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Jennifer Elaine Gerber, Speaker at Vaccines Conferences
Johns Hopkins Bloomberg School of Public Health, United States
Title : Vaccine hesitancy and influenza vaccine uptake among children and adults a cross sectional survey


Background: Vaccine coverage is lower for influenza than for other vaccines, varying by age, race/ethnicity, and region. Vaccine safety concerns are common despite a lack of epidemiological evidence. We characterized vaccine hesitancy and identified associations with influenza vaccination.

Methods: Respondents ≥18 years old were recruited from a non-probability-based Internet panel survey (N=1,925). We measured sociodemographic characteristics, vaccine confidence, influenza vaccination history (2018-2019 and 2019-2020), trust in pharmaceutical companies and public health authorities, and perceived vaccine reaction history. The association between variables hypothesized to be associated with vaccine hesitancy and influenza vaccination was estimated with Taylor-linearized variance estimation for tabulations and Poisson regression for unadjusted and adjusted prevalence ratios. Backwards stepwise regression identified parsimonious, adjusted models (p<0.05).

Results: The weighted study population was 50.6% female, 61.8% White, non-Hispanic. 62.9% had a child <18 years old, and 47.1% had a high school education or less. High vaccine hesitancy was greatest among parents of young children (45.4% vs. 27.6% parents of teenagers vs. 37.7% adults without minor children). Awareness of federal vaccine safety oversight was low across age groups. In adjusted models of all age groups, higher education and use of complementary/alternative medicine (CAM) were associated with higher vaccination prevalence. Vaccination prevalence was lower among those with high vaccine hesitancy.

Discussion: We identified common vaccine misconceptions associated with vaccine hesitancy. CAM use and higher education were associated with vaccination across age groups. Vaccine hesitancy differed by parental age, which may have influenced results. Results are subject to selection and social desirability biases, though quotas were used to enroll a sample representative of sociodemographic distribution of the U.S.

Conclusions: Age and education-level appropriate, targeted communications are needed. Future research should investigate how to reach sociodemographic minorities, less likely to use CAM or be vaccinated, and whether raising public awareness of federal vaccine safety oversight improves confidence.


Jennifer E. Gerber is an epidemiologist and vaccine subject matter expert in RTI’s Survey Research Division. She is experienced at implementing surveys and multisite cohort studies involving biospecimen collection during the H1N1 and COVID-19 pandemics and collecting data from special populations, including racial/ethnic minorities and pregnant women. Dr. Gerber earned her PhD in Global Disease Epidemiology and Control (2020) and a Certificate in Vaccine Science and Policy (2018) from Johns Hopkins Bloomberg School of Public Health. She earned her MSc in Epidemiology from the London School of Hygiene and Tropical Medicine (2013).