Prolonged postpartum length of hospital stay among women with disabilities

BackgroundPrior studies have found higher proportions of cesarean deliveries and longer postpartum hospital stays among women with disabilities compared to women without disabilities. However, no research has assessed how length of stay may differ for women with different types of disability while also considering mode of delivery.ObjectiveTo examine the association of disability status and disability type with length of stay, taking into account disability-related differences in mode of delivery.MethodsWe conducted a retrospective cohort study using linked maternal and infant hospital discharge and vital records data for all births in California between 2000 and 2012 (n = 6,745,201). We used multivariable regression analyses to assess association of disability status and type with prolonged length of stay (>2 days for vaginal delivery or >4 days for cesarean) while controlling for covariates.ResultsWomen with disabilities had significantly elevated adjusted odds of prolonged length of stay compared to women without disabilities (aOR = 1.40, 95% CI = 1.32–1.49). Adjusted odds were highest for women with vision disabilities (aOR = 1.67, 95% CI = 1.46–1.90), followed by women with IDD (aOR = 1.53, 95% CI = 1.30–1.80), and women with physical disabilities (aOR = 1.41, 95% CI = 1.32–1.50). Women with hearing disability had the lowest adjusted odds of prolonged length of stay (aOR = 1.17, 95% CI = 1.03–1.33).ConclusionsProlonged length of stay did not appear to be due solely to the higher proportion of cesarean deliveries in this population. Further research is needed to better understand the reasons for prolonged length of stay among women with disabilities and develop strategies to assist women with disabilities in preparing for and recovering from childbirth.     

Post-COVID conditions and healthcare utilization among adults with and without disabilities—2021 Porter Novelli FallStyles survey

BackgroundAdults with disabilities are at increased risk for SARS-CoV-2 infection and severe disease; whether adults with disabilities are at an increased risk for ongoing symptoms after acute SARS-CoV-2 infection is unknown.ObjectivesTo estimate the frequency and duration of long-term symptoms (>4 weeks) and health care utilization among adults with and without disabilities who self-report positive or negative SARS-CoV-2 test results.MethodsData from a nationwide survey of 4510 U.S. adults administered from September 24, 2021–October 7, 2021, were analyzed for 3251 (79%) participants who self-reported disability status, symptom(s), and SARS-CoV-2 test results (a positive test or only negative tests). Multivariable models were used to estimate the odds of having ≥1 COVID-19–like symptom(s) lasting >4 weeks by test result and disability status, weighted and adjusted for socio-demographics.ResultsRespondents who tested positive for SARS-CoV-2 had higher odds of reporting ≥1 long-term symptom (with disability: aOR = 4.50 [95% CI: 2.37, 8.54] and without disability: aOR = 9.88 [95% CI: 7.13, 13.71]) compared to respondents testing negative. Among respondents who tested positive, those with disabilities were not significantly more likely to experience long-term symptoms compared to respondents without disabilities (aOR = 1.65 [95% CI: 0.78, 3.50]). Health care utilization for reported symptoms was higher among respondents with disabilities who tested positive (40%) than among respondents without disabilities who tested positive (18%).ConclusionsOngoing symptoms among adults with and without disabilities who also test positive for SARS-CoV-2 are common; however, the frequency of health care utilization for ongoing symptoms is two-fold among adults with disabilities.     

