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Kaneko M, Yamada H, Okada T. Higher person-centered primary care measure score is associated with better influenza vaccine uptake: a nationwide cross-sectional study. Fam Pract 2025; 42:cmaf030. [PMID: 40432301 DOI: 10.1093/fampra/cmaf030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2025] Open
Abstract
BACKGROUND Patient experience (PX) is one of the important primary care (PC) indicators. Therefore, PX measurement is essential for assessing PC quality. However, no single standard measure has been established. Although the Person-Centered Primary Care Measure (PCPCM) is a comprehensive and concise measure for evaluating PX in PC, the association between the score and clinical outcomes remains unclear. OBJECTIVE This study aimed to assess the association between the PCPCM score and influenza vaccine uptake, an important clinical outcome in PC for all ages. METHODS This nationwide cross-sectional study conducted in 2022 used an online survey with stratified random sampling in Japan. PX in PC was evaluated using the PCPCM. The outcome variable was influenza vaccine uptake in the past year. A modified Poisson regression analysis was conducted to investigate the relationship between the PCPCM score and influenza vaccine uptake to adjust for possible confounders. RESULTS Among 1112 potential participants, 800 responded; 32.4% received influenza vaccination. After adjusting for possible confounders, PX was found to be associated with influenza vaccine uptake (risk ratio [RR] = 2.02, 95% confidence interval [CI], 1.51-2.70 for the highest score quartile, compared with no usual source of care). The relationship between the PCPCM score quartile and vaccine uptake was dose-dependent. CONCLUSIONS A higher PCPCM score was associated with better influenza vaccine uptake. Because the PCPCM is a concise and validated measure of PX in PC and has been translated into many languages, the results provide important evidence to promote the measurement of PX in PC worldwide.
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Affiliation(s)
- Makoto Kaneko
- Department of Health Data Science, Yokohama City University, 22-2, Seto, Kanazawa-ku, Yokohama, Kanagawa 236-0027, Japan
- Department of Family and Community Medicine, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192, Japan
| | - Hironori Yamada
- Department of Health Data Science, Yokohama City University, 22-2, Seto, Kanazawa-ku, Yokohama, Kanagawa 236-0027, Japan
- Tama Family Clinic, 337, Noboritoshinmachi, Tama-ku, Kawasaki, Kanagawa 214-0013, Japan
- Department of General Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Tadao Okada
- Department of Family Medicine, Tessyoukai Kameda Family Clinic Tateyama, 4304-9, Masaki, Tateyama Chiba, 294-0051, Japan
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Huseth-Zosel AL, Fuller H, Carson PJ. Vaccination Motivators and Deterrents Among Undervaccinated Older Adults in North Dakota. J Community Health 2024; 49:848-856. [PMID: 38615100 DOI: 10.1007/s10900-024-01351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 04/15/2024]
Abstract
Despite increased risk of morbidity and mortality among older adults due to preventable infectious diseases such as influenza, shingles, pneumonia, and COVID-19, many forego receiving some, if not all, of these vaccinations. This study examines vaccination motivators and deterrents for undervaccinated older adults in North Dakota (ND). Adults aged 65+ in ND were mailed a survey (n = 901) with questions gauging vaccination behaviors and perceptions, with 132 of these indicating not receiving certain vaccinations. Further questions assessed reasons they have not been vaccinated against the following diseases: influenza, shingles, pneumonia, and COVID-19 (e.g., "Concerned about side effects", "Vaccines are dangerous", "I'm healthy and I do not need it") and what would make it more likely to get a vaccine (e.g., "More information", "Doctor recommendation", "Easy access to vaccines"). Reasons for remaining unvaccinated varied by vaccine. For influenza and pneumococcal vaccines, respondents were more likely to indicate they are healthy and do not need the vaccine. For shingles and COVID-19, respondents were more likely to indicate concerns about side effects. Factors reported to motivate increasing the likelihood of getting a vaccine were receiving a doctor recommendation, receiving more information, and having a vaccine provided at no cost. These results contribute to our understanding of vaccination behaviors among older adults and underscore specific issues around which to frame interventions tailored to increase vaccine uptake for this population.
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Affiliation(s)
- Andrea L Huseth-Zosel
- Department of Public Health, North Dakota State University, Dept. 2662, PO Box 6050, Fargo, ND, 58108-6050, USA.
| | - Heather Fuller
- Department of Human Development and Family Science, North Dakota State University, Fargo, ND, USA
| | - Paul J Carson
- Department of Public Health, North Dakota State University, Dept. 2662, PO Box 6050, Fargo, ND, 58108-6050, USA
- Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
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Havelka EM, Sanfilippo JE, Juneau PL, Sherman G, Cooper D, Leggio L. The effect of alcohol, tobacco, and other drug use on vaccine acceptance, uptake, and adherence: a systematic review. Alcohol Alcohol 2024; 59:agae057. [PMID: 39371015 PMCID: PMC11456869 DOI: 10.1093/alcalc/agae057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 08/01/2024] [Accepted: 08/05/2024] [Indexed: 10/08/2024] Open
Abstract
BACKGROUND Vaccine hesitancy is increasingly recognized as a health challenge affecting populations worldwide. Given the biological vulnerabilities and structural barriers people who use substances and/or have behavioral addictions face, this systematic review aims to evaluate whether this subpopulation is less prone to adhere to vaccination recommendations. METHODS Electronic searches of published original research were conducted in PubMed, EMBASE, Scopus, and PsycINFO from database inception to December 2022. Our strategy encompassed retrievals regardless of languages and date of publication. Animal studies, abstracts without a full manuscript, and studies which were considered to have lower robustness of scientific evidence were excluded. Outcomes measured were vaccine acceptance, uptake, and adherence. Results were interpreted through a narrative synthesis. RESULTS The search yielded 103 retrievals encompassing data collected on 5 576 374 persons who were predominantly residents of Europe (n = 39) and North America (n = 27). Tobacco use, the substance for which many studies were found (n = 91), was significantly associated with poorer vaccine acceptance, uptake and adherence for influenza, COVID-19, human papillomavirus (HPV), and maternal and childhood vaccines. Peri-natal and parental substance use was identified as a risk factor for suboptimal vaccine-related outcomes concerning maternal COVID-19 and childhood vaccines. Finally, people identified as 'using', 'abusing', or 'misusing' drugs or substances may be at decreased odds of all outcomes in various vaccines. CONCLUSIONS Collectively, the studies identified several groups with statistically significant greater vaccine hesitancy and decreased engagement among whom targeted measures could be beneficial. Timely evidence, especially on behavioral addictions and substances besides tobacco, is lacking, and warrants urgent attention.
