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Does health plan type influence receipt of an annual influenza vaccination?
  1. Ian W Watson,
  2. Sanda Cristina Oancea
  1. Population Health, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
  1. Correspondence to Dr Sanda Cristina Oancea, Population Health, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA; cristina.oancea{at}


Background The influenza virus caused 48.8 million people to fall ill and 79 400 deaths during the 2017–2018 influenza season, yet less than 50% of US adults receive an annual flu vaccination (AFV). Having health insurance coverage influences whether individuals receive an AFV. The current study aims to determine if an association exists between an individual’s health plan type (HPT) and their receipt of an AFV.

Methods Data from the 2017 Behavioral Risk Factor Surveillance System and the optional ‘Health Care Access’ module were used for this study. The final study sample size was 35 684. Multivariable weighted and adjusted logistic regression models were conducted to investigate the association between HPT and AFV.

Results Medicare coverage was significantly associated with an increase in AFV for both men (adjusted OR (AOR) 1.62 (95% CI 1.28 to 2.06)) and women (AOR 1.28 (95% CI 1.00 to 1.53)). For men, other sources of coverage were also significantly positively associated with AFV (AOR 1.67 (95% CI 1.27 to 2.19)), while for women obtaining coverage on their own was significantly negatively associated with AFV (AOR 0.75 (95% CI 0.59 to 0.97)).

Conclusion These findings are of interest to health policy makers as these show there are HPTs which are effective at improving vaccination rates. Adopting methods used by these HPTs could help the USA reach its Healthy People 2020 AFV coverage goal of 70%.

  • BRFSS 2017
  • health plans
  • influenza
  • influenza vaccination

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  • Contributors IWW and SCO contributed equally to this work.

  • Funding This work was supported by an Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the National Institutes of Health (grant no P20GM103442).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository.