Factors associated to repeated influenza vaccination in the Portuguese adults with chronic conditions |
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| Institution: | 1. Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal;2. Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal;3. CICS.NOVA-Interdisciplinary Centre of Social Sciences – Faculty of Social Sciences and Humanities FCSH/NOVA, Portugal;1. National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands;2. European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden;1. Department of Pediatrics, University of Colorado Anschutz Medical Campus, B065, 13123 E 16th Ave, Aurora, CO 80045, USA;2. Center for Global Health, Colorado School of Public Health, A090, 13199 E Montview Blvd, Suite 310, Aurora, CO 80045, USA;3. Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Campus, F443, 13199 E Montview Blvd, Suite 300, Aurora, CO 80045, USA;4. Department of Community and Behavioral Health, Colorado School of Public Health, B119, 13001 E 17th Place, Aurora, CO 80045, USA;5. Center for Health Studies, Universidad del Valle de Guatemala, 18 Av. 11-95, Zona 15, Vista Hermosa III, Guatemala City, Guatemala;6. Center for Human Development at the Southwest Trifinio, Finca Mojarras, aldea Los Encuentros, Caballo Blanco, Retalhuleu, Guatemala;7. Department of Epidemiology, Colorado School of Public Health, B119, 13001 E 17th Place, Aurora, CO 80045, USA;1. Department of Infectious Diseases, Italian National Institute of Health (ISS), Viale Regina Elena 299, 00161 Rome, Italy;2. Regional Directorate for Health and Social Policy, Lazio Region, Via R. Raimondi Garibaldi 7, 00145 Rome, Italy;3. Bambino Gesù Paediatric Hospital, Piazza Sant’Onofrio 4, 00165 Rome, Italy;4. Italian National Institute of Statistics (ISTAT), Via Cesare Balbo 16, 00184 Rome, Italy;1. Centro de Salud de Gama, Servicio Cántabro de Salud, Bárcena de Cicero, Cantabria, Spain;2. Servicio de Neumología, Hospital Laredo, Laredo, Cantabria, Spain;3. Centro de Salud de Liérganes, Servicio Cántabro de Salud, Miera, Cantabria, Spain;4. Centro de Salud Bajo Asón, Servicio Cántabro de Salud, Ampuero, Cantabria, Spain;5. Centro de Salud de Suances, Servicio Cántabro de Salud, Suances, Cantabria, Spain;6. Centro de Salud Campoo-Los Valles, Servicio Cántabro de Salud, Mataporquera, Cantabria, Spain;7. Área de Medicina Preventiva y Salud Pública, Universidad de Cantabria-IDIVAL, Santander, Spain;1. Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA;2. Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA;3. Department of Biostatistics and Bioinformatics, University of New South Wales, Sydney, NSW, Australia;4. Pan American Health Organization, Washington, DC, USA;5. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa;6. Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital and University of Oslo, Norway;7. Domain for Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway;8. Infection Disease Prevention and Control Branch, Public Health Agency Canada, Ottawa, ON, Canada;9. WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China;10. Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic;11. Department of Infectious Diseases Epidemiology, Ministry of Health, Singapore;12. Department of Virology, Medical University of Vienna, Vienna, Austria;13. Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China;14. Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark;15. All India Institute of Medical Sciences, New Delhi, India;p. Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya;q. National Institute for Public Health and the Environment, Bilthoven, Netherlands;r. Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal;s. International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand;t. Department for Infectious Disease Epidemiology, Robert Koch-Institute, Berlin, Germany |
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| Abstract: | 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. |
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| Keywords: | Influenza vaccination Repeated vaccination Chronic condition Associated factors INSEF |
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