In the article by Ford and colleagues, the evaluation of sociodemographic characteristics and influenza vaccination provides indirect insight into potential barriers to immunization among adults with asthma. Male sex, younger age, lower educational attainment, and Hispanic or African-American race/ethnicity were associated with a lower likelihood of vaccination. Although reasons for these associations cannot be ascertained from these published data, possible explanations include access to health care, quality of health care, cost of vaccination, logistical constraints, flexibility of employment, or availability of health information. Previous work also indicates that health-related beliefs, such as the perceived efficacy of influenza vaccination, may have an important impact on a person’s decision to be vaccinated. In a study of 1,007 older adults, the positive belief that influenza vaccine prevents influenza was associated with a nearly 50% higher probability of being vaccinated.17
Moreover, concern that influenza vaccine will cause influenza infection, which was stated by 14% of respondents, was associated with a sixfold higher risk of nonvaccination. Further work will be necessary to better understand perceptions of influenza vaccine among adults with asthma.