Abstract P629: Influenza Vaccine Uptake is Associated With Cholesterol Treatment Adherence: An Analysis of the Behavioral Risk Factor Surveillance System Survey

Introduction: Misinformation, distrust, and other sociocultural factors that influence vaccine uptake may also influence adherence to cholesterol treatment. Hypothesis: Among American adults with hyperlipidemia, individuals who receive influenza vaccination are more likely to report use of cholesterol lowering medication. Methods: We pooled 2017 and 2019 survey data from the Behavioral Risk Factor Surveillance System (BRFSS). Our sample included all respondents aged 40 to 75 years with self-reported high cholesterol. We used logistic regression models adjusted for potential confounders to examine the association between influenza vaccine uptake and use of cholesterol medication. We also evaluated whether the association was different among those with and without established atherosclerotic cardiovascular disease (ASCVD). All analyses accounted for survey weighting. Results: Of 228,338 (weighted = 107,893,277) participants with hyperlipidemia, 51% reported influenza vaccination and 61% reported taking cholesterol medication. Vaccine uptake was associated with cholesterol medication use (OR 2.08, 95% CI 2.00-2.16, p <0.001). Although slightly attenuated, this association persisted after adjustment for socio-demographics, access to care, comorbidities, and adherence to hypertension treatment (OR 1.53, 95% CI 1.42-1.65, p-value <0.001). The association was similar in those with ASCVD (OR 1.63, 95% CI 1.32-2.03, p-value <0.001) and those without ASCVD (OR 1.52, 95% CI 1.40-1.64, p-value <0.001), p-value for interaction = 0.89. Conclusions: Influenza vaccine uptake is associated with cholesterol medication use among American adults with high cholesterol, including those with ASCVD. The sociocultural factors affecting vaccine avoidance, such as misinformation and distrust, merit investigation as potential targets of cardiovascular prevention efforts.