COVID-19 vaccine intentions in the United States,a social-ecological framework

BackgroundCOVID-19 vaccine hesitancy is a major obstacle for pandemic mitigation. As vaccine hesitancy occurs along multiple dimensions, we used a social-ecological framework to guide the examination of COVID-19 vaccine intentions.MethodsUsing an online survey in the US conducted in July 2020, we examined intentions to obtain a COVID-19 vaccine, once available. 592 respondents provided data, including measures of demographics, vaccine history, social norms, perceived risk, and trust in sources of COVID-19 information. Bivariate and multivariate multinomial models were used to compare respondents who intended to be vaccinated against COVID-19 to respondents who did not intend or were ambivalent about COVID-19 vaccination.ResultsOnly 59.1% of the sample reported that they intended to obtain a COVID-19 vaccine. In the multivariate multinomial model, those respondents who did not intend to be vaccinated, as compared to those who did, had significantly lower levels of trust in the CDC as a source of COVID-19 information (aOR = 0.29, CI = 0.17–0.50), reported lower social norms of COVID-19 preventive behaviors (aOR = 0.67, CI 0.51–0.88), scored higher on COVID-19 Skepticism (aOR = 1.44, CI = 1.28–1.61), identified as more politically conservative (aOR = 1.23, CI = 1.05–1.45), were less likely to have obtained a flu vaccine in the prior year (aOR = 0.21, CI = 0.11–0.39), were less likely to be female (aOR = 0.51, CI = 0.29–0.87), and were much more likely to be Black compared to White (aOR = 10.70, CI = 4.09–28.1). A highly similar pattern was observed among those who were ambivalent about receiving a COVID-19 vaccine compared to those who intended to receive one.ConclusionThe results of this study suggest several avenues for COVID-19 vaccine promotion campaigns, including social network diffusion strategies and cross-partisan messaging, to promote vaccine trust. The racial and gender differences in vaccine intentions also suggest the need to tailor campaigns based on gender and race.     

Awareness of and attitude towards human papillomavirus infection and vaccination for cervical cancer prevention among adult males and females in Korea: A nationwide interview survey

We assessed adult male and female awareness and acceptance of human papillomavirus (HPV) infection and vaccination for cervical cancer prevention, as well as factors associated with willingness to be administered the HPV vaccine. A nationwide population-based interview survey was conducted in Korea. One thousand male and female adults were included with random sampling. Despite the fact that awareness of HPV infection (13.3%) and the preventive effect of HPV vaccination (8.6%) were low, willingness to vaccinate against HPV (55.0%) was relatively high, especially with regard to participants’ daughters (77.0%). Those who were informed about HPV infection (adjusted odds ratio, aOR = 2.5 and 95% confidence interval, CI = 1.1–5.3 in males; aOR = 2.5 and 95% CI = 1.5–4.2 in females) or vaccination (aOR = 2.9 and 95% CI = 1.1–7.6 in males; aOR = 2.9 and 95% CI = 1.6–5.4 in females), or who perceived a susceptibility to HPV infection (aOR = 3.6 and 95% CI = 1.9–6.8 in males; aOR = 2.8 and 95% CI = 1.6–5.0 in females) were more accepting of vaccination than those who did not.     

Associations between neighborhood characteristics and sexual risk behaviors among HIV-infected and HIV-uninfected women in the southern United States

PurposeNeighborhood characteristics shape sexual risk in HIV-uninfected adults in the United States (US). We assess relationships between census tract characteristics and sexual risk behaviors in a predominantly HIV-infected cohort of women living in the Southern US.MethodsThis cross-sectional multilevel analysis included data from 737 HIV-infected and HIV-uninfected women enrolled in the Women's Interagency HIV Study. Administrative data captured characteristics of census tracts where women lived; participant-level data were gathered via survey. We used principal components analysis to condense tract-level variables into components: social disorder (e.g., violent crime rate), and social disadvantage (e.g., alcohol outlet density). We used hierarchical generalized linear models to assess relationships between tract-level characteristics and condomless vaginal intercourse, anal intercourse, and condomless anal intercourse.ResultsGreater social disorder was associated with less anal intercourse (OR = 0.63, 95% CI = 0.43–0.94) and condomless anal intercourse (OR = 0.49, 95% CI = 0.30–0.80), regardless of HIV status. There were no statistically significant additive or multiplicative interactions between tract characteristics and HIV status.ConclusionsNeighborhood characteristics are associated with sexual risk behaviors among women living in the Southern US, these relationships do not vary by HIV status. Future studies should establish temporality and explore the causal pathways through which neighborhoods influence sexual risk.     

