Influenza vaccination in old adults in Spain

BACKGROUND: to describe population patterns of influenza vaccination, and to analyse the effect of a set of demographic, socio-economic status, lifestyles, health status, and health services variables, on the likelihood of being vaccinated in the those > or = 65 years. METHODS: Cross-sectional study. From the 1997 National Health Survey those > or = 65 years old were selected. Adjusted odds ratios were calculated through multiple logistic regression models, reporting having an influenza vaccination last season as a dependent variable. RESULTS: A total sample of 1148 was analysed: 51.3% of subjects reported having received a vaccination last year. Adjusted odds ratios showed that the risk of not having been vaccinated was higher for people from 65-69 years (OR: 1.70; 95% CI [1.32-2.19]), women (OR: 1.48; 95% CI [1.14-1.92]), residents in cities of more than 1 million inhabitants (OR: 1.74; 95% CI [1.12-2.70]), smokers (OR: 1.92; 95% CI [1.24-2.96]), having high-risk chronic conditions (OR: 1.41; 95% CI [1.08-1.85]), and for those whose last physician visit was between 2 weeks and 6 months ago (OR: 1.40; 95% CI [1.07-1.85]), and more than 6 months ago (OR: 2.13; 95% CI [1.52-2.98]). CONCLUSION: Influenza vaccination levels are sub-optimal. Factors that have been identified as barriers to receiving this effective intervention are: younger age, female sex, less contact with the health care system, smokers, and not having high-risk chronic conditions. No effect was found for socio-economic status or variables related with health, functional status or other health-related behaviours. This study may contribute to identifying population groups who could be targeted for health promotion interventions aimed to improve their influenza vaccination uptake.     

Effectiveness of age-based strategies to increase influenza vaccination coverage among high risk subjects in Madrid (Spain)

We aim to assess the effectiveness of age-based strategies to increase influenza vaccination coverage among high risk subjects. To do so, we describe and compare the influenza vaccination coverage in the 2006/2007 campaign between the Autonomous Community of Madrid (ACM), where in year 2005 the recommendation was extended by 5 years to cover all those aged 60 and over, and other regions of Spain where the universally recommended age was 65 years and above.We used individualized secondary data provided by two surveys carried out in 2007 in ACM and in the rest of Spain. The total number of subjects included in the study was 21,948. For the 60-64 years age group influenza vaccination coverage was significantly higher 40.1% (CI 95% 36.4-43.8) in ACM residents than among residents in the Rest of Spain 29.1% (CI 95% 24.5-33.7). The difference in vaccine uptake was even greater, 59% (CI 95% 51.8-66.2) vs. 43.5%(CI 95% 34.3-52.7), when we compared subjects who suffered a chronic condition, which represents an indication for the anti-influenza vaccination. The results of the multivariate analysis show that the probability of a subject aged 60-64 living in ACM of being vaccinated was almost two times higher (OR 1.95 CI 95% 1.46-2.61) than a person of the same age who lived in a region of Spain where the universal recommendation for influenza vaccine started at 65 years.In conclusion, the available evidence indicates the effectiveness of age-based strategies to increase influenza vaccination coverage among high risk subjects aged 60-64 years in our population.     

Influenza vaccination rates in Ontario children: Implications for universal childhood vaccination policy

The aims of this study were to estimate influenza vaccination coverage for children during the 2006–2007 influenza season in Ontario, Canada, where universal vaccination is available, and to compare the rate among children aged 6–23 months with corresponding rates from other Canadian provinces that specifically target this high-risk group. We conducted a telephone survey of caregivers of children aged 6 months–11 years that included 4854 children from 3029 households. Ontario's vaccination rate (complete and partial coverage combined) for children aged 2–11 years was 28.3% (95% CI 26.3–30.5%) for healthy children and 36.8% (95% CI 31.4–42.5%) for those with chronic conditions. Immunization coverage of children aged 6–23 months was 24.0% (95% CI 20.6–27.7%) in Ontario, similar to Manitoba's rate of 24.1% but lower than rates in other provinces: Nova Scotia (35.5%), Quebec (41.8% for 1 year olds and 37.7% for 2 year olds during the 2005–2006 season), Saskatchewan (32.5%) and Alberta (52.2%). Universal vaccination in Ontario has achieved modest coverage in children aged 2–11 years, but has been less successful than targeted programs in vaccinating infants aged 6–23 months.     