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Affiliation(s)
- Eva M Havelka
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, United States
- Centre for Addictive Disorders, Department of Adult Psychiatry, Psychiatric University Hospital Zurich, University of Zurich, Zurich, 8001, Switzerland
| | - Jenna E Sanfilippo
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, United States
- Northwestern University Feinberg School of Medicine Department of Psychiatry & Behavioral Sciences, Chicago, IL 60611, United States
| | - Paul L Juneau
- National Institutes of Health Library, Office of Research Services, National Institutes of Health, Bethesda, MD 20894, United States
| | - Garrick Sherman
- Office of the Clinical Director, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD 21224, United States
| | - Diane Cooper
- Office of Research Services, Division of Library Services, National Institutes of Health; Building 10 Bethesda, MD 20892, United States
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Suite 200, Baltimore, MD 21224, United States
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Benedict Kpozehouen E, Raina Macintyre C, Tan TC. Coverage of influenza, pneumococcal and zoster vaccination and determinants of influenza and pneumococcal vaccination among adults with cardiovascular diseases in community. Vaccine 2024; 42:126003. [PMID: 38789372 DOI: 10.1016/j.vaccine.2024.05.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/05/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death and illness globally. Influenza, pneumococcal disease and herpes zoster infection may trigger acute cardiovascular events or cause complications among cardiac patients. Vaccination is recommended for adults with CVD. There is a gap in research evidence around determinants and uptake of influenza, pneumococcal and zoster vaccines in adults with CVD. OBJECTIVE The aim of this study is to examine the rate of the uptake of influenza, zoster and pneumococcal vaccines, factors associated with the uptake of influenza vaccine, and the perceptions of influenza and pneumococcal vaccination among people with CVD in the community. METHOD Cross-sectional survey data was analysed from three separate surveys carried out in Australia between October 2019 and September 2020 of 972 adults with CVD. We used descriptive statistics to describe data. Thematic analysis examined the reasons for taking influenza vaccine. Multivariable analysis was used to identify independent predictors of the influenza vaccine uptake and perceptions associated with the uptake of influenza and pneumococcal vaccines. RESULTS Out of 972 participants, a total of 661 (68 %) people said they had received influenza vaccine in the last 12 months; 361 (37 %) had ever received pneumococcal vaccine; 196 (20 %) had ever received zoster vaccine. Among 661 participants who said they received influenza vaccine within the 12 months prior to the study, 543 (82 %) participants received it from doctors or general practitioners (GPs) offices. Age 65 and older, being born in Australia, being employed or retired and having comorbidity were positive predictors of influenza vaccination. Doctors' recommendations to take the vaccine and awareness of free vaccines positively predicted influenza and pneumococcal vaccine uptake. CONCLUSION The uptake of recommended pneumococcal and zoster vaccines is low in people with CVD. Doctors' recommendations, targeted health promotion programs in general practice, and easy access to vaccination may optimise vaccination uptake in patients with CVD.
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Affiliation(s)
| | - C Raina Macintyre
- Biosecurity Program, The Kirby Institute, Faculty Medicine and Health, University of New South Wales, Australia
| | - Timothy C Tan
- Department of Cardiology, Blacktown Hospital, Sydney, NSW, Australia; Western Sydney University, Australia; School of Medical Sciences, Faculty of Medicine, University of New South Wales, NSW, Australia
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Wold M, Oancea SC. Influenza Vaccination in Adults in the United States with COPD before and after the COVID-19 Pandemic (2017-2022): A Multi-Year Cross-Sectional Study. Vaccines (Basel) 2024; 12:931. [PMID: 39204054 PMCID: PMC11359522 DOI: 10.3390/vaccines12080931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 09/03/2024] Open
Abstract
There is limited literature regarding seasonal influenza vaccination (SIV) among those with a history of chronic obstructive pulmonary disease (HCOPD) prior to the COVID-19 pandemic, and no information on the topic assessing the years following the pandemic. This cross-sectional study used the Behavioral Risk Factor Surveillance Survey (BRFSS) data from the years 2017 to 2022 (n = 822,783 adults ages 50-79 years; 50.64% males). The exposure was a HCOPD, and the outcome was SIV within the past year. Weighted and adjusted logistic regression models were conducted overall and by the significant effect modifiers: smoking status, sex, and year. Having an HCOPD significantly increases the weighted adjusted odds (WAO) of SIV when compared to not having an HCOPD overall and by smoking status, sex, and year. For 2017 through 2022, among all current, former, and never smokers with an HCOPD, the WAO of SIV were: 1.36 (1.28, 1.45), 1.35 (1.27, 1.43), and 1.18 (1.09, 1.27), respectively. Among males with an HCOPD who were current, former, and never smokers, the WAO of SIV were: 1.35 (1.23, 1.48), 1.45 (1.33, 1.58), and 1.23 (1.05, 1.44), respectively. Among females with an HCOPD who were current, former, and never smokers, the WAO of SIV were: 1.31 (1.20, 1.43), 1.24 (1.15, 1.35), and 1.13 (1.04, 1.23), respectively. Study findings suggest males had significantly greater WAO ratios of receiving SIV than females in 2020 and 2022, during and after the COVID-19 pandemic. More specifically, males with an HCOPD who were former smokers had significantly greater WAOR of receiving SIV than females in 2020 and 2022. Understanding the potential barriers to SIV receipt by smoking status and sex, especially during a pandemic, and especially for individuals impacted by an HCOPD, is essential for better health interventions in times of a national crisis such as a pandemic. Additionally, SIV receipt is low among those with an HCOPD, and efforts should be made to improve this.
