To assess the health related quality of life (HRQOL) factors and social determinants associated with obtaining the influenza immunization within the past 12 months. METHODS:

Data was analyzed on 123,641 survey participants, aged ≥18 years, using the 2014 BRFSS. A weighted multivariable logistic regression was used to assess associations between influenza immunization and HRQOL. RESULTS:

The social determinants of sexual orientation, race/ethnicity, income, age, education, marital, drinking and smoking status, and health insurance were significantly associated with influenza immunization. Five domains of HRQOL were examined; general health, mental and physical health (≥14 unhealthy days), lifetime depression, and activity limitation. Accounting for social determinants, compared to those who perceived to have excellent health, self-perceived very good health had 1.02 (95% CI: 0.96-1.09) times higher odds of getting the flu vaccine, self-perceived good health had 1.10 (95% CI: 1.03-1.18) times higher odds, and self-perceived fair/poor health had 1.27 (95% CI: 1.16-1.40) times higher odds of getting the flu vaccine. Participants with poor physical health had 1.05 (95% CI: 0.96-1.14) times higher odds of getting the flu vaccine compared to their counterparts. However, participants with poor mental health had 19% (aOR = 0.81; 95% CI: 0.74-0.89) lower odds of getting the flu vaccine compared to their counterparts. Furthermore, compared to those without depression, depressed participants had 1.29 (95% CI: 1.21-1.38) times higher odds of getting the flu vaccine. Compared to those who did not report to be limited in any activity because of physical, mental or emotional problems, those who were limited in any way had 1.13 (95% CI: 1.07-1.21) times higher odds of getting the flu vaccine. CONCLUSIONS:

The results of this study show a significant role of HRQOL and social determinants on influenza immunization. Further research is needed to evaluate potential disparities surrounding immunization against influenza to inform and improve current health promotion activities.