7 of 21 (33%) reported the inoculation of children < or = 17 years old in their household. Only 65% of the 134 patients considered themselves to be of high-risk status. Chief reasons for remaining unvaccinated were disbelief in being at risk and fear of contracting influenza from the vaccine. Although seasonal influenza vaccination is recommended for all coronary heart disease patients and their household contacts, the practice is less prevalent than is optimal. Intensified approaches are needed to increase vaccination rates. These findings suggest a need to increase vaccination efforts in high-risk subjects, particularly amidst the emerging H1N1 pandemic.