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Gavulic KA, Wallace J. Medicare Eligibility and Changes in Coverage, Access to Care, and Health by Sexual Orientation and Gender Identity. JAMA HEALTH FORUM 2024; 5:e241756. [PMID: 38967949 PMCID: PMC11227074 DOI: 10.1001/jamahealthforum.2024.1756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/09/2024] [Indexed: 07/06/2024] Open
Abstract
Importance Medicare provides nearly universal insurance coverage at age 65 years. However, how Medicare eligibility affects disparities in health insurance coverage, access to care, and health status among individuals by sexual orientation and gender identity is poorly understood. Objective To assess the association of Medicare eligibility with disparities in health insurance coverage, access to care, and self-reported health status among individuals by sexual orientation and by gender identity. Design, Setting, and Participants This cross-sectional study used the age discontinuity for Medicare eligibility at age 65 years to isolate the association of Medicare with health insurance coverage, access to care, and self-reported health status, by their sexual orientation and by their gender identity. Data were collected from the Behavioral Risk Factor Surveillance System for respondents from 51 to 79 years old from 2014 to 2021. Data analysis was performed from September 2022 to April 2023. Exposures Medicare eligibility at age 65 years. Main Outcomes and Measures Proportions of respondents with health insurance coverage, usual source of care, cost barriers to care, influenza vaccination, and self-reported health status. Results The study population included 927 952 individuals (mean [SD] age, 64.4 [7.7] years; 524 972 [56.6%] females and 402 670 [43.4%] males), of whom 28 077 (3.03%) identified as a sexual minority-lesbian, gay, bisexual, or another sexual minority identity (LGB+) and 3286 (0.35%) as transgender or gender diverse. Respondents who identified as heterosexual had greater improvements at age 65 years in insurance coverage (4.2 percentage points [pp]; 95% CI, 4.0-4.4 pp) than those who identified as LGB+ (3.6 pp; 95% CI, 2.3-4.8 pp), except when the analysis was limited to a subsample of married respondents. For access to care, improvements in usual source of care, cost barriers to care, and influenza vaccination were larger at age 65 years for heterosexual respondents compared with LGB+ respondents, although confidence intervals were overlapping and less precise for LGB+ individuals. For self-reported health status, the analyses found larger improvements at age 65 years for LGB+ respondents compared with heterosexual respondents. There was considerable heterogeneity by state in disparities by sexual orientation among individuals who were nearly eligible for Medicare (close to 65 years old), with the US South and Central states demonstrating the highest disparities. Among the top-10 highest-disparities states, Medicare eligibility was associated with greater increases in coverage (6.7 pp vs 5.0 pp) and access to a usual source of care (1.4 pp vs 0.6 pp) for LGB+ respondents compared with heterosexual respondents. Conclusions and Relevance The findings of this cross-sectional study indicate that Medicare eligibility was not associated with consistently greater improvements in health insurance coverage and access to care among LGBTQI+ individuals compared with heterosexual and/or cisgender individuals. However, among sexual minority individuals, Medicare may be associated with closing gaps in self-reported health status, and among states with the highest disparities, it may improve health insurance coverage, access to care, and self-reported health status.
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Affiliation(s)
- Kyle A. Gavulic
- Yale School of Medicine, New Haven, Connecticut
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
| | - Jacob Wallace
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
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Skyles TJ, Stevens HP, Obray AM, Jensen JL, Miner DS, Bodily RJ, Nielson BU, Poole BD. Changes in Attitudes and Barriers to Seasonal Influenza Vaccination from 2007 to 2023. J Community Health 2024; 49:207-217. [PMID: 37697225 DOI: 10.1007/s10900-023-01277-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 09/13/2023]
Abstract
This study investigated how factors and barriers to flu vaccination among college students has changed over the past 16 years. Data were collected from 440 students using a survey and compared to previous data from the same university. Respondents were also asked about their experiences with Covid-19 and its effect on their intent to vaccinate. We found that vaccination rates had increased from 12.4 to 30.5%. Among the unvaccinated, expense, fear of getting influenza from vaccination, fear of side effects, and lack of information have decreased by 28%, 20%, 17%, and 15% respectively. Time, convenience, and perceived risk are still significant barriers to vaccination. Students are getting more encouragement to vaccinate from their health care providers and parents, but it is becoming less effective. The Covid-19 pandemic has changed vaccine attitudes and vaccine fatigue has been a large contributor. Additionally, political affiliation has become a predictor of flu vaccine uptake with conservatives being less likely to vaccinate. There has also been a shift in motivation from concern for personal safety to concern for public safety.
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Affiliation(s)
- Ty J Skyles
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT, 84057, USA
| | - Harlan P Stevens
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT, 84057, USA
| | - Acelan M Obray
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT, 84057, USA
| | - Jamie L Jensen
- Department of Biology, Brigham Young University, Provo, UT, 84602, USA
| | - Dashiell S Miner
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT, 84057, USA
| | - Ruth J Bodily
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT, 84057, USA
| | - Bryce U Nielson
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT, 84057, USA
| | - Brian D Poole
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, UT, 84057, USA.
