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Understanding influenza vaccination attitudes and behaviors: An assessment of health decision-making preferences

2025/10/01 by Kerri-Ann Anderson, Glen Nowak, Michael A. Cacciatore +2 · 1 voice
Social Sciences · Medicine · #Vaccine Coverage and Hesitancy #Misinformation and Its Impacts #Influenza Virus Research Studies

paper · doi:10.1016/j.vaccine.2025.127804

openalex publication_date 2025/10/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/23

Abstract

Less than half of American adults comply with annual influenza vaccination recommendations. Stagnating flu vaccination rates suggest new approaches, particularly ones using theory-based approaches, are needed to better understand influenza vaccination beliefs, behaviors, and intentions. Health decision-making preferences are an important consideration rarely accounted for in understanding vaccination behavior and thus may provide further insight into stagnating vaccination rates. Building on the work of Groopman and Hartzband (2012), this study considers health decision-making preferences as a determinant of vaccination attitudes and behavior and introduces an instrument for measuring them. We constructed a measure of health decision-making preferences using population representative surveys of U.S. adults 18 years old and older, drawn from the National Opinion Research Center's (NORC) AmeriSpeak® Panel. We used ordinary least squares (OLS) regression to determine the relative explanatory power of health decision-making preferences in predicting vaccine confidence, vaccine hesitancy, recent vaccination behavior and future vaccination intention. In an initial assessment, our health decision-making preferences measure was significantly correlated with measures of vaccine confidence and vaccine hesitancy, prior flu vaccination and flu vaccination intentions. • Using health survey data, we operationalized the “Medical Mind” concept for application to vaccination. • There is a positive relationship between the health decision-making preference measure and support of influenza vaccines. • Higher health decision-making preference scores are positively correlated with past and future vaccination behavior. • Health decision-making preferences hold significant value for advancing our understanding of adults' influenza vaccination.

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