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NFID Surveys Find Gaps in Communication About Flu Between Healthcare Professionals & Patients with Chronic Health Conditions

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New survey data from the National Foundation for Infectious Diseases (NFID) show that while nearly 100 percent of healthcare professionals (HCPs) say they recommend flu vaccines to their patients with chronic health conditions at least some of the time, only 45 percent of US adults with chronic health conditions say they were vaccinated against influenza (flu) by early November 2021. Annual flu vaccination is especially important for those with certain chronic health conditions. During National Influenza Vaccination Week (December 5-11), NFID urges everyone age six months and older to follow the recommendations of the Centers for Disease Control and Prevention and get vaccinated against flu annually.

"Even when their condition is well-controlled, people with heart disease, lung disease, or diabetes are at increased risk for serious flu-related complications including hospitalization and death," said NFID Medical Director William Schaffner, MD. "In fact, during recent flu seasons, 9 out of 10 people hospitalized with flu had at least one underlying health condition. Healthcare professionals need to strongly and consistently recommend flu vaccination to this vulnerable population."

The data are the result of two national surveys NFID commissioned to better understand knowledge, attitudes, and practices toward flu vaccination as well as communication between HCPs and adult patients with chronic health conditions. The patient survey included adults with diabetes, chronic lung conditions such as COPD or asthma, and cardiovascular conditions. The HCP survey included primary care physicians, endocrinologists, cardiologists, and pulmonologists.

Overall, less than a third of HCPs (31 percent) said they recommend annual flu vaccination to all of their patients with chronic health conditions. Endocrinologists and pulmonologists appear to be less likely to recommend a flu vaccine compared to cardiologists. Seventy-two percent of patients with a cardiovascular condition said a cardiologist recommended they get a flu vaccine, while only 32 percent of patients with a lung condition said a pulmonologist recommended a flu vaccine, and only 10 percent of patients with diabetes say an endocrinologist recommended one.

Patients are more likely to get vaccinated if an HCP recommends it. More than half of patients (51 percent) who received or plan to get an annual flu vaccine said a doctor's recommendation motivated them to do so. In fact, of the patients surveyed who were unsure or not planning to get a flu vaccine, 47 percent said they would be more likely to consider getting one if an HCP recommended it.

The results revealed differences in perceptions between patients and HCPs about conversations around flu risk. Nearly half of patients with chronic health conditions (48 percent) report they have never been advised by an HCP that flu puts them at increased risk for serious complications and can make their health condition harder to manage. In contrast, 77 percent of HCPs who recommend annual flu vaccination to their patients report that they advise patients with chronic health conditions that their condition puts them at greater risk of flu-related complications, and 71 percent tell their patients that their conditions can become harder to manage.

The data shows the disconnect varies widely depending on the specific health condition. Sixty-two percent of patients with diabetes said they were not advised about the potentially serious consequences of flu, compared to 47 percent of those with a lung condition and 36 percent of patients with a heart condition.

HCPs may also be able to boost vaccination rates among patients with chronic health conditions by making it more convenient to get a flu vaccine. Seventy-five percent of cardiologists report that the location where they work offers flu vaccines to patients, compared with 71 percent of primary care physicians, 61 percent of endocrinologists, and 60 percent of pulmonologists. Among specialists who do not offer flu vaccines at their work location, a sizable portion of cardiologists (72 percent), endocrinologists (67 percent), and pulmonologists (50 percent) report it is because they believe vaccination is the responsibility of the primary care physician. This is problematic since only 65 percent of patients with chronic health conditions report seeing a primary care physician at least once a year.

"The findings reinforce how critical it is for all healthcare professionals, including specialists, to talk to their patients about the importance of annual flu vaccination and ensure that patients hear the message," said NFID Executive Director & CEO Marla Dalton. "HCPs have an important role to not only inform patients of their risks, but also to remove barriers to vaccination, by either offering vaccines or a vaccine referral during routine healthcare visits."

More information about the survey results and associated materials can be found at

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Schedule3 Oct 2023