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Alqifari SF, Esmail AK, Alarifi DM, Alsuliman GY, Alhati MM, Mutlaq MR, Aldhaeefi M, Alshuaibi SA, Amirthalingam P, Abdallah A, Wasel AS, Hamad HR, Alamin S, Atia TH, Alqahtani T. Adherence to Advisory Committee on Immunization Practices in diabetes mellitus patients in Saudi Arabia: A multicenter retrospective study. World J Diabetes 2024; 15:440-454. [PMID: 38591075 PMCID: PMC10999047 DOI: 10.4239/wjd.v15.i3.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/03/2024] [Accepted: 02/18/2024] [Indexed: 03/15/2024] Open
Abstract
BACKGROUND Patients with diabetes mellitus (DM) are predisposed to an increased risk of infection signifying the importance of vaccination to protect against its potentially severe complications. The Centers for Disease Control and Prevention/Advisory Committee on Immunization Practices (CDC/ACIP) issued immunization re-commendations to protect this patient population. AIM To assess the adherence of patients with DM to the CDC/ACIP immunization recommendations in Saudi Arabia and to identify the factors associated with the vaccine adherence rate. METHODS An observational retrospective study conducted in 2023 was used to collect data on the vaccination records from 13 diabetes care centers in Saudi Arabia with 1000 eligible patients in phase I with data collected through chart review and 709 patients in phase II through online survey. RESULTS Among participants, 10.01% (n = 71) had never received any vaccine, while 85.89% (n = 609) received at least one dose of the coronavirus disease 2019 (COVID-19) vaccine, and 34.83% (n = 247) had received the annual influenza vaccine. Only 2.96% (n = 21), 2.11% (n = 15), and 1.12% (n = 8) received herpes zoster, tetanus, diphtheria, and pertussis (Tdap), and human papillomavirus (HPV) vaccines, respectively. For patients with DM in Saudi Arabia, the rate of vaccination for annual influenza and COVID-19 vaccines was higher compared to other vaccinations such as herpes zoster, Tdap, pneumococcal, and HPV. Factors such as vaccine recommendations provided by family physicians or specialists, site of care, income level, DM-related hospitalization history, residency site, hemoglobin A1c (HbA1c) level, and health sector type can significantly influence the vaccination rate in patients with DM. Among non-vaccinated patients with DM, the most reported barriers were lack of knowledge and fear of side effects. This signifies the need for large-scale research in this area to identify additional factors that might facilitate adherence to CDC/ACIP vaccine recommendations in patients with DM. CONCLUSION In Saudi Arabia, patients with DM showed higher vaccination rates for annual influenza and COVID-19 vaccines compared to other vaccinations such as herpes zoster, Tdap, pneumococcal, and HPV. Factors such as vaccine recommendations provided by family physicians or specialists, the site of care, income level, DM-related hospitalization history, residency site, HbA1c level, and health sector type can significantly influence the vaccination rate in patients with DM.
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Affiliation(s)
| | - Aya K Esmail
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Dalal M Alarifi
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Ghalya Y Alsuliman
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Maram M Alhati
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - May R Mutlaq
- Department of Family Medicine, International Medical Center, Jeddah 23214, Saudi Arabia
| | - Mohammed Aldhaeefi
- Clinical and Administrative Pharmacy Sciences, College of Pharmacy, Howard University, Washington, DC 20059, United States
| | - Shaden A Alshuaibi
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | | | - Abrar Abdallah
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Afaf S Wasel
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Heba R Hamad
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Shoroq Alamin
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Tasneem H Atia
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Tariq Alqahtani
- Department of Pharmacology, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
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Cho BH, O'Halloran A, Pike J. Investigation of barriers to county-level seasonal influenza vaccine uptake among Medicare beneficiaries in the United States - 2018-2019 seasonal influenza season. Vaccine X 2023; 14:100326. [PMID: 37577260 PMCID: PMC10422654 DOI: 10.1016/j.jvacx.2023.100326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/11/2023] [Accepted: 05/30/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction As most public health decisions are made at the local level, public health interventions implemented at the local level may vary by their own unique circumstances, such as demographic composition or the availability of resources. Our objective is to estimate and characterize county-level flu vaccine uptakes among Medicare-covered adults aged ≥65 years. Methods The flu vaccine uptake was estimated from Medicare Fee-for-Service claims for those who continuously enrolled during the 2018-2019 flu season. County-level characteristics were obtained from Centers for Disease Control and Prevention (CDC)'s Minority Health Social Vulnerability Index and Behavioral Risk Factor Surveillance System data as well as Health Resources and Services Administration's Area Health Resources File. A generalized linear regression was used to assess the relationship between selected characteristics and uptake. Results A total of 30,265,047 beneficiaries from 3,125 counties were identified, of which 53% received a flu vaccination during the 2018-2019 flu season. For 3,006 counties with more than 500 Medicare beneficiaries, the mean county-level uptake was estimated to be 47.7%. The mean uptakes in counties designated as a health professional shortage area (HPSA) (42.6% and 48.4%, respectively), were lower than the uptakes for the non-HPSA counties (53.8%). Metro counties (53.2%) showed higher uptakes than non-metro counties (44.2%). Regression analysis results showed that the percent of working adults aged 18-64 years and female were positively associated, while the percent of Black and Hispanic adults were negatively associated. Proportions of persons with limited proficiency of English, college education or above, single parent families, multi-unit housing, and living in group quarters were positively associated and significant. Conclusions The results confirmed that county-level flu vaccine uptakes are low, reflect persistent racial disparities in vaccine uptake, and that Medicare populations in medically underserved communities with lower socioeconomic status need more attention in improving flu vaccine uptake.
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Affiliation(s)
- Bo-Hyun Cho
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Alissa O'Halloran
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jamison Pike
- Centers for Disease Control and Prevention, Atlanta, GA, United States
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Imp BM, Levine T, Satre DD, Skarbinski J, Luu MN, Sterling SA, Silverberg MJ. Influenza Vaccination Uptake and Associated Factors Among Adults With and Without Human Immunodeficiency Virus in a Large, Integrated Healthcare System. Clin Infect Dis 2023; 77:56-63. [PMID: 36857440 PMCID: PMC10320060 DOI: 10.1093/cid/ciad106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/09/2023] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Influenza vaccination is recommended for adults regardless of human immunodeficiency virus (HIV) status. There may be facilitators or barriers to vaccinating people with HIV (PWH) that differ from people without HIV (PWoH). We sought to describe the uptake of influenza vaccination by HIV status and identify factors associated with vaccination. METHODS We abstracted data from the electronic health records of PWH and PWoH in Kaiser Permanente Northern California during 6 influenza seasons (2013-2018). We determined vaccination uptake and used Poisson regression models to evaluate factors associated with vaccination in PWH and PWoH. RESULTS 9272 PWH and 194 393 PWoH matched by age, sex, and race/ethnicity were included (mean age: 48 vs 49 years; men: 91% vs 90%; White race: 53% for both groups). PWH were more likely to receive the influenza vaccine (65-69% across years for PWH and 37-41% for PWoH) with an adjusted risk ratio for all years of 1.48 (95% CI: 1.46-1.50). For PWH, lower vaccination uptake was associated with several factors that suggested more complex health needs, such as lower CD4 cell counts, higher HIV viral loads, prior depression diagnoses, having Medicare insurance, and having a higher number of comorbidities. Associations with vaccination uptake were attenuated in PWH, compared with PWoH, for smoking, alcohol, and demographic factors. CONCLUSIONS PWH had an almost 50% higher uptake of influenza vaccination than PWoH, possibly reflecting greater engagement with the healthcare system. We also found that PWH with more complex health needs had reduced vaccination uptake. Findings may inform outreach strategies to increase influenza vaccination in PWH.
