OBJECTIVES

: Understanding vaccination habits of United States (US) adults helps health authorities design interventions to improve compliance. This study evaluated the relationship between Patient Activation Measure (PAM) level, a validated measure of a patient’s awareness of and engagement in their health, and vaccination behavior in US adults over the age of 50.

METHODS

: An analysis was conducted using the 2018 National Health and Wellness Survey (NHWS), a nationally-representative, cross-sectional online survey, to determine the association between patient activation and vaccination for influenza, shingles, and pneumococcal disease. Patients were stratified by PAM level (1=disengaged,2=becoming aware,3=taking action,4=maintaining behaviors) and their demographics and health behaviors were analyzed. Logistic regression was used to examine the relationship between patient activation and vaccination behavior, adjusting for sociodemographic factors and health resource utilization.

RESULTS

: Of 74,977 US adults surveyed, PAM levels were calculated for 30,110 respondents over age 50. 23.23% were considered “engaged” (Level 4); all others were considered “unengaged”. 19.1% of engaged respondents had received all 3 vaccinations, compared to 16.4% of unengaged respondents(p<0.0001). After adjusting for sociodemographic factors, engaged respondents were found to have 1.17(95% CI:1.09-1.26, p<0.001) times the odds of having received all three vaccines. Higher proportions of engaged respondents had ever received a shingles vaccine (32.6% vs 28.2%, p<0.0001) and pneumococcal vaccine (43.1% vs 39.4%, p<0.0001). Equivalent proportions of respondents had received a flu vaccine in the past 12 months (49.9% engaged vs 49.1%, p=0.22). Engaged respondents were more likely to indicate they did not receive a flu vaccine because they “believe the flu vaccine is bad for you” (p=0.003) or they “do not need one” (p<0.001).

CONCLUSIONS

: Engaged patients are more likely to have received all three vaccinations, even when accounting for other factors. Explanations given for not receiving a flu vaccine indicate that patient education is critical even for highly activated patients.