Influenza vaccination in the time of COVID-19: A national U.S. survey of adults

IntroductionDecisions about influenza vaccination for fall-winter 2020 were made against the backdrop of the COVID-19 pandemic. During May 2020, the authors examined intended vaccination in the next 12 months in relationship to demographic variables, healthcare attitudes, and personal COVID-19 experiences for two samples of adults--those who did not receive influenza vaccine during the prior 12 months, and those who did.MethodsIn May 2020, a cross-sectional online survey was conducted with a national US sample. Participants reported prior influenza vaccination (yes/no during prior 12 months) and anticipated vaccination (yes/no during next 12 months). Covariates included demographic characteristics (e.g., gender, race-ethnicity, political ideology), general beliefs (e.g., benefits of vaccines, altruistic attitudes), and COVID-19 health beliefs and experiences (COVID-19 worry and severity, perception of COVID-19 as a community threat, knowing someone with COVID-19). For each group, hierarchical multivariable logistic regression was conducted with intent to vaccinate as the outcome.ResultsAmong participants (n = 3502), 47% did not receive influenza vaccine in the prior 12 months and 53% had; 25.5% of non-vaccinators and 91.9% of vaccinators intended future vaccination. For non-vaccinators, odds of intending vaccination was associated with race/ethnicity (Hispanics were more likely to intend than white-NH; AOR = 1.74; 95% CI = 1.23–2.4), greater perceived benefits of vaccination (AOR = 2.19; 95% CI = 1.88–2.54), and perception of COVID-19 as a community threat (AOR = 1.91; 95% CI = 1.49–2.45). For vaccinators, odds of intending vaccination was associated with age (AOR = 1.04; 95% CI = 1.03–1.05), race/ethnicity (Black-NH and Other-NH were less likely to intend than white-NH, AOR = 0.60; 95% CI = 0.36–0.999; and AOR = 0.45; 95% CI = 0.24–0.84, respectively), greater perceived benefits of vaccination (AOR = 1.88; 95% CI = 1.45–2.45) and greater perception of collective benefits of vaccines (AOR = 1.48; 95% CI = 1.15–1.90).ConclusionsThe COVID-19 pandemic may have served as a cue to action for influenza vaccination intention among some prior non-vaccinators whereas intention among prior vaccinators is more related to positive attitudes toward vaccination.     

Complementary and alternative medicine (CAM) use among children with current asthma

Objective

To estimate the prevalence of complementary and alternative medicine (CAM) use among children with current asthma.

Design

We analyzed data from the Asthma Call Back Survey (ACBS) 2006-2008. ACBS is a follow-up to the state-based Behavioral Risk Factor Surveillance System (BRFSS) survey that collects information on asthma and related factors including CAM use for asthma. The survey is administered to the parents who report in a subset of BRFSS states that their children have asthma. 5435 children had current asthma and were included in this analysis.

Results

Overall, 26.7% (95% confidence interval [CI] = 24.5-29.0) of children with current asthma reported CAM use in the previous 12 months. Among them, the three most commonly used therapies were breathing techniques (58.5%; 95% CI = 53.6-63.5), vitamins (27.3%; 95% CI = 23.0-31.5), and herbal products (12.8%; 95% CI = 9.2-16.4). Multivariate analysis of CAM use revealed higher adjusted odds ratios (aOR) among children who experienced cost barriers to conventional health care compared with children with no cost barrier (aOR = 1.8; 95% CI = 1.2-2.8). Children with poorly controlled asthma were most likely to use all types of CAM when compared to their counterpart with well-controlled asthma: aOR = 2.3 (95% CI = 1.6-3.3) for any CAM; aOR = 1.7 (95% CI = 1.2-2.6) for self-care based CAM; and aOR = 4.4 (95% CI = 1.6-9.3) for practitioner-based CAM.

Conclusions

Children with poorly controlled asthma are more likely to use CAM; this likelihood persists after controlling for other factors (including parent's education, barriers to conventional health care, and controller medication use). CAM is also more commonly used by children who experienced cost barriers to conventional asthma care. CAM use could be a marker to identify patients who need patient/family education and support thus facilitate improved asthma control.     

A paradox of need: Gaps in access to dental care among people who use drugs in Canada's publicly funded healthcare system

