scholarly journals Structural inequities in seasonal influenza vaccination rates

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lara I. Brewer ◽  
Mark J. Ommerborn ◽  
Augustina Le Nguyen ◽  
Cheryl R. Clark
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
American Indian ◽  
Low Socioeconomic Status ◽  
Behavioral Risk ◽  
Vaccination Rates ◽  
Access To Primary Care ◽  
Structural Inequities

Abstract Background Influenza immunization is a highly effective method of reducing illness, hospitalization and mortality from this disease. However, influenza vaccination rates in the U.S. remain below public health targets and persistent structural inequities reduce the likelihood that Black, American Indian and Alaska Native, Latina/o, Asian groups, and populations of low socioeconomic status will receive the influenza vaccine. Methods We analyzed correlates of influenza vaccination rates using the 2019 Behavioral Risk Factor Surveillance System (BRFSS) in the year 2020. Our analysis compared influenza vaccination as the outcome of interest with the variables age, sex, race, education, income, geographic location, health insurance status, access to primary care, history of delaying care due to cost, and comorbidities such as: asthma, cardiovascular disease, hypertension, body mass index, cancer and diabetes. Results Non-Hispanic White (46.5%) and Asian (44.1%) participants are more likely to receive the influenza vaccine compared to Non-Hispanic Black (36.7%), Hispanic (33.9%), American Indian/Alaskan Native (36.6%), and Native Hawaiian/Other Pacific Islander (37.9%) participants. We found persistent structural inequities that predict influenza vaccination, within and across racial and ethnic groups, including not having health insurance [OR: 0.51 (0.47–0.55)], not having regular access to primary care [OR: 0.50 (0.48–0.52)], and the need to delay medical care due to cost [OR: 0.75 (0.71–0.79)]. Conclusion As COVID-19 vaccination efforts evolve, it is important for physicians and policymakers to identify the structural impediments to equitable U.S. influenza vaccination so that future vaccination campaigns are not impeded by these barriers to immunization.

scholarly journals Structural Inequities in Seasonal Influenza Vaccination Rates

2020 ◽  
Author(s):  
Lara Brewer ◽  
Mark Ommerborn ◽  
Augustina Nguyen ◽  
Cheryl Clark
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
Influenza Vaccination ◽  
Geographic Location ◽  
Behavioral Risk ◽  
Insurance Status ◽  
Vaccination Rates ◽  
Health Insurance Status ◽  
Access To Primary Care ◽  
Structural Inequities

Abstract BackgroundInfluenza immunization is a highly effective method of reducing illness, hospitalization and mortality from this disease. However, influenza vaccination rates in the U.S. remain below public health targets. MethodsWe analyzed correlates of influenza vaccination rates using the 2019 Behavioral Risk Factor Surveillance System (BRFSS) in the year 2020. Our analysis compared influenza vaccination as the outcome of interest with the variables age, sex, race, education, income, geographic location, health insurance status, access to primary care, and history of delaying care due to cost.ResultsOur results showed that several persistent structural inequities predict influenza vaccination, within and across racial and ethnic groups, including geographic location, health insurance status, regular access to primary care, and the need to delay medical care due to cost.ConclusionWith the impending rollout of a COVID-19 vaccine, it is important for physicians and policymakers to recognize and eliminate structural racism and inequities in U.S. influenza vaccination rates so that future vaccination campaigns are not impeded by these barriers to immunization.

scholarly journals Influenza vaccine uptake among adults living with young children

2018 ◽  
Vol 4 (1) ◽  
pp. 41 ◽  
Author(s):  
Nirma Khatri Vadlamudi ◽  
Fawziah Marra
Keyword(s):  
Young Children ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Perceived Health ◽  
Canadian Community Health Survey ◽  
Demographic Characteristics ◽  
Vaccine Uptake ◽  
Vaccination Programs ◽  
Vaccination Rates ◽  
Vaccination Uptake

Background: Many studies report vaccine uptake among young adults aged 18 to 49 years is low. In Canada, the National Advisory Committee on Immunization (NACI) recommends influenza vaccination for adults in contact with young children, however vaccination rates for this specific population are missing. An estimate is required to identify appropriate public health interventions. The objective of this study was to describe recent trends in influenza vaccination uptake among Canadian adults aged 18 to 49 years old living with or without young children.Methods: The Canadian Community Health Survey (2013-2014) dataset, available for public use was used after grouping individuals by influenza vaccination uptake within the past year in adults aged 18 to 49 years.  The relationship between living in a household with young children and influenza vaccination uptake was examined using a multivariable logistic regression model.Results: Among Canadian adults aged 18 to 49 years, the influenza vaccination uptake was 24.1% in adult household contacts with young children compared to 18.2% in those without young children (p<.0001). After adjusting for socio-demographic characteristics and self-perceived health, we determined that vaccine uptake was associated with living in a household with young children (adjusted OR: 1.30 [95%CI: 1.17-1.44]). While socio-demographic characteristics and self-perceived health greatly influenced influenza vaccination uptake, we also found marital status was a strong influencer of influenza vaccine uptake (adjusted OR:  1.31 [95%CI: 1.16-1.48]). Conclusion: Overall, influenza vaccination uptake among caregiving adults is low. Increased vaccine uptake was associated with living in a household with one or more young children. Targeted education and vaccination programs are required to improve uptake of the influenza vaccine in this age group.

