Meng Li

Uptake of vaccination against seasonal influenza is suboptimal
in most countries, and campaigns to promote vaccination
may be weakened by clustering of opinions and
decisions not to vaccinate. This clustering can occur at myriad
interacting levels: within households, social circles, and
schools. Given that influenza is more likely to be transmitted
to a household contact than any other contact, clustering of
vaccination decisions is arguably most problematic at the
household level. We conducted an international survey
study to determine whether household members across different
cultures offered direct advice to each other regarding
influenza vaccination and whether this advice was associated
with vaccination decisions. The survey revealed that
household members across the world advise one another
to vaccinate, although to varying degrees, and that advice
correlates with an increase in vaccination uptake. In addition,
respondents in Japan, China, and the United States
were less likely to offer advice to older adults than to the
young, despite older adults’ being the target age group for
vaccination in both Far Eastern countries. Furthermore,
advice was not primarily directed to household members
within the age groups advised to vaccinate by national
health policies. In Japan, advice was offered more to ages
outside of the policy guidelines than inside. Harnessing
the influence of household members may offer a novel strategy
to improve vaccination coverage across cultures worldwide.