Korean J Fam Pract 2019; 9(5): 431-437  https://doi.org/10.21215/kjfp.2019.9.5.431
Factors Associated with Influenza Vaccination Location in Korean Adult Population
Hyon Chong Kim1, Do-Hoon Kim1,*, Joo-Hyun Park1, E Yeon Kim1, Moon Young Choi1, Soo Gyeong Park1, Da Eun Seul1, Hyun Jin Kim1, Myung Ji Nam1, Kang Uk Lee1, Kyungdo Han2, Da Hye Kim2
1Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan; 2Department of Biostatistics, The Catholic University of Korea College of Medicine, Seoul, Korea
Do-Hoon Kim
Tel: +82-31-412-4261, Fax: +82-31-412-5364
E-mail: kmcfm@hanmail.net
ORCID: http://orcid.org/0000-0001-7421-4501
Received: July 26, 2018; Revised: November 19, 2018; Accepted: September 2, 2019; Published online: October 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Increasing the influenza vaccination rate is important because influenza infection can cause serious illness or death. One way to increase vaccination rates is to expand the number of vaccination sites. This study examined the location of influenza vaccination in 2016 according to sex, age, socioeconomic status, and health behavior variables.
Methods: The study included 2,485 subjects from the Korean National Health and Nutrition Examination Survey aged 19 years or older who had received the vaccine. Variables that could affect health behaviors were examined by the chi-square test or t-test. The odds ratios (ORs) of public health center inoculations between different income and education groups, adjusted for age and sex, were analyzed using multivariate logistic regression.
Results: People aged 65 years or older, those living in rural areas, those with low incomes, those with up to elementary school education, and those with underlying diseases had the lowest vaccination rates at medical clinics and hospitals (P-value<0.05). The ORs for public health center inoculations were significantly higher in those with lower incomes and those with elementary school education than in those with higher incomes and those with more than university level education (OR 2.50, 95% confidence interval [CI]; 1.67–3.77 and OR 2.60, 95% CI; 1.72–3.95, respectively).
Conclusion: To improve the influenza vaccination rates at medical clinics and hospitals among groups with low vaccination rates, we need to actively encourage high-risk patients to receive vaccinations.
Keywords: Influenza; Vaccination; Health Behavior
  1. Centers for Disease Control and Prevention (CDC). Public health and aging:influenza vaccination coverage among adults aged > or =50 years and pneumococcal vaccination coverage among adults aged > or =65 years--United States, 2002. MMWR Morb Mortal Wkly Rep 2003; 52: 987-92.
  2. World Health Organization. Influenza (Seasonal) [Internet]. Geneva: WHO; c2018. [2018 Nov 6].
  3. Simonsen L, Reichert TA, Viboud C, Blackwelder WC, Taylor RJ, Miller MA. Impact of influenza vaccination on seasonal mortality in the US elderly population. Arch Intern Med 2005; 165: 265-72.
    Pubmed CrossRef
  4. Nichol KL, Wuorenma J, von Sternberg T. Benefits of influenza vaccination for low-, intermediate-, and high-risk senior citizens. Arch Intern Med 1998; 158: 1769-76.
    Pubmed CrossRef
  5. Gross PA, Hermogenes AW, Sacks HS, Lau J, Levandowski RA. The efficacy of influenza vaccine in elderly persons. A meta-analysis and review of the literature. Ann Intern Med 1995; 123: 518-27.
    Pubmed CrossRef
  6. Gasparini R, Amicizia D, Lai PL, Panatto D. Clinical and socioeconomic impact of seasonal and pandemic influenza in adults and the elderly. Hum Vaccin Immunother 2012; 8: 21-8.
    Pubmed CrossRef
  7. Lee BY, Mehrotra A, Burns RM, Harris KM. Alternative vaccination locations: who uses them and can they increase flu vaccination rates? Vaccine 2009; 27: 4252-6.
    Pubmed KoreaMed CrossRef
  8. Korea Centers for Disease Control and Prevention. 2017-2018 national management guidelines for seasonal influenza vaccination. Cheongju: Korea Centers for Disease Control and Prevention; 2017 Aug. Report No.: 11-1352159-000958-10. 158 p.
  9. Kee SY, Cheong HJ, Chun BC, Kim WJ. Influenza vaccination coverage rate and factors associated with vaccination in people with chronic disease. Infect Chemother 2011; 43: 406-11.
  10. Shin HY, Chung JH, Hwang HJ, Kim TH. Factors influencing on influenza vaccination and its trends of coverage in patients with diabetes in Korea: a population-based cross-sectional study. Vaccine 2018; 36: 91-7.
    Pubmed CrossRef
  11. Byeon GR, Hur YI, Kang JH, Park HA, Kim KW, Cho YG, et al. Influenza vaccination status in Korean adult population in relation with socioeconomic and medical factors. Korean J Health Promot 2016; 16: 20-31.
  12. Lee HY, Yu JH, Hong JI. Elderly immunization program against influenza in Korea, 2015. Public Health Weekly Report, KCDC 2016; 9: 242-5.
  13. Chun JD, Ryu SY, Han MA, Park J. Comparisons of health status and health behaviors among the elderly between urban and rural areas. J Agric Med Community Health 2013; 38: 182-94.
  14. Palache A. Seasonal influenza vaccine provision in 157 countries (2004-2009) and the potential influence of national public health policies. Vaccine 2011; 29: 9459-66.
    Pubmed CrossRef
  15. Linn ST, Guralnik JM, Patel KV. Disparities in influenza vaccine coverage in the United States, 2008. J Am Geriatr Soc 2010; 58: 1333-40.
    Pubmed KoreaMed CrossRef
  16. Schneider EC, Cleary PD, Zaslavsky AM, Epstein AM. Racial disparity in influenza vaccination: does managed care narrow the gap between African Americans and whites? JAMA 2001; 286: 1455-60.
    Pubmed CrossRef
  17. Lim BD, Lee JY. A survey on utilization of health center and health service demand of residents in a urban and rural unified community. Koean J of Rural Med 2000; 25: 99-112.

This Article