In Canada, publicly funded healthcare provides no-cost access to a large but not comprehensive suite of services. Dental care is largely funded by private insurance or patients, creating employment- and income-dependent gaps in care access. Difficulties accessing dental care may be amplified among vulnerable populations, including people who use drugs (PWUD), who may experience greater dental need due to side effects of substance use and health comorbidities, as well as barriers to care. Using data collected between 2014 and 2018 from two ongoing prospective cohort studies of PWUD in Vancouver, Canada, the aim of this study was to explore factors associated with dental care access. Among 1,638 participants, 246 participants (15%) reported never or only occasionally accessing adequate dental care. In generalised linear mixed-effects models, results showed significant negative associations between accessing dental care and using opioids (Adjusted Odds Ratios [AOR] = 0.73, 95% Confidence Interval [CI] = 0.58–0.91), methamphetamine (AOR = 0.75, 95% CI = 0.59–0.95) and cannabis (AOR = 0.78, 95% CI = 0.63–0.97), as well experiencing homelessness (AOR = 0.54, 95% CI = 0.42–0.70) and street-based income generation (AOR = 0.75, 95% CI = 0.59–0.94). There were significant positive associations between adequate dental care and accessing opioid agonist treatment (OAT) for opioid dependence (AOR = 1.36, 95% CI = 1.07–1.72) and receiving income assistance (AOR = 1.70, 95% CI = 1.05–2.77). These results highlight specific substance use patterns and structural exposures that may hinder dental care access, as well as how direct and indirect benefits of income assistance and OAT may improve access. These findings provide support for recent calls to expand healthcare coverage and address dental care inequities.     

Dual Use of Condoms With Other Contraceptive Methods Among Adolescents and Young Women in the United States

PurposeTo estimate the prevalence of and factors associated with dual method use (i.e., condom with hormonal contraception or an intrauterine device) among adolescents and young women in the United States.MethodsWe used 2006–2010 National Survey of Family Growth data from 2,093 unmarried females aged 15–24 years and at risk for unintended pregnancy. Using multivariable logistic regression, we estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to assess the associations between dual method use at last sex and sociodemographic, behavioral, reproductive history, and sexual behavior factors.ResultsAt last sex, 20.7% of adolescents and young women used dual methods, 34.4% used condoms alone, 29.1% used hormonal contraception or an intrauterine device alone, and 15.8% used another method or no method. Factors associated with decreased odds of dual method use versus dual method nonuse included having a previous pregnancy (aOR = .44, 95% CI .27–.69), not having health insurance coverage over the past 12 months (aOR = .41, 95% CI .19–.91), and having sex prior to age 16 (aOR = .49, 95% CI .30–.78).ConclusionsThe prevalence of dual method use is low among adolescents and young women. Adolescents and young women who may have a higher risk of pregnancy and sexually transmitted infections (e.g., those with a previous pregnancy) were less likely to use dual methods at last sex. Interventions are needed to increase the correct and consistent use of dual methods among adolescents and young women who may be at greater risk for unintended pregnancy and sexually transmitted infections.     

Influenza vaccine acceptance and hesitancy among adults hospitalized with severe acute respiratory illnesses,United States 2019–2020

IntroductionUnderstanding patient factors associated with not being vaccinated is essential for successful implementation of influenza vaccination programs.MethodsWe enrolled adults hospitalized with severe acute respiratory illness at 10 United States (US) hospitals during the 2019–2020 influenza season. We interviewed patients to collect data about influenza vaccination, sociodemographic characteristics, and vaccine perceptions.ResultsAmong 679 participants, 264 (38.9%) reported not receiving influenza vaccination. Among those not vaccinated, 135 (51.1%) reported choosing not to receive a vaccine because of perceived ineffectiveness (36.7%) or risk (14.4%) of influenza vaccination. Sociodemographic factors associated with not being vaccinated included no medical insurance (aOR = 6.42; 95% CI: 2.52–16.38) and being non-White or Hispanic (aOR = 1.54, 95% CI: 1.02–2.32).ConclusionsOptimizing uptake of influenza vaccination in the US may be improved by educational programs regarding vaccine safety and effectiveness and enhancing vaccine access, particularly among non-White and Hispanic Americans and those without medical insurance.     

Acceptance of pneumococcal vaccination in older adults: A general population-based survey