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Affiliation(s)
- Brandon M Imp
- Department of Adult and Family Medicine, Kaiser Permanente Oakland Medical Center, Oakland, California, USA
| | - Tory Levine
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Derek D Satre
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| | - Jacek Skarbinski
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Infectious Diseases, Kaiser Permanente Oakland Medical Center, Oakland, California, USA
| | - Mitchell N Luu
- Department of Adult and Family Medicine, Kaiser Permanente Oakland Medical Center, Oakland, California, USA
| | - Stacy A Sterling
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
| | - Michael J Silverberg
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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11
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Srivastav A, Lu PJ, Amaya A, Dever JA, Stanley M, Franks JL, Scanlon PJ, Fisher AM, Greby SM, Nguyen KH, Black CL. Prevalence of influenza-specific vaccination hesitancy among adults in the United States, 2018. Vaccine 2023; 41:2572-2581. [PMID: 36907734 PMCID: PMC10941755 DOI: 10.1016/j.vaccine.2023.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 01/17/2023] [Accepted: 03/05/2023] [Indexed: 03/12/2023]
Abstract
BACKGROUND The role of vaccine hesitancy on influenza vaccination is not clearly understood. Low influenza vaccination coverage in U.S. adults suggests that a multitude of factors may be responsible for under-vaccination or non-vaccination including vaccine hesitancy. Understanding the role of influenza vaccination hesitancy is important for targeted messaging and intervention to increase influenza vaccine confidence and uptake. The objective of this study was to quantify the prevalence of adult influenza vaccination hesitancy (IVH) and examine association of IVH beliefs with sociodemographic factors and early-season influenza vaccination. METHODS A four-question validated IVH module was included in the 2018 National Internet Flu Survey. Weighted proportions and multivariable logistic regression models were used to identify correlates of IVH beliefs. RESULTS Overall, 36.9% of adults were hesitant to receive an influenza vaccination; 18.6% expressed concerns about vaccination side effects; 14.8% personally knew someone with serious side effects; and 35.6% reported that their healthcare provider was not the most trusted source of information about influenza vaccinations. Influenza vaccination ranged from 15.3 to 45.2 percentage points lower among adults self-reporting any of the four IVH beliefs. Being female, age 18-49 years, non-Hispanic Black, having high school or lower education, being employed, and not having primary care medical home were associated with hesitancy. CONCLUSIONS Among the four IVH beliefs studied, being hesitant to receiving influenza vaccination followed by mistrust of healthcare providers were identified as the most influential hesitancy beliefs. Two in five adults in the United States were hesitant to receive an influenza vaccination, and hesitancy was negatively associated with vaccination. This information may assist with targeted interventions, personalized to the individual, to reduce hesitancy and thus improve influenza vaccination acceptance.
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Affiliation(s)
- Anup Srivastav
- Leidos Incorporated, Atlanta, GA, USA; Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | - Jill A Dever
- RTI International, District of Columbia, WA, USA.
| | | | | | - Paul J Scanlon
- Division of Research and Methodology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.
| | - Allison M Fisher
- Office of Health Communications, Office of the Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Stacie M Greby
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Kimberly H Nguyen
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Carla L Black
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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12
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Boersma P, Cohen RA, Zelaya CE, Moy E. Influenza and Pneumococcal Vaccination Among Male Veterans and Nonveterans, 2016-2018. Public Health Rep 2023; 138:259-264. [PMID: 35238250 PMCID: PMC10031843 DOI: 10.1177/00333549221081119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The Advisory Committee on Immunization Practices recommends persons aged ≥6 months receive an influenza vaccination annually, and certain adults aged ≥19 years receive the 23-valent pneumococcal polysaccharide vaccine alone or in series with the 13-valent pneumococcal conjugate vaccine, depending on age, chronic conditions, and smoking status. This study examines the prevalence of influenza and pneumococcal vaccination relative to Healthy People 2020 goals to understand how vaccination receipt differs by veteran status and sociodemographic subgroups. METHODS We analyzed pooled data from the 2016-2018 National Health Interview Survey (N = 35 094) in 2021 to estimate the prevalence of influenza and pneumococcal vaccination for men aged 25-64 years and for men aged ≥65 years by veteran status and selected sociodemographic subgroups. We used 2-tailed t tests with an α = .05 to identify significant differences. RESULTS Among men, 44.7% of veterans and 33.5% of nonveterans aged 25-64 years and 71.0% of veterans and 64.9% of nonveterans aged ≥65 years received an influenza vaccine in the past year. Among men aged 25-64 years at high risk for pneumococcal disease, 35.9% of veterans and 20.8% of nonveterans had ever received ≥1 dose of any pneumococcal vaccination. Disparities in the prevalence of vaccination within examined sociodemographic characteristics were often smaller in magnitude among veterans than among nonveterans for both vaccinations. CONCLUSIONS Vaccination rates were below Healthy People 2020 targets for both groups, except influenza vaccination among veterans aged ≥65 years. Understanding differences in vaccine uptake may inform efforts to improve vaccination rates by identifying subgroups who are at high risk of disease and have low vaccination rates.
