Organising services for influenza vaccination for older people.

Objectives: To follow up a trial of home-administered influenza vaccination of older people to explore reasons for their immunisation behaviour, including their views on the organisation of services. Methods: Follow-up of original trial using analysis of records of 1865 older people and semi-structured interviews of 25 older people. Results: A once-off home visit does not appear to result in sustained changes in immunisation behaviour. Older people's behaviour appears to be largely explained by their beliefs about immunisation; the organisation of services may exert only small effects. Older people can be characterised as belonging to one of four groups in their orientation towards influenza vaccination: the 'faithful', who are keen to have vaccination; the 'converts', who have been persuaded of the benefits of vaccination and are likely to self-initiate appointments for vaccination; the 'easy-going', who require prompting for vaccination; and the 'sceptics', who perceive influenza vaccination to be ineffective or to be irrelevant for them because of their perceived inherent resistance to influenza. The last group sees vaccination as a form of interference and may be resistant to home visits to administer the vaccine. Conclusions: Targets for immunising older people require more debate because of the delicate balance between achieving herd immunity and preserving autonomy and choice for older people. [ABSTRACT FROM AUTHOR]