BackgroundPneumococcal infection is a leading cause of disability and death globally. The Hong Kong Government has launched two programmes for pneumococcal vaccination - The Vaccination Subsidy Scheme (VSS) and the Government Vaccination Programme (GVP). This study aimed to examine the enabling factors, obstacles and perception of pneumococcal vaccination, and their association with its uptake in a general Chinese population.MethodsWe performed a population-based, telephone survey in the general public aged 65 or above via simple random sampling. A validated survey based on the Health Belief Model (HBM) was used. Their socio-demographic information; history of previous participation in the GVP or VSS; and self-perceived health status were captured. Binary logistic regression models were constructed to examine the factors independently associated with vaccination.ResultsA total of 1,000 respondents were enrolled in the study, with 402 (40.2%) respondents having intention to join the GVP/VSS in 12 months. Respondents with long-term medical consultant and medication (adjusted odds ratios [aOR] = 1.541, 95% confidence interval (CI): 1.008–2.356, p = 0.046); high levels of perceived susceptibility of infections (aOR = 3.624, 95 %CI: 2.318–5.665, p < 0.001); high levels of perceived benefits of vaccine (aOR = 1.699, 95 %CI: 1.153–2.504, p < 0.001); recommendations from government (aOR = 8.025, 95 %CI: 4.771–13.497, p < 0.001) or physicians (aOR = 7.399, 95 %CI: 3.472–15.764, p = 0.008); and high levels of self-efficacy (aOR = 3.045, 95 %CI: 1.458–6.362, p = 0.003) were more likely to have intention to participate in the vaccination programme.ConclusionsThe acceptance rate of pneumococcal vaccination programme remained suboptimal in the population. The government and physicians should be involved in the promotion of pneumococcal vaccination and GVP/VSS by increasing perceived benefits and self-efficacy, and reducing barriers towards vaccination among the target population. More studies are required to confirm our findings in other settings.     

Patterns of use of a maternal mental health service in a low‐resource antenatal setting in South Africa

The prevalence of perinatal common mental disorders in South Africa is high, yet little is known about mental health service use among pregnant and postnatal women. This paper reports on pregnant women's patterns of use of a counselling service at a primary level obstetric facility in Cape Town, South Africa, between January 2010 and December 2011. It investigates whether these are associated with demographics, severity and risk of depressive symptoms. Participants (N = 3311) were screened for psychological distress using the Edinburgh Postnatal Depression Scale (EPDS) at their first antenatal visit. Risk factors for antenatal depression were assessed using a 11‐item checklist. Questionnaires were self‐administered, but some participants required assistance. Participants scoring positive (≥13) on the EPDS were offered referral to on‐site, individual counselling, and assigned to one of three groups according to their service use: declined referral; accepted referral and attended counselling sessions; and accepted referral but defaulted all appointments. Consent to participate was received by 3437 (96.4%) participants who were offered screening, of which 627 (18.9%) screened positive on the EPDS. Of these, 363 (57.9%) attended counselling. Both bivariate analyses and regression analyses revealed that age and risk factor assessment score were associated with screening positive on the EPDS. Odds ratios (OR) for accepting counselling were OR = 0.94 (95% CI = 0.92–0.97) for gestation, OR = 1.27 (95% CI = 1.15–1.39) for EPDS score and OR = 0.48 (95% CI = 0.23–0.99) for reporting three or more risk factors. OR for attending counselling were, for age: OR = 1.06 (95% CI = 1.00–1.12) and for reporting three or more risk factors: OR = 0.60 (95% CI = 0.37–0.97). While the majority of women with psychological distress accessed the counselling service provided, strategies to increase service use of younger pregnant women specifically are required.     

Coincident alcohol dependence and depression increases risk of suicidal ideation among Army National Guard soldiers

PurposeSuicide rates among military service members have risen dramatically, while drivers remain poorly understood. We examined the relationship between coincident alcohol dependence and depression in shaping risk of suicidal ideation among National Guard forces.MethodsWe performed a longitudinal analysis using a randomly selected, population-based sample of Ohio Army National Guard soldiers. Telephone-based surveys of 1582 soldiers who participated in both wave 1 (2008–2009) and wave 2 (2009–2010) were analyzed.ResultsOdds ratios (ORs) for suicidal ideation among those with versus without alcohol dependence were similar among nondepressed (OR = 3.85 [95% confidence intervals (CIs) = 1.18–12.52]) and depressed individuals (OR = 3.13 [95% CI = 0.88–11.14]); multiplicative interaction was not observed. In contrast, the risk differences (RDs) among those with versus without alcohol dependence diverged for those without depression (RD = 0.04 [95% CI = 0.02–0.07]) compared with those with depression (RD = 0.11 [95% CI = 0.06–0.18]); strong evidence of additive interaction was observed.ConclusionsWe found that alcohol dependence and depression interact statistically in shaping risk for incident suicidal ideation among Army National Guard service members. A high-risk prevention approach including population-based screening for suicidality among patients with alcohol dependence, depression, and particularly those with both conditions is warranted in military populations.     