Factors associated with influenza vaccination among elderly Spanish women

OBJECTIVES: Influenza vaccination is an effective intervention to diminish morbidity and mortality associated with this disease in aged populations and at-risk groups. The objective of this work was to describe population patterns of vaccination among Galician women and to identify factors associated with vaccination. STUDY DESIGN: Cross-sectional study. METHODS: Cases aged 65 years and over were selected from the Women's Social and Health Interview, Galicia 2000 (n = 1111). The association between influenza vaccination last season and several sociodemographic, lifestyle, health status and health services variables was assessed by logistic regression. RESULTS: In total, 56.3% of cases had received the influenza vaccine. The following variables were significantly associated with vaccination: age 70-74 years (odds ratios, OR=1.56; 95% CI: 1.09-2.26); age> or =75 years (OR=1.88; 95% CI: 1.31-2.71); residence in towns with 5000-20,000 inhabitants (OR=1.79; 95% CI: 1.16-2.77); annual income 6.010 (OR=1.39; 95% CI: 1.01-1.90); unfavourable self-perception of health (OR=1.46; 95% CI: 1.06-2.00); not being a caregiver (OR=1.67; 95% CI: 1.17-2.38); married (OR=1.45; 95% CI: 1.05-2.01); tetanus vaccination (OR=1.43; 95% CI: 1.07-1.93); and visiting a physician in the last 2 years (OR=4.83; 95% CI: 2.61-8.93). CONCLUSIONS: The level of vaccination among Galician women is low, although it is higher than that in Spanish women overall. This work has identified groups of women who are less likely to be vaccinated, and who should be targeted in future vaccination campaigns.     

Negative trends from 2008/9 to 2011/12 seasons in influenza vaccination coverages among high risk subjects and health care workers in Spain

Objectives

We aim to describe influenza vaccination coverage for the Spanish population across four consecutive campaigns (2008/2009 to 2011/2012). The data was analyzed by high risk groups and health care workers (HCWs). Also, coverage trends were analyzed to assess uptake in post-pandemic seasons.

Methods

We used data from two nation-wide representative health surveys namely the 2009/10 European Health Interview Survey for Spain (N = 22,188) and the 2011–12 Spanish National Health Survey (N = 21,007) Influenza vaccination status was self-reported. We analyzed influenza vaccine coverage by age, sex, number of chronic conditions, being a heath care worker (HCWs) and nationality. Time trends for campaigns among high risk groups were estimated by a multivariate logistic regression model.

Results

We analyzed data from 43,072 subjects aged ≥16 years. As a whole, coverage decreased by 3.31% (22.57–19.26%) between the 2008/2009 and 2011/2012 campaigns with a significant decreasing trend (OR 0.92; 95% CI: 0.90–0.94).Coverage in people under 60 years with a chronic disease decreased significantly (OR 0.92: 95% CI: 0.85–0.99) during the analyzed period from 21.02% in 2008/2009 to 17.40% in 2011/2012. Among HCWs, the highest influenza vaccination coverage was achieved in 2009/2010 (31.08%) in the latest campaign coverage has almost halved (17.88%). For the 2011/2012 season and for all age groups the variables associated with a higher probability of having received the influenza vaccine were older age and presence of associated chronic conditions. Among those aged ≥60 years, immigrants had lower uptake (OR 0.60; 95% CI: 0.32–0.99).

