Non-medical Settings Becoming Popular for Seasonal Influenza Vaccination

Public-health experts recommend that the seasonal influenza vaccine be available in more non-medical settings in hopes that with increased accessibility, more people will choose to get vaccinated.

In general, people are choosing to receive the flu shot in an expanding number of locales such as mobile clinics, retail establishments, and their own workplaces; however, certain segments of the population still go to a doctor’s office, health clinic, hospital, or health department to receive their flu shot.

A recent study conducted by researchers from the University of Michigan looked at self-reported data from several thousands of participants to determine patterns of early-season vaccination in 2012 and 2013. Although for both years medical settings were the most popular setting for receiving the vaccine, the proportion of respondents receiving the vaccine in a medical setting declined from 57.2% in 2012 to 50% in 2013. The percentage of respondents receiving their shot in a retail establishment, such as a pharmacy or supermarket, increased from 18.2% in 2012 to 21.9% in 2013, and the percentage receiving the shot in a mobile clinic such as a workplace, school, community center, or military base, increased from 24.6% in 2012 to 28.1% in 2013.

Nonetheless, the changes in location from year to year did not hold across the board for all groups. The researchers found that people ages 65 and older were more likely than other age groups to have received their flu shots in a medical setting—67.1% did so in 2012 and 59.2% did so in 2013. People with chronic health conditions also tended to receive the shot in a medical setting, from 61.2% doing so in 2012 to 58.6% in 2013. Perhaps due to chronic health conditions, those respondents who reported having visited a health practitioner since July 1 of each survey year were much more likely to have received the shot in a medical setting: 62.6% of this group in 2013 and 58.3% in 2013. Finally, education level was a factor as well. People who didn’t finish high school were much more likely to opt for a medical setting—78.8% in 2012 and 59.7% in 2013—compared with respondents who possessed a college degree or higher; only 49.5% of these populations received their vaccine in a medical setting in 2012 and 40.3% in 2013.

Public-health experts are pushing non-medical settings for flu shots primarily as a way to encourage healthier young adults to get the shots, and to get them early in the season. In contrast to physicians’ offices, where an appointment may be necessary and which may not be offered at a convenient time or in a convenient location, retail or workplace settings usually offer walk-in services in an easy-to-get-to location; this may be key to getting people vaccinated who otherwise might not bother. However, medical settings may still be the best bet for people who already see a doctor on a regular basis.

“There’s no ideal percentage of flu vaccination in medical versus retail settings,” explained Sarah Clark, MPH, an author of the study. “However, there’s a great benefit to a dual approach. Doctors have a very important role to play in recommending annual flu vaccine to patients who are uninformed or unconvinced of its importance; for those patients, having vaccine onsite reinforces the message about the importance of flu vaccine. For patients who do not need that provider push, retail settings tend to be more convenient.”

According to Dr. Clark, older people are much more likely to be proactive about receiving a flu shot, either in a medical or—increasingly—a non-medical setting. “The elderly have a much greater belief in annual flu vaccine, perhaps because it has long been recommended for that group, and also because the consequences [of flu] can be so serious,” she said. “We’re still in the stage of pushing the non-elderly adults to see vaccination as part of their routine health care.”

In order to make it easier for everyone to receive a flu shot, the researchers say health officials must lift existing barriers that prevent all eligible people from getting vaccinated. A greater number of mobile or retail settings is one step. Another would be to ensure that all health plans cover the cost of flu shots given at all locations, which is not currently the case, and to bolster training programs for non-medical providers so that they’re confident that they know how to properly administer the vaccine.

Laurie Saloman, MS, is a health writer with more than 20 years of experience working for both consumer and physician-focused publications. She is a graduate of Brandeis University and the Medill School of Journalism at Northwestern University. She lives in New Jersey with her family.