Facilitators and barriers to influenza vaccine uptake in adults with chronic respiratory conditions (CRC): a qualitative study

Background: Vaccination is the most effective means to prevent influenza infection among adults with Chronic Respiratory Conditions (CRC). However, uptake of the vaccination is low, with less than half of adults with CRC choosing to be vaccinated. The aim of the study was to explore adults with CRC views of influenza vaccination, in order to better understand the barriers and facilitators to uptake among this 'high risk' group. Methods: Fifty-nine adults with CRC aged 18-64 years old participated in one of eight focus groups (n= 38) or a semi-structured interview (n=21). The focus groups and interviews explored participants' experiences in relation to their decisions on influenza vaccination uptake. Data were recorded and transcribed verbatim, managed in NVIVO and analysed using Thematic Analysis. Results: The qualitative analysis identified three themes that were identified as facilitators to influenza vaccination uptake among adults with CRC: 'Sense of feeling protected', 'reduced vulnerability, fear and anxiety about getting ill', and 'Acceptance of the advice to vaccinate given 'at risk' status'. Barriers to vaccination uptake were captured in three themes: 'Perceived adverse reactions and/or side-effects based on lived experiences', 'lack of rapport and/or trust in medical practitioners', and 'Not knowing how or why it works'. Conclusions and implications: These findings identify facilitators and barriers at the provider, interpersonal and practice level that need to be addressed in future efforts to increase vaccine uptake among adults with CRC. Implementation strategies that aim to improve facilitators and address multi-level barriers to vaccine uptake merit further investigation.