Trusted information sources in the early months of the COVID-19 pandemic predict vaccination uptake over one year later

IntroductionCOVID-19 vaccine uptake has been a major barrier to stopping the pandemic in many countries with vaccine access. This longitudinal study examined the capability to predict vaccine uptake from data collected early in the pandemic before vaccines were available.Methods493 US respondents completed online surveys both at baseline (March 2020) and wave 6 (June 2021), while 390 respondents completed baseline and wave 7 (November 2021) surveys. The baseline survey assessed trust in sources of COVID-19 information, social norms, perceived risk of COVID-19, skepticism about the pandemic, prevention behaviors, and conspiracy beliefs. Multivariable logistic models examined factors associated with the receipt of at least one COVID-19 vaccine dose at the two follow-ups.ResultsIn the adjusted model of vaccination uptake at wave 6, older age (aOR = 1.02, 95 %CI = 1.00–1.04) and greater income (aOR = 1.69, 95 %CI = 1.04–2.73) was associated with positive vaccination status. High trust in state health departments and mainstream news outlets at baseline were positively associated with vaccination at wave 6, while high trust in the Whitehouse (aOR = 0.42, 95 %CI = 0.24–0.74) and belief that China purposely spread the virus (aOR = 0.66, 95 %CI = 0.46–0.96) at baseline reduced the odds of vaccination. In the adjusted model of vaccination uptake at wave 7, increased age was associated with positive vaccination status, and Black race (compared to white) was associated with negative vaccination status. High trust in the CDC and mainstream news outlets at baseline were both associated with being vaccinated at wave 7, while high trust in the Whitehouse (aOR = 0.24, 95 %CI = 0.11–0.51) and belief that the virus was spread purposefully by China (aOR = 0.60, 95 %CI = 0.39–0.93) were negatively associated with vaccination.ConclusionsThese findings indicated that vaccine uptake could be predicted over a year earlier. Trust in specific sources of COVID-19 information were strong predictors, suggesting that future pandemic preparedness plans should include forums for news media, public health officials, and diverse political leaders to meet and develop coherent plans to communicate to the public early in a pandemic so that antivaccine attitudes do not flourish and become reinforced.     

Herpes zoster vaccine coverage in Australia before and after introduction of a national vaccination program

BackgroundIn Australia, a herpes zoster (HZ) vaccination program targeting adults aged 70 years old with catch-up for those 71-79 years began in November 2016 but there is limited information on vaccine uptake and coverage achieved since commencement.MethodsWe used a national de-identified electronic primary care dataset, MedicineInsight, and extracted records from patients turning 50–90 years old during 2016–2018. Among patients considered regular attenders, with at least one visit per year in the two years prior, we estimated the crude and adjusted average monthly HZ vaccine uptake in the target population (70–79 years old) for each year since program implementation as well as cumulative vaccine coverage until December 2018. Multivariate logistic regression was used to analyse characteristics associated with higher coverage.ResultsAmong 52,229, 55,034, and 57,316 regular attenders turning 70–79 years old in 2016, 2017 and 2018 respectively, the average monthly vaccine uptake rate was 5.5%, 3.3%, and 1.6% respectively. Up to 31st December 2018, the estimated cumulative vaccine coverage in regularly attending adults was 46.9% (25,791/55,034). It was substantially lower at 41.6% (27,040/65,010) using an alternate definition of a regular attender. Vaccine coverage differed by sex (women: 48.5% versus men: 45.1%, adjusted OR = 1.1, 95% CI: 1.1–1.2); by jurisdiction (compared to New South Wales: 43.7%, South Australia: 55.6%, aOR = 1.6, 95% CI (1.5–1.8); Northern Territory: 27.6%, aOR = 0.6, (0.5–0.7)); by remoteness status (compared to major cities: 47.6%, remote/very remote areas: 38.2%, aOR = 0.7, (0.6–0.8)); and by socioeconomic disadvantage (compared to most disadvantaged: 41.8%, most advantaged: 48.6%, aOR = 1.6 (1.2–2.1)).ConclusionsOur estimates of HZ vaccine coverage are substantially higher than the only other reports based on the Australian Immunisation Register however they still suggest that uptake is suboptimal. The use of electronic medical records can complement other data for estimating vaccine coverage in Australian adults.