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Affiliation(s)
- Peter Boersma
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Robin A. Cohen
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Carla E. Zelaya
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Ernest Moy
- Office of Health Equity, Veterans Health Administration, Washington, DC, USA
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13
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Fix J, Donneyong MM, Rapp SR, Sattari M, Snively BM, Wactawski-Wende J, Gower EW. Predictors of Influenza and Pneumococcal Vaccination Among Participants in the Women's Health Initiative. Public Health Rep 2023; 138:281-291. [PMID: 35301881 PMCID: PMC10031837 DOI: 10.1177/00333549221081817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Older adults typically experience higher rates of severe disease and mortality than the general population after contracting an infectious disease. Vaccination is critical for preventing disease and severe downstream outcomes; however, vaccination rates among older adults are suboptimal. We assessed predictors associated with pneumococcal and seasonal influenza vaccination among older women. METHODS We used data from the Women's Health Initiative, a nationwide cohort of women. We ascertained seasonal influenza and pneumococcal vaccination status through a questionnaire administered in 2013. We limited analyses to women aged ≥65 years at questionnaire administration. We used logistic regression to estimate associations between demographic, lifestyle, and health-related factors and vaccination and explored stratification by race. RESULTS Of participants who responded to each question, 84.3% (n = 60 578) reported being vaccinated for influenza and 85.5% (n = 59 015) for pneumonia. The odds of reporting influenza vaccination were significantly lower among non-Hispanic Black participants than among non-Hispanic White participants (odds ratio [OR] = 0.53; 95% CI, 0.49-0.58), women with no health insurance versus private health insurance (OR = 0.61; 95% CI, 0.54-0.68), and women living in rural versus urban settings (OR = 0.84; 95% CI, 0.73-0.96). Current smoking, lower education levels, and having comorbid conditions were associated with lower likelihood of being vaccinated for influenza (than not); past pneumonia diagnosis and being currently married were associated with a higher likelihood. We observed similar associations for pneumococcal vaccination coverage. CONCLUSIONS These findings reinforce the need to enact policy and implement programs to improve access to, education and awareness about, and provider recommendations for these critical disease-prevention tools. Results from our study should guide strategies for SARS-CoV-2 vaccination.
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Affiliation(s)
- Jonathan Fix
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Macarius M Donneyong
- Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, Columbus, OH, USA
- Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Maryam Sattari
- Department of Medicine, Division of General Internal Medicine, University of Florida College of Medicine, Gainesville, FL, USA
| | - Beverly M Snively
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Emily W Gower
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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14
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Kunnuru S, Godella V, Vinala S, Anne B. A study to evaluate the knowledge, vaccination status and acceptance of adult vaccinations against respiratory infections in patients with type 2 diabetes in South India. Int J Diabetes Dev Ctries 2023; 43:1-7. [PMID: 36684486 PMCID: PMC9838543 DOI: 10.1007/s13410-022-01166-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/26/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Respiratory infections like influenza and pneumococcus increase mortality, morbidity, hospitalisation risks and healthcare costs in people with type 2 diabetes which can be prevented by vaccinations. However, there is not much data regarding how many people with type 2 diabetes in India receive pneumococcal and influenza vaccinations. Methods This is a cross-sectional study conducted between March 2022 to May 2022 at a tertiary care centre in South India. Patients were interviewed through face to face questionnaire regarding awareness, knowledge of influenza and pneumococcal infections, availability and need of vaccines, vaccination status and the possible reasons for not receiving vaccines. Results A total of 388 patients were recruited in the study. Knowledge about influenza and pneumococcal infections were present only in 4.8% and 4.1% respectively. And 98.7% of patients had no awareness about the availability and need for vaccines. Only 0.5% and 0.7% of patients received influenza and pneumococcal vaccinations respectively. After counselling and spreading awareness, 76.2% of patients said that they would receive vaccination in the next visit. Also, 23.19% of the patients refused to take any vaccinations even after counselling. And 23.7% of patients feared complications after vaccinations. Conclusion Pneumococcal and Influenza vaccination uptake rates are extremely low in people with type 2 diabetes in India. Urgent measures are required to increase the awareness in patients and healthcare workers about the availability, need for vaccinations and effectiveness of vaccines which would lead to improvement in vaccination rates.
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Affiliation(s)
- Sumana Kunnuru
- Department of Endocrinology, Nizam’s Institute of Medical Sciences, Hyderabad, Telanagana India
| | - Vandana Godella
- Department of Clinical Pharmacology and Therapeutics, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana India
| | - Shanthan Vinala
- Department of General Medicine, Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana India
| | - Beatrice Anne
- Department of Endocrinology, Nizam’s Institute of Medical Sciences, Hyderabad, Telanagana India
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15
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Choi H, Jeon B, Han E. Seasonal influenza vaccine uptake among adults with disabilities in Korea. Disabil Health J 2023; 16:101372. [PMID: 36156272 DOI: 10.1016/j.dhjo.2022.101372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 07/29/2022] [Accepted: 08/25/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Previous research on vaccination among people with disabilities has focused on children or adolescents. OBJECTIVE To examine variations in seasonal influenza vaccination (SIV) uptake according to disability type and age group and explore the vulnerable groups and risk factors of non-vaccination to identify areas of policy support in Korea. METHODS This pooled cross-sectional study included adults who participated in the 2011, 2014, and 2017 National Survey of Persons with Disabilities. The dependent variable was SIV uptake. Age-stratified multivariate logistic regression was conducted to assess its relationship with disability characteristics. RESULTS Among 18,069 adults with disabilities, the overall SIV uptake rate increased with age (33.8%, 50.1%, and 85.3% in 20-49, 50-65, and ≥65 years, respectively). In the multivariate analyses (reporting the adjusted odds ratio and 95% confidence interval), severe disability was associated with lower and higher SIV uptake rates in older adults and younger age-groups (0.88, 0.76-1.01; 1.62, 1.42-1.86; and 1.54, 1.24-1.92 in those aged ≥65; 50-64; and 20-49 years), respectively. Health behaviors (regular doctor visits, general health examinations, and non-smoking) were significantly associated with higher odds of SIV uptake. After adjusting for covariates (age, medical conditions, functional ability, and behavioral factors), individuals with brain, epileptic, and psychiatric disabilities showed lower odds of SIV uptake compared to those with internal organ disabilities across all age groups. CONCLUSIONS Policy initiatives that can improve the health behaviors of people with disabilities (especially the elderly and people with intellectual, brain, epilepsy, and psychiatric disabilities) to promote SIV uptake are needed.
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Affiliation(s)
- HeeKyoung Choi
- Department of Infectious Diseases, National Health Insurance Service Ilsan Hospital, Goyang, South Korea; College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Seoul, South Korea
| | - Boyoung Jeon
- Department of Health and Medical Information, Myongji College, Seoul, South Korea
| | - Euna Han
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Seoul, South Korea.