scholarly journals A Meta-Analysis of Influenza Vaccination Following Correspondence: Considerations for COVID-19

2021 ◽  
Author(s):  
Robert P Murphy ◽  
Carol Taaffe ◽  
Elayne Ahern ◽  
Grace McMahon ◽  
Orla Muldoon
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Publication Bias ◽  
English Language ◽  
Meta Analysis ◽  
Group Analysis ◽  
Vaccine Uptake ◽  
Vaccination Rates ◽  
Health Authorities ◽  
Direct Correspondence

Background: High vaccination rates are needed to protect against influenza and to end the COVID-19 pandemic. Health authorities need to know if supplementing mass communications with direct correspondence to the community would increase uptake. Objectives: The primary objective is to determine if sending a single written message directly to individuals increases influenza vaccine uptake, and a secondary objective is to identify any identified content shown to increase influenza vaccine uptake. Methods: PubMed, PsycInfo and Web of Science were searched for English language RCTs testing a single correspondence for members of the community in OECD countries to obtain influenza vaccination. A meta-analysis with inverse-variance, random-effects modelling was used to estimate a mean, weighted risk ratio effect size measure of vaccine uptake. Studies were quality assessed and analysis was undertaken to account for potential publication bias. Results: Twenty-two randomized controlled trials were included covering 37 interventions. Of the 37 interventions, 32 (86%) report an increase in influenza vaccination rates. A formal meta-analysis shows that sending a single written message increases influenza vaccine uptake by 18% (RR = 1.18, 95%CI [1.13-1.22], Z = 8.56, p < .001) relative to the no contact comparator group. Analysis shows that the intervention is effective across correspondence type, age group, time, and location, and after allowing for risk of publication bias. Limitations: The review was restricted to English language publications, and the generalizability of results across the OECD may be questioned. Conclusions and implications: The implication for public health authorities organizing vaccination programs for influenza, and arguably also for COVID-19, is that sending written vaccination correspondence to members of the community is likely to increase uptake. Keywords: vaccine uptake, COVID-19, influenza, direct correspondence, meta-analysis.

scholarly journals Demographics, perceptions, and socioeconomic factors affecting influenza vaccination among adults in the United States

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5171 ◽  
Author(s):  
Kaja M. Abbas ◽  
Gloria J. Kang ◽  
Daniel Chen ◽  
Stephen R. Werre ◽  
Achla Marathe
Keyword(s):  
United States ◽  
Health Insurance ◽  
Influenza Vaccination ◽  
Vaccine Efficacy ◽  
Herd Immunity ◽  
The United States ◽  
Vaccine Cost ◽  
Factors Affecting ◽  
Vaccination Rates ◽  
Healthy People 2020

Objective The study objective is to analyze influenza vaccination status by demographic factors, perceived vaccine efficacy, social influence, herd immunity, vaccine cost, health insurance status, and barriers to influenza vaccination among adults 18 years and older in the United States. Background Influenza vaccination coverage among adults 18 years and older was 41% during 2010–2011 and has increased and plateaued at 43% during 2016–2017. This is below the target of 70% influenza vaccination coverage among adults, which is an objective of the Healthy People 2020 initiative. Methods We conducted a survey of a nationally representative sample of adults 18 years and older in the United States on factors affecting influenza vaccination. We conducted bivariate analysis using Rao-Scott chi-square test and multivariate analysis using weighted multinomial logistic regression of this survey data to determine the effect of demographics, perceived vaccine efficacy, social influence, herd immunity, vaccine cost, health insurance, and barriers associated with influenza vaccination uptake among adults in the United States. Results Influenza vaccination rates are relatively high among adults in older age groups (73.3% among 75 + year old), adults with education levels of bachelor’s degree or higher (45.1%), non-Hispanic Whites (41.8%), adults with higher incomes (52.8% among adults with income of over $150,000), partnered adults (43.2%), non-working adults (46.2%), and adults with internet access (39.9%). Influenza vaccine is taken every year by 76% of adults who perceive that the vaccine is very effective, 64.2% of adults who are socially influenced by others, and 41.8% of adults with health insurance, while 72.3% of adults without health insurance never get vaccinated. Facilitators for adults getting vaccinated every year in comparison to only some years include older age, perception of high vaccine effectiveness, higher income and no out-of-pocket payments. Barriers for adults never getting vaccinated in comparison to only some years include lack of health insurance, disliking of shots, perception of low vaccine effectiveness, low perception of risk for influenza infection, and perception of risky side effects. Conclusion Influenza vaccination rates among adults in the United States can be improved towards the Healthy People 2020 target of 70% by increasing awareness of the safety, efficacy and need for influenza vaccination, leveraging the practices and principles of commercial and social marketing to improve vaccine trust, confidence and acceptance, and lowering out-of-pocket expenses and covering influenza vaccination costs through health insurance.