Conclusions

Seasonal influenza vaccine uptake rates in the recommended target groups in Spain are unacceptably low and seem to be decreasing in the post pandemic seasons. Further studies are necessary to precisely identify reasons for non-compliance and barriers to influenza vaccination. Meanwhile urgent strategies to improve seasonal vaccination uptake must be discussed and implemented.     

Associations between 5-year influenza vaccination and sociodemographic factors and healthcare access among Arkansans

Despite wide availability, only 50.2% of the United States (US) adult population and 50.3% of adult Arkansans were vaccinated for influenza during the 2020–2021 influenza season. The proportion of the population vaccinated for influenza varies by age, sex, race/ethnicity, education, rural/urban residence, and income. However, measures of healthcare access have not been adequately investigated as predictors of influenza vaccination. Using a large, statewide random sample, this study examined 5-year influenza vaccination among Arkansans by sociodemographic characteristics (age, sex, race/ethnicity, education, rural/urban residence), general vaccine hesitancy, and healthcare access (having a primary care provider, having health insurance, forgoing health care due to cost, and frequency of doctor checkups). Older age, being female, being Hispanic, having a bachelor’s degree or higher, having a primary care provider, visiting a doctor for a checkup in the past two years, and lack of hesitancy towards vaccines were significant predictors of receiving influenza vaccination.     

Beliefs and Attitudes about Influenza Immunization among Parents of Children with Chronic Medical Conditions over a Two-Year Period

Influenza vaccination is recommended for children with chronic medical conditions yet is infrequently performed. The reasons for low influenza vaccination rates in this group have not been well studied. We assessed and compared parents of children with chronic medical conditions regarding their beliefs and attitudes about influenza vaccination in 2003 and 2004. Parents of 2- to 13-year-old children with chronic medical conditions from health centers in low-income urban neighborhoods completed a 19-question survey, mailed following the 2002–2003 and 2003–2004 influenza seasons. Parent-reported influenza vaccination rate declined from 2003 (44%) to 2004 (25%). The most important factors related to influenza vaccination status were perceived doctor's recommendation (odds ratio [OR] = 6.0, 95% confidence interval [CI] = 3.7–9.7), parents' belief that the child should be vaccinated (OR = 5.4, 95%CI = 3.3–8.8), relatives' belief that the child should be vaccinated (OR = 1.7, 95%CI = 1.1–2.7), easy access to the doctor's office for a flu shot (OR = 2.4, 95%CI = 1.4–4.2), and receipt of a reminder from the doctor's office (OR = 1.7, 95%CI = 1.1–2.6). In 2004 compared with 2003, fewer parents reported getting a reminder, and fewer believed that their child's doctor recommended flu vaccine. Doctors' recommendation that children with chronic medical conditions should receive an annual influenza vaccine and vaccine availability are important factors that resulted in a higher likelihood of influenza vaccination. Our findings that fewer parents reported receiving reminders and that fewer children were vaccinated in 2004 suggest that sustained improvements in vaccination rates may require continual changes in the format and delivery method of vaccination reminders from physicians.     

Factors associated to repeated influenza vaccination in the Portuguese adults with chronic conditions

