Abstract
Background/Objectives: Health literacy and vaccine literacy influence vaccine uptake behavior. Ensuring that people in rural communities are knowledgeable about vaccines can be an important tool in increasing influenza vaccination rates. The goal of this research was to evaluate rural community member knowledge of influenza and influenza vaccine. Methods: A cross-sectional survey was conducted with residents of a rural a medically underserved community in Washington State. Three thousand rural residents were contacted up to five times by a survey research center with a request to participate, with the goal of receiving 500 returned surveys based on the current population size, a z-score of 95, and an error rate of 5%. The survey evaluated rural resident knowledge and opinions about influenza and influenza vaccine. Results: Participants who were vaccinated against influenza in the last five years were more likely to know that influenza vaccine does not cause influenza (χ(2) = 13.44, p < 0.01) and that antibiotics cannot be used to treat influenza (χ(2) = 19.36, p < 0.01) than people who were not vaccinated. There was no statistical difference between people who are vaccinated and unvaccinated regarding knowing that influenza is viral rather than bacterial with the majority in both groups responding correctly (χ(2) = 0.05, p < 0.82), or that people who have influenza are at higher risk for contracting pneumonia (χ(2) = 0.78, p = 0.08) or COVID-19 (χ(2) = 1.54, p = 0.21). Unvaccinated people were more likely to have had their opinion about vaccines changed in recent years (p < 0.01) and feel that COVID-19 impacted their ability to trust public health officials (p < 0.01). Conclusions: Understanding gaps that exist in rural resident knowledge about influenza could be valuable in developing future educational outreach efforts in these communities.