Influenza Vaccination in Massachusetts Jails: A Mixed-Methods Analysis

2021 ◽  
pp. 003335492110416
Author(s):  
Sarah Khorasani ◽  
Julia Zubiago ◽  
Jac Carreiro ◽  
Rubeen Guardado ◽  
Alysse G. Wurcel
Keyword(s):  
Public Health ◽  
Health Care ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Summary Statistics ◽  
Vaccination Rates ◽  
Delivery Practices ◽  
County Jails ◽  
Influenza Vaccinations ◽  
Health Administrators

Objectives Influenza infects millions of people each year and contributes to tens of thousands of deaths annually despite the availability of vaccines. People most at risk of influenza complications are disproportionately represented in people incarcerated in US prisons and jails. The objectives of this study were to survey health administrators in Massachusetts county jails about institutional influenza vaccine policies and practices and estimate influenza vaccination rates in Massachusetts jails from 2013 to 2020. Methods In April 2020, we administered surveys to the health services administrators in Massachusetts’ 14 county jails to gather information about influenza vaccination policies and delivery practices. To calculate influenza vaccination rates for each facility, we obtained data on influenza vaccine orders from the Massachusetts Department of Public Health for each county in Massachusetts for influenza seasons 2013-2020. We calculated summary statistics for each reporting facility and each year, conducted a Kruskal–Wallis analysis to compare vaccination rates between years, and used a linear regression model to identify predictors of vaccination rates. Results Influenza vaccination rates in Massachusetts jails ranged from 1.9% to 11.8%. We found no significant differences in vaccination rates between years. Influenza vaccine ordering and delivery practices varied by jail, and respondents had high levels of confidence in influenza policies and vaccine delivery practices. Conclusions Influenza vaccination rates in Massachusetts jails are low, and delivery practices in jails vary. Lack of influenza vaccinations in jails is a gap in health care that needs to be prioritized, especially considering the current COVID-19 pandemic. Further investigations for effective and equitable vaccination in this population should involve people who are incarcerated and people who make influenza vaccine policies in jails.

Abstract P271: Influenza and Herpes Zoster Vaccination in United States Stroke Survivors: A Nationwide Analysis

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Mu Ji Hwang ◽  
Setareh Salehi Omran ◽  
Saad Mir ◽  
Alexander E Merkler ◽  
Hooman Kamel ◽  
...  
Keyword(s):  
United States ◽  
Herpes Zoster ◽  
Influenza Vaccination ◽  
Vaccination Rate ◽  
Behavioral Risk ◽  
Stroke Survivors ◽  
Cross Sectional ◽  
Vaccination Rates ◽  
Increased Risk ◽  
Prior Stroke

Introduction: Patients with stroke face an increased risk of contracting influenza and herpes zoster. We compared vaccination rates in stroke survivors versus the general United States population. Methods: We performed a cross-sectional analysis of data from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System, which is an annual, nationally representative, health survey. Respondents are asked about medical conditions and care. We used the most recent years with complete data for influenza (2018) and zoster (2017). We utilized survey procedures to estimate CDC-recommended vaccination rates for influenza (annual vaccination for all) and zoster (one-time vaccination for those at least 50 years old). Multiple logistic regression was used to compare the odds of vaccination in those with and without prior stroke, while adjusting for demographics (including income and health insurance) and comorbidities that may influence vaccination rates (obesity, diabetes, heart disease, cancer, pulmonary disease, and smoking). Results: In 2018, 8,254,136 (3.4%; 95% CI, 3.3-3.5) Americans were stroke survivors. The influenza vaccination rate was 44.4% (95% CI, 42.8-46.2) in stroke survivors and 32.8% (95% CI, 32.5-33.1) otherwise. In unadjusted models, stroke survivors were more likely to have had an influenza vaccination in the past year than those without stroke (OR, 1.6; 95% CI, 1.5-1.8). In 2017, 5,839,186 (5.7%; 95% CI, 5.5-5.9) Americans over 50 years old (i.e., eligible for zoster vaccination) were stroke survivors. The zoster vaccination rate was 30.3% (95% CI, 28.8-32.0) in stroke survivors and 27.6% (95% CI, 27.3-28.0) in those without prior stroke. Stroke survivors were more likely to have had zoster vaccination than those without stroke (OR, 1.14; 95% CI, 1.06-1.23). However, after accounting for demographics and comorbidities, stroke survivors were not more likely to be vaccinated for influenza (OR, 1.01; 95% CI, 0.93-1.10) or zoster (OR, 1.00; 95% CI, 0.90-1.12). Conclusion: Stroke survivors were not vaccinated at higher rates than expected based on demographics and comorbidities, and absolute vaccination rates were low, especially for zoster. Efforts to increase vaccination after stroke may be needed.

