Public Health Association of Australia
Winter is coming…and every year influenza causes thousands of hospitalisations and hundreds of deaths in Australia, though 2020 was an outlier in this regard as COVID restrictions led to a significant decline in influenza cases nationally.
Vaccination is one of the most effective ways to prevent the flu, yet only 40% of Australian adults receive the vaccine each year.
At a time when there’s so much focus – and largely unwarranted criticism – on the roll out of COVID-19 vaccinations in Australia, the findings of a new study tell an interesting story about why, and where, Australians receive their annual flu shots. The full report has just been published in the Australian and New Zealand Journal of Public Health (ANZJPH).
Conducted at the end of the last pre-COVID flu season, in October 2019, the research involved an online survey of 1,444 Australian adults, with a focus on where people chose to be vaccinated.
This is the first Australia-wide research conducted since all states and territories modified their legislation between 2014 and 2016, to allow pharmacies to administer flu vaccines.
‘Pharmacies provide a low-cost, convenient option for vaccination,’ the ANZJPH report says. ‘They are often conveniently located, have extended opening hours, and do not typically require appointments for vaccination services. Furthermore, they may increase access to vaccines in medically under-served regions.’
Where people got their shot
Notwithstanding this, most participants (73%) received their flu vaccine in a medical setting (at their GP’s or a medical centre), while 14% received it in their workplace, and 13% at a pharmacy. Pharmacy and workplace settings were more common among younger adults without high-risk health issues.
This compares with a 2014 survey of Australian adults (prior to pharmacy vaccinations) which found that 69% of flu vaccines were given in a GP’s office, 21% in workplaces and 7% in community clinics. This shows the proportion of vaccinations in medical settings has changed little since the introduction of pharmacist vaccinations, but the proportion of vaccinations given in workplaces has decreased.
For the latest survey, 12% reported it was the first time they’d received the flu vaccine, while 81% had been vaccinated the previous year in 2018.
Vaccine timing
For all three vaccination locations, the majority of shots were received in the months of April and May.
- For medical settings: 29.3% in April, 34.6% in May, and 12.7% in June
- For pharmacy settings: 32.6% in April, 30.5% in May, and 17.9% in June
- For workplace settings: 34.6% in April, 30.8% in May, and 13.1% in June
Why people chose a vaccine location
The survey received a broad range of responses to an open-ended question ‘why did you choose to be vaccinated there?’
In medical settings, the most common response was ‘preference to do all medical procedures at the same place’ (23.8%), followed by ‘combined vaccination with a check-up or other procedure’ (14.6%) and ‘provider has their records/will keep record of flu vaccination’ (5.9%). Other important reasons given included ‘familiarity with provider’, ‘convenience’ and ‘cost’.
In workplace settings, the most common responses were ‘cost’ (56.1%) and ‘convenience’ (55.1%).
In pharmacy settings, ‘Convenience’ (52%) was the most common response, followed by ‘cost’ (30.5%), and then ‘needed to have the vaccination done quickly’ (12.6%).
Many participants in the study who were vaccinated in a pharmacy said they chose that location because their employer offered to reimburse the cost.
‘Thus, pharmacy vaccination may have provided a more cost-effective way for employers to encourage vaccination compared to onsite vaccination,’ the ANZJPH report said.
Conclusion
With the majority of adult Australians still choosing not to receive a flu shot each year, the report suggests ‘further research is needed to determine how to best promote influenza vaccination in all three settings, as they appear to cater to different populations with different motivations.
It will be interesting to see how the active promotion of COVID-19 vaccines this year impacts on numbers who choose to receive their annual flu shot.
The ANZJPH article: ‘Pharmacy, workplace or primary care? Where Australian adults get their influenza vaccines’ was jointly authored by Mallory Trent, Daniel Salmon and Raina MacIntyre, from the University of NSW’s Kirby Institute.