Uptake rate of influenza vaccines and its associated factors among patients with asthma or chronic obstructive pulmonary disease in Klang Valley: A health belief model study

ABSTRACT

Introduction: Influenza is a significant cause of morbidity among patients with asthma and chronic obstructive pulmonary disease (COPD). In Malaysia, the Ministry of Health recently updated the national formulary to include influenza vaccination for senior citizens aged 60 years and above with at least one chronic illness, effective from 18 February 2025. However, the uptake rate of influenza vaccination among patients with asthma and COPD remains unclear. This study aimed to determine the association between sociodemographic factors, health belief model components and influenza vaccine uptake among patients with asthma or COPD in Klang Valley.
Methods: A cross-sectional survey was conducted among 200 adults with asthma or COPD attending follow-up at five primary care clinics in Klang Valley. Sociodemographic data, vaccination history and vaccination beliefs were recorded using a questionnaire based on the health belief model. Data were examined using univariate and multivariate analyses.
Results: A total of 200 patients participated. The influenza vaccine uptake rate was 24.0%. The employed patients were significantly more likely to be vaccinated (odds ratio [OR] =3.68; 95% confidence interval [CI]=1.09–12.38; P=0.036). Stronger cues to action increased uptake (OR = 4.04; 95% CI = 1.94–8.40; P = 0.001), with healthcare provider recommendation being the main contributing factor. Higher perceived barriers reduced uptake (OR = 0.41; 95% CI = 0.18–0.93; P = 0.032), particularly concerns regarding vaccine side effects.
Conclusion: Influenza vaccine uptake among high-risk patients in Malaysia is low. Employment, healthcare provider recommendations and perceived barriers strongly influence vaccination behaviour.