scholarly journals The influence of a community intervention on influenza vaccination knowledge and behavior among diabetic patients

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lili Tao ◽  
Ming Lu ◽  
Xiaoning Wang ◽  
Xiaoyan Han ◽  
Shuming Li ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Community Intervention ◽  
Vaccination Rate ◽  
Control Group ◽  
Diabetic Patients ◽  
Vaccination Rates ◽  
Significant Difference ◽  
The Impact ◽  
Experimental Group

Abstract Background This study was conducted to evaluate the impact of a comprehensive community intervention on cognition and inoculation behaviors of diabetic patients immunized with influenza vaccine. Methods A total of 1538 diabetic patients aged 35 years and above for outpatient visits and follow-up treatments were selected from six community health service centers (three for the experimental group, and the other three for the control group) in Chaoyang District, Beijing. Comprehensive interventions applied to the experimental group include patient intervention and community climate interventions. We compared the total awareness of influenza vaccine knowledge and influenza vaccination rates between the two groups before and after the intervention. Results Before the intervention, the total awareness rate of influenza vaccine in the experimental group and the control group was similar (50.6 and 50.2%, respectively. P = 0.171). After the intervention, the awareness rate of influenza vaccine in the experimental group and the control group increased. The amplitude of the increase was similar (70.3 and 70.1%, respectively. P = 0.822,). Before the intervention, there was no significant difference in the influenza vaccination rate between the experimental group and the control group (29.0 and 26.8%, respectively. P = 0.334). After the intervention, the vaccination rate of the experimental group was higher than that of the control group. The difference was statistically significant (The vaccination rate 45.8 and 27.4% for the experimental group and the control group, respectively. P < 0.001). Conclusion Comprehensive community interventions had a positive effect on vaccination in diabetic patients. Trial registration ChiCTR1900025194, registered in Aug,16th, 2019. Retrospectively registered.

scholarly journals Promotion of the influenza vaccination to hospital staff during pre-employment health check: a prospective, randomised, controlled trial

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Michael Currat ◽  
Catherine Lazor-Blanchet ◽  
Giorgio Zanetti
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Vaccination Campaign ◽  
Intervention Group ◽  
Vaccination Rate ◽  
Health Check ◽  
Control Group ◽  
Vaccination Rates ◽  
Newly Hired

Abstract Background Vaccination is the most effective prevention of seasonal influenza. Despite its recommendation and active promotion, vaccination coverage remains low among healthcare staff. The goal of the study was to test if a pre-employment health check is a good opportunity to promote future vaccination against influenza among healthcare workers newly hired by a university hospital. Methods All new hospital employees active at the bedside who underwent a pre-employment health check between the end of 2016’s influenza epidemic and the start of the next influenza vaccination campaign were randomly allocated to a control group or an intervention group. The intervention consisted of a semi-structured dialog and the release of an information leaflet about influenza and influenza vaccination during the check-up, and the shipment of a postcard reminder 2 weeks before the next vaccination campaign. Vaccination rates during the campaign were compared among the two groups. Results Three hundred fifty-seven employees were included. Vaccination rates were similar in both groups: 79/172 (46%) in the control and 92/185 (50%) in the intervention group. A significantly higher rate of vaccination was noted among physicians (70/117, 60%) than among other employees (101/240, 42%, p = 0.001). In a pre-defined exploratory analysis among physicians, the vaccination rate was higher in the intervention group (36/51, 71%) than in the control group (34/65, 52%, p = 0.046). Conclusions Promotion of the influenza vaccine during pre-employment health check did not improve the vaccination rate of newly hired hospital healthcare workers overall during the next influenza vaccination campaign. Results suggest a favourable impact on the vaccination rate of physicians. Thus, there may be an interest in using communication strategies tailored to the different categories of healthcare workers to promote the influenza vaccine during pre-employment health check. Trial registration ClinicalTrials, NCT02758145. Registered 26 April 2016.

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