Annual influenza vaccination is recommended to people with chronic conditions. This study aimed to estimate the proportion of chronically ill adults vaccinated against influenza in consecutive seasons and to identify associated factors.We used data from the first National Health Examination Survey (INSEF), a cross-sectional study conducted in 2015 on a probabilistic sample of individuals aged 25–74 years. The population was restricted to individuals who self-reported diabetes, a respiratory, cardiovascular, liver or kidney disease. Self-reported vaccination in 4 consecutive seasons was categorized in 3 levels: unvaccinated, occasionally (vaccinated 1–3 seasons) and repeatedly vaccinated (in all 4 seasons). A multinomial logistic regression was applied to estimate odds-ratio (OR) of influenza vaccination according to sociodemographic factors, chronic condition, health care use and status.In the target population, the 2014/15 influenza vaccine coverage was 33.8% (95% CI: 29.8–38.1). The higher coverage was found in individuals reporting renal disease (66.7%) and diabetes (43.8%). The coverage decreased to 32.6%, 26.0% and 20.8% for individuals with respiratory, cardiovascular and liver diseases, respectively. The probability of being repeatedly vaccinated, compared to unvaccinated, was higher in males (OR = 2.14: 95% CI: 1.31–3.52); aged 65 and 74 (OR = 4.39; 95% CI: 1.99–9.69); whom had an appointment with a general practitioner (OR = 2.77; 95% CI: 1.00–7.66) or other physician (OR = 3.95: 95% CI: 2.53–6.16); with no smoking habits (OR = 1.58; 95% I: 1.02–2.46) and reporting diabetes (OR = 2.13; 95% CI: 1.02–4.45). Finally, having a self-reported cardiovascular condition decreased the likelihood of being occasionally (OR = 0.38; 95% CI = 0.22–0.65) vaccinated against influenza.Younger individuals, females and the ones with a self-reported cardiovascular condition were identified as more likely of non-compliance to the vaccine uptake recommendation. Future vaccination strategies should focus on the previous identified population subgroups. Also, the medical recommendation of the influenza vaccine uptake should continue and be reinforced particularly in individuals with a cardiovascular condition.     

Vaccine effectiveness in preventing influenza hospitalizations in Navarre, Spain, 2010-2011: cohort and case-control study

We evaluated the 2010-2011 seasonal influenza vaccine effectiveness in preventing hospitalizations. Using healthcare databases we defined the target population for vaccination in Navarre, Spain, consisting of 217,320 people with major chronic conditions or aged 60 years and older. All hospitalized patients with influenza-like illness (ILI) were swabbed for influenza testing. A total of 269 patients with ILI were hospitalized and 61 of them were found positive for influenza virus: 58 for A(H1N1)2009 and 3 for B virus. The incidence rates of hospitalization with laboratory-confirmed influenza were compared by vaccination status. In the Cox regression model adjusted for sex, age, children in the household, urban/rural residence, comorbidity, pandemic vaccination, pneumococcal vaccination, outpatient visits and hospitalization in the previous year, the seasonal vaccine effectiveness was 58% (95% CI: 16-79%). The nested test-negative case-control analysis gave an adjusted estimate of 59% (95% CI: 4-83%). These results suggest a moderate effect of the 2010-2011 seasonal influenza vaccine in preventing hospitalization in a risk population. The close estimates obtained in the cohort and the test-negative case-control analyses suggest good control of biases.     

Influenza coverages in Spain and vaccination-related factors in the subgroup aged 50-64 years

This study sought to describe influenza vaccination coverages for different Spanish population subgroups, stressing the analysis of vaccination-related factors in subjects aged 50-64 years and estimating the possible beneficial effect of extending universal vaccination to this age group. A total of 6,400 surveys, targeting subjects over the age of 16 years and drawn from the 1997 Spanish National Health Survey, were used for study purposes. Influenza coverage was observed to rise significantly with age, and the reason cited by most subjects for seeking vaccination was medical indication. Coverage of the 50-64 age group was 21.6% (95% CI 19.4-23.8) and the variables associated with a greater probability of being vaccination were: residence in towns or cities with <10,000 inhabitants (OR 1.45); monthly income of less than 600 (OR 1.71); and presence of associated chronic disease (OR 3.07.) It is estimated that in Spain, 524,514 (40.7%) persons aged 50-64 years with associated chronic disease receive and 764,218 persons aged 50-64 years with associated chronic disease do not receive influenza vaccine. We conclude that the extremely high number of subjects in the 50-64 age range susceptible to influenza-related complications each year constitutes good grounds for universal vaccination being extended to said age group.     

