Associations of health literacy with missed free influenza immunization in people with chronic diseases.

We aimed to examine the association between health literacy with missing free influenza immunization. This research focused on people with chronic illnesses living in the Foca region (Republic of Srpska, Bosnia and Herzegovina) and who were entitled to receive a free influenza shot in season 2017/2018. All non-vaccinated people (cases) and corresponding number vaccinated people (controls) were included. People were interviewed using the socio-demographic questionnaire, Health Literacy Questionnaire (HLQ) and Health Belief Model Applied to Influenza (HBMAI). Mathematical model suggested potential difference between men and women, so the analyses were performed separately for each gender. People who had better health literacy were not more likely to receive the influenza vaccine. Men who felt better understood and supported by healthcare providers, who had more social support and were actively engaging with healthcare providers were more likely to perceive benefits of influenza immunization. People who felt less understood and supported by healthcare providers, who felt that they did not have sufficient information to manage health and social support and were not actively engaging with healthcare providers were more likely to perceive barriers to influenza immunization. People with chronic diseases should be encouraged to improve their health literacy to better understand influenza immunization.