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16
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Komada MT, Lee JS, Watanabe E, Nakazawa E, Mori K, Akabayashi A. Factors of influenza vaccine inoculation and non-inoculation behavior of community-dwelling residents in Japan: suggestions for vaccine policy and public health ethics after COVID-19. Vaccine X 2022; 13:100245. [PMCID: PMC9744486 DOI: 10.1016/j.jvacx.2022.100245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022] Open
Abstract
The aim of this study is to provide basic information that contributes to vaccine inoculation policy after COVID-19. We used the secondary data of the influenza vaccine inoculation behavior survey for community-dwelling adults conducted in 2011, before the COVID-19 pandemic, but after the 2009 novel influenza A (H1N1) pdm 09 pandemic. All factors such as socio-demographic characteristics, health-related behaviors, family environment, physical and social environment, and area of residence were adjusted, and factors related to vaccine inoculation behavior were analyzed. Those living with pregnant women had a significantly higher odds ratio of inoculation; this was self-evident in that those people considered infection to their family. Regarding the social environment, those aged 20–64 years with a significantly higher adjusted odds ratio of inoculation were those with “at least five people with which they interacted in the neighborhood”. This result can be interpreted in two ways relating to altruism in Japan. Finally, we indicated the importance of learning from the past, including the case of 2009.
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Affiliation(s)
- Mayuko T. Komada
- Division of Nursing, Higashigaoka Faculty of Nursing, Tokyo Healthcare University, 2-5-1, Higashigaoka, Meguro-ku, Tokyo 152-8558, Japan
| | - Jung Su Lee
- Postgraduate School of Healthcare, Tokyo Healthcare University 4-1-17 Higashigotanda, Shinagawa-ku, Tokyo 141-8648, Japan
| | - Etsuko Watanabe
- Postgraduate School of Healthcare, Tokyo Healthcare University 4-1-17 Higashigotanda, Shinagawa-ku, Tokyo 141-8648, Japan
| | - Eisuke Nakazawa
- Department of Biomedical Ethics, University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Katsumi Mori
- Department of Biomedical Ethics, University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Akira Akabayashi
- Department of Biomedical Ethics, University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Division of Medical Ethics, New York University School of Medicine, 227 East 30th Street, New York, NY 10016, USA
- Corresponding author at: Department of Biomedical Ethics, University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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17
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Delays and declines in seasonal influenza vaccinations due to Hurricane Harvey narrow annual gaps in vaccination by race, income and rurality. Infect Control Hosp Epidemiol 2022; 43:1833-1839. [PMID: 35292125 PMCID: PMC9753087 DOI: 10.1017/ice.2022.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Temporal overlap of the Atlantic hurricane season and seasonal influenza vaccine rollout has the potential to result in delays or disruptions of vaccination campaigns. We documented seasonal influenza vaccination behavior over a 5-year period and explored associations between flooding following Hurricane Harvey and timing and uptake of vaccines, as well as how the impacts of Hurricane Harvey on vaccination vary by race, wealth, and rurality. DESIGN Retrospective cohort analysis. SETTING Texas counties affected by Hurricane Harvey. PATIENTS Active users of the Veterans' Health Administration in 2017. METHODS We used geocoded residential address data to assess flood exposure status following Hurricane Harvey. Days to receipt of seasonal influenza vaccines were calculated for each year from 2014 to 2019. Proportional hazards models were used to determine how likelihood of vaccination varied according to flood status as well as the race, wealth, and rural-urban residence of patients. RESULTS The year of Hurricane Harvey was associated with a median delay of 2 weeks to vaccination and lower overall vaccination than in prior years. Residential status in flooded areas was associated with lower hazards of influenza vaccination in all years. White patients had higher proportional hazards of influenza vaccination than non-White patients, though this attenuated to 6.39% (hazard ratio [HR], 1.0639; 95% confidence interval [CI], 1.034-1.095) in the hurricane. year. CONCLUSIONS Receipt of seasonal influenza vaccination following regional exposure to the effects of Hurricane Harvey was delayed among US veterans. White, non-low-income, and rural patients had higher likelihood of vaccination in all years of the study, but these gaps narrowed during the hurricane year.
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18
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Parekh T, Javed Z, Khan SU, Xue H, Nasir K. Disparities in Influenza Vaccination Coverage and Associated Factors Among Adults with Cardiovascular Disease, United States, 2011-2020. Prev Chronic Dis 2022; 19:E67. [PMID: 36302382 PMCID: PMC9616130 DOI: 10.5888/pcd19.220154] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
INTRODUCTION Influenza vaccination can reduce the incidence of cardiovascular disease (CVD) in the US. However, differences in state-level trends in CVD and sociodemographic and health care characteristics of adults with CVD have not yet been studied. METHODS In this repeated cross-sectional study, we extracted 476,227 records of adults with a self-reported history of CVD from the Behavioral Risk Factor Surveillance System from January 2011 through December 2020. We calculated the prevalence and likelihood of annual influenza vaccination by sociodemographic characteristics, health care characteristics, and CVD risk factors. Additionally, we examined annual trends of influenza vaccination by geographic location. RESULTS The annual age-adjusted influenza vaccination rate among adults with CVD increased from 38.6% (2011) to 44.3% (2020), with an annual average percentage change of 1.1%. Adults who were aged 18 to 44 years, male, non-Hispanic Black/African American, or Hispanic, or had less than a high school diploma, annual household income less than $50,000, and no health insurance had a lower prevalence of vaccination. The odds of vaccination were lower among non-Hispanic Black/African American (adjusted odds ratio, 0.73; 95% CI, 0.70-0.77) and non-Hispanic American Indian/Alaska Native (adjusted odds ratio, 0.86; 95% CI, 0.75-0.98) compared with non-Hispanic White adults. Only 16 states achieved a vaccination rate of 50%; no state achieved the Healthy People 2020 goal of 70%. Nonmedical settings (supermarkets, drug stores) gained popularity (19.2% in 2011 to 28.5% in 2018) as a vaccination setting. CONCLUSION Influenza vaccination among adults with CVD improved marginally during the past decade but is far behind the targeted national goals. Addressing existing disparities requires attention to the role of social determinants of health in determining access to vaccination, particularly among young people, racial and ethnic minority populations, people who lack health insurance, and people with comorbidities.