Factors associated with influenza vaccination among elderly persons in Southeastern Brazil

OBJECTIVE: Even though influenza vaccination is free and widely available in Brazil since 1999, coverage is still inadequate in several of the country's municipalities. The aim of the present study was to estimate vaccine coverage and to identify factors related to vaccination against influenza in the elderly population. METHODS: A household survey was carried out using a systematic random sample (N=365) of the urban population older than 60 years from the city of Botucatu, Southeastern Brazil. A logistic regression model using vaccination in 2002 as the dependent variable was used. The following covariables were tested: sex, age, socioeconomic variables (per capita income, number of persons per dormitory, schooling, marital status, occupation, time living in the city), history of morbidity and hospital admission, smoking, respiratory symptoms in last 15 days, and community activities (voluntary work, neighborhood and church activities). RESULTS: Vaccine coverage was 63.2% (95% CI: 58.3-68.2). We found a lower proportion of vaccination among the 60-64 years age group. Variables associated with vaccination in the final model were age (OR=1.09 per year; 95% CI: 1.06-1.13); arterial hypertension (OR=1.92; 95% CI: 1.18-3.13); and participation in community activities (OR=1.63; 95% CI: 1.01-2.65). With the exception of hypertension, vaccination among subjects with chronic diseases did not reach adequate levels, as expected for this high-risk group. Participation in social and community activities was associated with vaccination status. CONCLUSIONS: Socioeconomic conditions, habits, and age did not restrict access to vaccination campaigns. On the other hand, specific campaigns aimed at the 60-64 years age group may increase vaccination coverage.     

Parental perspectives on influenza vaccination among children with asthma

OBJECTIVES: The objectives of this study were to: (1) identify modifiable factors influencing receipt of influenza vaccination among children with asthma, and (2) to evaluate the effect of heightened media attention on vaccination rates. METHODS: During November and December 2003, we interviewed parents of children with asthma about their experiences with and beliefs about influenza vaccination. We randomly selected 500 children from a study population of 2,140 children identified with asthma in a managed care organization in Massachusetts. We obtained data on influenza vaccination status from computerized medical records and determined significant factors influencing receipt of influenza vaccination. RESULTS: Children were more likely to be vaccinated if their parent recalled a physician recommendation (odds ratio [OR] 2.6; 95% confidence interval [CI] 1.5, 4.5), believed the vaccine worked well (OR 2.0; 95% CI 1.4, 2.8), or expressed little worry about vaccine adverse effects (OR 1.3; 95% CI 1.0, 1.6), or if the child was younger (OR 1.1 per year of age; 95% CI 1.0, 1.2). During the study period, there was heightened media attention about influenza illness and the vaccine. The influenza vaccination rate for children with asthma was 43% in 2003-04 compared with 27% in 2002-03. Comparison of weekly influenza vaccination rates in 2003-04 and 2002-03 suggested that the media attention was associated with the increase in vaccination rates. CONCLUSIONS: Physician recommendations and parental education about influenza vaccine availability, effectiveness, and adverse effects are potentially important influences on influenza vaccination. Our findings suggest that media coverage of the risks of influenza was associated with a significant increase in vaccination rates.     

Maternal knowledge,attitudes and beliefs regarding gastroenteritis and rotavirus vaccine before implementing vaccination program: Which key messages in light of a new immunization program?

