Of note, there are still some individuals who should not receive the influenza vaccine; depending on the type of vaccine, such contraindications include those with an egg allergy, those who have had Guillain-Barré syndrome in the past, and pregnant women.3,4,6 All this aside, the influenza vaccine’s benefits still largely outweigh the risks and potential adverse side effects, and it is therefore recommended for individuals as young as 6 months in the United States (Table 3).6


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Patient perceptions of the influenza vaccine


For years, Americans have had mixed opinions regarding the efficacy and benefits of receiving vaccinations, including the influenza vaccine. Some studies have noted that a common reason why patients refuse the influenza vaccine is their perception that they do not need one, as they rarely become ill; others recall having had a negative experience as a result of the vaccine and believe that they may become infected with the virus if they receive the shot.7-9

Another important component that largely influences how patients perceive the influenza vaccine is the array of side effects that have been highly publicized and subsequently feared by the community. In a study analyzing how patients perceived the influenza vaccine during the H1N1 outbreak, research participants tended to believe that acquiring the H1N1 virus was less likely than having some of the adverse side effects associated with the corresponding vaccine, which ultimately served as a deterrent to vaccination.10 The media has also played a role in how the population perceives the influenza vaccine, often portraying vaccination in a negative light, overemphasizing the serious adverse reactions without adequate mention of the advantages vaccines provide to a population at risk of infection.8,9,11

Negative depictions of and attitudes toward the influenza vaccine can place the patient population at serious risk, especially those who have increased susceptibility to influenza virus infection and its resultant severe complications. To further understand the perceptions Americans have regarding influenza vaccination, discussions of how different age groups and patient populations may view the annual vaccine follow. 


Case Study

Mr. O is a 20-year-old man with asthma, well-controlled on an albuterol inhaler used as needed, who presents for his annual physical examination prior to returning to college.

It is fall, and the updated influenza vaccine has just been made available to the clinic for appropriate administration to the patient population. Mr. O is aware of the upcoming influenza season; however, he has a few questions regarding the potential side effects of the vaccine. He mentions further that he recently heard on a popular celebrity television show that the vaccine does more harm than good, as one can develop brain damage and may become severely ill from the vaccine. Mr. O asks you for more information.

His vital signs are as follows:

  • Temperature: 98.6°F
  • Heart rate: 82 beats/min
  • Respiration rate: 16 breaths/min
  • Blood pressure: 119/63 mm Hg
  • Oxygen saturation on room air: 98%

Results of a complete physical examination are unremarkable.

A reasonable approach to the patient’s concerns includes respectfully discussing the following:

  • Assess the patient’s current understanding of what the influenza vaccine is, why it is given, and the risks and benefits associated with vaccination.
  • Ask if the patient was vaccinated in the previous year. If not, politely ask why.
  • If the patient exhibits a negative perception about the vaccine, ask why he or she feels that way.

After obtaining a better grasp on the patient’s perceptions regarding the influenza vaccine, you should ask if the patient would like to hear why you recommend the vaccine. If the patient agrees to discussion, respectfully explain what the influenza vaccine is, its purpose, and the common side effects people can have after getting vaccinated. Proper education through simple dialog in an unbiased setting is critical to increasing the likelihood of the patient getting vaccinated. You should make a point to directly address the patient’s concerns in a polite, nonjudgmental fashion. Furthermore, sharing with the patient educational materials that display the background and benefits of the vaccine in a concise format is encouraged. If the patient is still hesitant, you should allow some time for the patient to digest the material discussed, making sure to avoid excessive swaying or bullying. If the patient leaves without getting his vaccine, you can also remind him about the vaccine at a later date through the mail or by phone.