Determinants of influenza vaccination during the 2021/2022 influenza season in the United States: interactive roles of immunosuppression, cancer diagnosis, and healthcare access barriers

Despite current gains in public health awareness and cost-reduction strategies to accelerate vaccination against influenza during yearly influenza seasons, the U.S. adult population, especially those with immunosuppression and cancer, has yet to achieve its target vaccination rate. This study aims to investigate the factors (including access to healthcare) that influence decisions to accept or refuse influenza vaccination among healthy individuals and those with weakened immune status and cancer in the U.S. Data from the 2022 National Health Interview Survey (NHIS) were used. Data from 27,651 adults were analyzed using SAS software version 9.4. Descriptive and inferential statistics (including logistic regression analyses) were conducted, and 95% confidence intervals and P < .05 were used to determine the level of significance. The average age in the NHIS 2022 adult sample was 53.1 years, 55.8% were females, 67.4% were non-Hispanic White, 6.3% had immunosuppression, 13.8% had one or more cancers, and 47.2% had been vaccinated against influenza during the 2021/2022 influenza season. Adults that were diagnosed with one or more cancers (aOR = 1.31; 95% CI, 1.19–1.45; P < .001), those that reported delay in care because an appointment was not available (aOR = 1.13; 95% CI, 1.02–1.26; P = .02), and those who had a weak immune status (aOR = 1.47; 95% CI, 1.26–1.71; P < .001), were more likely to receive influenza vaccination in the past year (2021). However, those who reported a delay in care because there was no doctor to accept their health insurance (aOR = 0.82; 95% CI, 0.70–0.97; P = .03) were less likely to be vaccinated against influenza in the previous year (2021). This study has identified key factors influencing influenza vaccine uptake among healthy people, people with immunosuppression, and individuals with cancer in the U.S. Based on these findings, there is a need to intensify efforts to increase vaccination rates, especially among vulnerable adults.