In July 2010, the National Advisory Committee on Immunization (NACI) recommended the systematic administration of rotavirus vaccines for all infants in Canada. According to the Erickson and De Wals framework, multiple factors need to be evaluated before implementing such a decision, including the study of the acceptability of this vaccine by the general population. A cross-sectional survey was conducted from February 10 to February 18, 2011, at the Sherbrooke University Hospital Center in the province of Quebec. A questionnaire, based upon the Health Belief Model (HBM) and theoretical planned action, was self-administered to pregnant or early post-partum women. The variables collected included socio-demographic data, past experience with gastroenteritis, cues to vaccination and HBM dimensions. The associations between questionnaire variables and vaccination intention were assessed using univariate and multivariate analyses. Of the 343 respondents, only 29% had already heard about rotavirus vaccination and among these, the intention of vaccination was 74%. In multivariate analysis, having a perception of infant vulnerability to gastroenteritis (OR=2.3, 95% CI 1.3-4.0) and having no other child at home (OR=2.3, 95% CI 1.3-4.2) were factors positively associated with a higher intention of vaccination, contrary to having already heard about the rotavirus vaccine in the media (OR=0.5, 95% CI 0.2-0.9). The three cues independently associated with intention of vaccination were the reimbursement of the vaccine (OR=3.0, 95% CI 1.6-5.7), its recommendation by a doctor (OR=21.2, 95% CI 5.8-75.9) and its protection against the most severe forms of gastroenteritis (OR=4.4, 95% CI 1.4-13.6). To improve the success of this new vaccination program, several key messages should be integrated in the information made available to the general population: (1) rotavirus gastroenteritis is a mandatory infection for every child <5 years; (2) the vaccine is reimbursed and included in the provincial vaccination program; and (3) the vaccine protects against the worst forms of gastroenteritis. Finally, support should be offered to physicians as they play a key role in public acceptance of new vaccines.     

Parental perspectives on influenza immunization of children aged 6 to 23 months

BACKGROUND: For the first time, in 2002, the Advisory Committee on Immunization Practices encouraged the vaccination of healthy children 6 to 23 months against influenza, whenever feasible. Participating inner-city health centers designed interventions to introduce influenza vaccination among this group of children. The study was designed to assess parents' attitudes toward the vaccine. METHODS: Following the 2002-2003 influenza vaccination season, parents were surveyed to identify barriers to and facilitators of influenza vaccination. A low-literacy level, 19-question survey was mailed to parents in three waves, 4 weeks apart. A subset of children had medical record data available to confirm vaccination status. Measures of validity were calculated. This paper focused only on the children whose parent-reported vaccination status was concordant with that reported in medical records (n = 193). Associations of responses to vaccination status were calculated in 2004, using chi-square and logistic regression procedures. RESULTS: Sensitivity was 85.7% and specificity was 66% (kappa = 0.50), assessing the ability of parents to recall receipt or nonreceipt of influenza vaccine. The most important factors related to immunization of healthy infants were perceived doctor's recommendation (odds ratio [OR] = 5.5; 95% confidence interval [CI] = 2.4-12.3; p < 0.001) and belief that getting an influenza shot is a smart idea (OR = 3.5; 95% CI = 1.3-8.9; p < 0.01) for those with medical record-confirmed vaccination status. CONCLUSIONS: A clear message that the doctor recommends influenza vaccination for a child is an important factor for ensuring vaccination, and may foster the idea that vaccination is "smart."     

Influence of family on acceptance of influenza vaccination among Japanese patients

BACKGROUND: Influenza is a major cause of morbidity and mortality in Japan and worldwide, especially for people of >65 years old and those with high-risk medical conditions. Although the influenza vaccine is effective in reducing the morbidity and mortality, the vaccine coverage rate has not increased adequately in Japan, compared with western countries. OBJECTIVE: Our aim was to assess whether medical and personal characteristics are associated with receiving influenza vaccination in Japanese patients. METHODS: Out-patients of a city hospital were recruited for a case-control study between November 1998 and February 1999. Cases were 98 out-patients aged 18 years or older who received influenza vaccination. Controls were 112 non-vaccinated out-patients matched with cases for primary physician and date of clinic visit. The candidates were interviewed by telephone and asked to respond to a 26-item questionnaire. The data were analysed using multiple logistic regression models. RESULTS: The factors associated with the acceptance of influenza vaccination were: (i) recommendation by a family member and/or a close friend [odds ratio (OR) 17.74; 95% confidence interval (CI) 1.95-161.77]; (ii) belief in influenza vaccine efficacy (OR 10.55; 95% CI 3.42-32.49); (iii) having a family member and/or friends who had been vaccinated before (OR 6.44; 95% CI 2.37-17.50); (iv) physician's recommendation (OR 4.03; 95% CI 1.42-11.37); and (v) knowledge about the influenza vaccine (OR 3.06; 95% CI 1.02-9.20). Fear of adverse reactions (OR 0.21; 95% CI 0.07-0.66) was the sole factor associated with non-acceptance of influenza vaccine. CONCLUSION: Patients in Japan are likely to be greatly influenced by their family members or close friends in their decision of whether to accept influenza vaccination, unlike US patients who make health care decisions on their own. When implementing an influenza vaccination programme, this effect of cultural background observed in Japan should be taken into account in other countries.     

