Using the health belief model to identify barriers to seasonal influenza vaccination among Australian adults in 2019

Mallory J. Trent, Daniel A. Salmon, C. Raina MacIntyre

Research output: Contribution to journalArticlepeer-review


Background: Each year tens of thousands of Australians become ill with influenza, resulting in thousands of severe infections that require hospitalisation. However, only 40% of adults receive the annual influenza vaccine. We surveyed Australian adults to provide up to date, population-specific data on the predictors and barriers of seasonal influenza vaccination. Methods: We administered an online survey to a nationally representative sample of Australian adults. We designed survey questions using the theoretical constructs of the health belief model. Using simple and multivariable Poisson regression, we identified attitudes and beliefs associated with influenza vaccination in 2019. Results: Among 1,444 respondents, 51.7% self-reported influenza vaccination in 2019. We estimated vaccine coverage to be 44% for adults under 45, 46% for adults aged 45 to 64 and 77% for adults aged 65 and over. The strongest individual predictors of self-reported vaccination were believing the vaccine is effective at preventing influenza (APR = 3.71; 95% CI = 2.87-4.80), followed by recalling their doctor recommending the vaccine (APR = 2.70; 95% CI = 2.31-3.16). Common perceived barriers that predicted self-reported vaccination included believing the vaccine could give you influenza (APR = 0.59; 95% CI = 0.52-0.67), believing the vaccine can make you ill afterwards (APR = 0.68; 95% CI = 0.62-0.74) and preferring to develop immunity “naturally” (APR = 0.38; 95% CI = 0.32-0.45). Conclusion: Although vaccine uptake in 2019 appears to be higher than previous years, there are perceived barriers which may limit uptake among Australians. Tailored interventions are needed to combat widespread influenza vaccine hesitancy, particularly among high-risk groups.

Original languageEnglish (US)
Pages (from-to)678-687
Number of pages10
JournalInfluenza and other Respiratory Viruses
Issue number5
StatePublished - Sep 2021


  • Australia
  • barriers
  • health belief model
  • influenza
  • predictors of vaccination
  • vaccine hesitancy

ASJC Scopus subject areas

  • Epidemiology
  • Pulmonary and Respiratory Medicine
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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