Impact of severe acute respiratory syndrome and the perceived avian influenza epidemic on the increased rate of influenza vaccination among nurses in Hong Kong.

OBJECTIVE: To determine the rate of influenza vaccination and the factors associated with the vaccination's acceptance among nurses in Hong Kong. DESIGN: Cross-sectional survey. PARTICIPANTS: Nurses practicing between 2003 and 2007. METHODS: A questionnaire was sent to all nurses registered with any of the 3 nursing associations that participated in this study. RESULTS: A total of 941 completed questionnaires were available for analysis, though not all nurses responded to every question (response rate, 33.5%-36.3%). Vaccination rates in 2006 and 2007 were 57.2% and 46.2%, respectively. Nurses who were vaccinated in 2006 were more likely to get vaccinated in 2007 (P<.01); 56% of the nurses perceived influenza vaccine as being effective against influenza. The perceived effectiveness of influenza vaccine was a consistent predictor of rates of vaccination in 2006 (odds ratio [OR], 8.47 [95% confidence interval {CI}, 6.13-11.70]; P<.01) and 2007 (OR, 6.05 [95% CI, 3.79-9.67]; P<.01). Concern about contracting avian influenza was a predictor of the vaccination rate in 2006 but not in 2007 (OR, 1.47 [95% CI, 1.03-2.09]; P<.05), as was the perceived lack of control over avian influenza infection (OR, 1.52 [95% CI, 1.06-2.18]; P<.05). CONCLUSIONS: The overall influenza vaccination rate for nurses in Hong Kong was about 50%. It was affected by the perceived threat of an impending outbreak. The attitudes of nurses toward the effectiveness of and rationale for vaccination were a major barrier to increasing the rate of vaccination.     

Prevalence and determinants of influenza vaccination in Australians aged 40 years and over--a national survey

OBJECTIVES: To determine influenza vaccination coverage in 2001 in Australian adults aged > or = 40 years, assess awareness of and attitudes to influenza vaccine, factors associated with vaccination, and estimate uptake of free vaccine provided to those aged > or = 65 years. METHODS: National computer-assisted telephone interview (CATI) survey in October/November 2001. RESULTS: Interviews were completed with 5,266 people aged > or = 65 and 2,415 aged 40-64 years. Thirty per cent of selected households participated. Overall, 67% of respondents believed that the vaccine was somewhat to very effective in preventing influenza. Seventy-eight per cent of those aged > or = 65 years reported influenza vaccination; 89% had received it free. Independent predictors of vaccination were: belief that influenza vaccine is effective in preventing influenza (OR=13.5, 95% CI 10.6-17.2); and the presence of chronic disease (OR=1.6, 95% CI 1.3-2.0). Overall, 24% of those aged 40-64 years were vaccinated; only 34% of those who met any of the criteria for vaccination (medical risk factor, at-risk occupation, or being Aboriginal or Torres Strait Islander) reported vaccination. CONCLUSIONS: Influenza vaccine coverage was high in those aged > or = 65 years, but coverage of those at-risk aged 40-64 years remained suboptimal. Immunisation against influenza was influenced more by beliefs about the vaccine's effectiveness and existing medical risk factors, rather than socio-demographic factors such as gender and income.     

Effectiveness of influenza vaccine in reducing hospital admissions during the 1989-90 epidemic.

The effectiveness of influenza vaccine in reducing hospital admissions for pneumonia, influenza, bronchitis, or emphysema was assessed by a case-control study of people aged 16 years and older who were admitted to 10 Leicestershire hospitals between 1 December 1989 and 31 January 1990. Hospital and general practitioners'' records for 156 admissions (the cases) and 289 controls matched for age and sex were reviewed. Information was collected on demography, the usual place of residence (institutional or non-institutional), the existence of chronic illness, and vaccination during the 5 years before admission. The odds ratio for hospital admission among vaccinees was 0.67 (95% CI 0.39-1.12) giving an estimate of vaccine effectiveness in this setting of 33% (95% CI 0-61). However, multivariate logistic regression, adjusting for the effects of institutional care and chronic illness, revealed that influenza vaccination reduced hospital admissions by 63% (95% CI 17-84%). There was a strong trend towards improved vaccine effectiveness when used in institutional settings. Influenza vaccine is effective in reducing hospital admissions for influenza, pneumonia, bronchitis and emphysema, and effectiveness is comparable to that observed for influenza and pneumonia admissions in North America.     

广州市家长对儿童流感疫苗接种意愿及影响因素

目的 了解广州市家长对儿童流感疫苗接种的意愿及影响因素,为有效提高儿童流感疫苗的覆盖率提供科学依据。方法 采用分层整群抽样方法,按照经济水平在广州市中心和周边行政区各抽取1所中学和1所小学,对5 133名中小学生家长进行问卷调查,问卷内容主要包括儿童及其家长的基本情况,家长对儿童接种流感疫苗知识的知晓情况等。结果 14.57%(748/5 133)的家长不愿意为孩子接种流感疫苗。多因素Logistic回归显示,与年龄≤35岁的家长相比,41～45和≥46岁的家长不愿意为儿童接种疫苗的可能性分别增高49%(调整OR=1.49,95% CI=1.11～2.00)和86%(调整OR=1.86,95% CI=1.33～2.60);与家庭年收入<10万元的家长相比,年收入≥20万元的家长不愿意的可能性增高52%(调整OR=1.52,95% CI=1.12～2.06);与从家步行到接种点时间≤10 min的家长相比,步行时间≥30 min的家长不愿意的可能性增高52%(调整OR=1.52,95% CI=1.16～1.99);与认为疫苗安全的家长相比,认为疫苗不太安全及不清楚安全性的家长不愿意...     

The impact of socioeconomic level on influenza vaccination among Italian adults and elderly: a cross-sectional study

OBJECTIVE: To assess the predictive factors of influenza vaccination among Italian adults, focusing on socioeconomic differences. METHODS: A cross-sectional study was carried out using interview and self-reported data on 102,095 subjects aged 25-89 years from the national survey "health conditions and health care services use" conducted in Italy in 1999-2000. Analyses were stratified by age and multiple logistic regression models were used to estimate odds ratios (OR) of influenza vaccination. RESULTS: Approximately one in six individuals (17.3%) received an influenza vaccine in the previous 12 months. Older age, poor health status and former smoking were all positively associated with influenza vaccination (P-value<0.05). Lower educated individuals and subjects with manual occupations were less likely to be vaccinated than those better off, with an OR ranging from 0.65 (95% CI 0.55, 0.77) to 0.82 (95% CI 0.71, 0.93). Among individuals aged 65-89 there was no apparent influence of both variables on the likelihood of receiving the influenza vaccine. CONCLUSIONS: Socioeconomic inequalities in influenza vaccine uptake were present among the adults but not among the elderly. Because in Italy the National Health Service provides influenza vaccination to the elderly free of charge, it is possible that this policy attenuated the socioeconomic differential.