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Affiliation(s)
- Tarang Parekh
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
- Center for Health Data Science and Analytics, Houston Methodist Hospital, 7550 Greenbriar Dr, Houston, TX 77030.
| | - Zulqarnain Javed
- Center for Health Data Science and Analytics, Houston Methodist Hospital, Houston, Texas
| | - Safi U Khan
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
| | - Hong Xue
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Khurram Nasir
- Center for Health Data Science and Analytics, Houston Methodist Hospital, Houston, Texas
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
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19
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Romate J, Rajkumar E, Gopi A, Abraham J, Rages J, Lakshmi R, Jesline J, Bhogle S. What Contributes to COVID-19 Vaccine Hesitancy? A Systematic Review of the Psychological Factors Associated with COVID-19 Vaccine Hesitancy. Vaccines (Basel) 2022; 10:vaccines10111777. [PMID: 36366286 PMCID: PMC9698528 DOI: 10.3390/vaccines10111777] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/06/2022] Open
Abstract
Vaccine hesitancy plays a crucial role in worldwide pandemic-control efforts. The multifaceted nature of vaccine hesitancy entails many psychological factors that are widely discussed in the literature, although few studies specifically compile these factors. Thus, this systematic review aims to synthesize the psychological factors contributing to vaccine hesitancy. As per the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines, a systematic search was conducted on electronic databases PubMed, Scopus, Science Direct, PsycNET, and Web of Science, and a manual search was conducted on Google Scholar. Out of the 2289 articles obtained, 79 studies that met the inclusion criteria were deemed eligible for the review. The findings highlight appraisals of the COVID-19 pandemic, vaccine safety and side effects, vaccine confidence/trust, trust in government and healthcare professionals, scepticism around vaccine production, conspiracy beliefs, emotions, and information and knowledge about the vaccine as the major psychological factors contributing to vaccine hesitancy. Concerningly, misinformation on COVID-19 vaccination spread through social media platforms, increasing vaccine hesitancy. Recommendations for government authorities, healthcare professionals, and implications for future research are also outlined.
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Affiliation(s)
- John Romate
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
| | - Eslavath Rajkumar
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
- Correspondence:
| | - Aswathy Gopi
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
| | - John Abraham
- St. John’s Medical College, St. John’s National Academy of Health Sciences, Bangalore 560034, India
| | - John Rages
- Government College of Teacher Education, Calicut 673004, India
| | - R. Lakshmi
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
| | - Joshy Jesline
- Department of Psychology, Central University of Karnataka, Kalaburagi 585367, India
| | - Sudha Bhogle
- Psychology & Head, Student Solutions, Eduquity Career Technologies, Bangalore 560095, India
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Gatwood J, Brookhart A, Kinney O, Hagemann T, Chiu CY, Ramachandran S, Hohmeier KC. Clinical Nudge Impact on Herpes Zoster Vaccine Series Completion in Pharmacies. Am J Prev Med 2022; 63:582-591. [PMID: 35705425 DOI: 10.1016/j.amepre.2022.04.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION A new recombinant herpes zoster vaccine has advanced efforts to prevent shingles, but its multidose regimen introduces potential barriers to full protection that must be managed by community pharmacies. To address this potential patient management challenge, a pharmacy records clinical support tool was implemented to assist pharmacy staff in managing herpes zoster vaccine dose completion. METHODS Beginning in November 2018, a large community pharmacy chain (operating in 36 states) implemented a provider nudge within its clinical decision support tool across all locations that fit seamlessly into the existing workflow, alerting the pharmacy staff of the need for a patient's second dose. Initial and second doses were followed over 2 overlapping, 10-month periods before and after system launch. Differences in vaccine completion rates before and after the system was operational were assessed by chi-square tests and predictors of completion, controlling for store- and patient-level characteristics, and were analyzed by multivariable logistic regression and generalized linear models throughout 2021. RESULTS Across 2,271 pharmacies, 71,459 and 41,982 initial doses of the herpes zoster vaccine were given in the baseline and intervention period, respectively. The proportion of patients completing both doses increased slightly after system implementation (before: 71.9%, after: 75.2%; p<0.0001). However, dramatic improvements in time to dose completion were observed (before: 109.8 days, after: 93.3 days; p<0.001), and changes were significant in stores in all but 4 states. CONCLUSIONS Results suggest that the use of a clinical nudge improved the occurrence of and time to herpes zoster vaccine dose completion in adults across the U.S.
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Affiliation(s)
- Justin Gatwood
- Department of Clinical and Translational Sciences, College of Pharmacy, The University of Tennessee Health Science Center, Nashville, Tennessee.
| | | | | | - Tracy Hagemann
- Department of Clinical and Translational Sciences, College of Pharmacy, The University of Tennessee Health Science Center, Nashville, Tennessee
| | - Chi-Yang Chiu
- Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee
| | - Sujith Ramachandran
- Department of Pharmacy Administration, School of Pharmacy, The University of Mississippi, Oxford, Mississippi
| | - Kenneth C Hohmeier
- Department of Clinical and Translational Sciences, College of Pharmacy, The University of Tennessee Health Science Center, Nashville, Tennessee
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Ngo VM, Zimmermann KF, Nguyen PV, Huynh TLD, Nguyen HH. How education and GDP drive the COVID-19 vaccination campaign. Arch Public Health 2022; 80:171. [PMID: 35850775 PMCID: PMC9289083 DOI: 10.1186/s13690-022-00924-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since vaccination is the decisive factor for controlling the COVID-19 pandemic, it is important to understand the process of vaccination success which is not well understood on a global level. The study is the first to judge the now completed "first wave" of the vaccination efforts. The analysis is very relevant for the understanding why and where the vaccination process observed got stuck by the end of 2021. METHODS Using data from 118 countries globally and weighted least squared and survival analysis, we identify a variety of factors playing crucial roles, including the availability of vaccines, pandemic pressures, economic strength measured by Gross Domestic Product (GDP), educational development, and political regimes. RESULTS Examining the speed of vaccinations across countries until the Fall of 2021 when the global process got stuck, we find that initially authoritarian countries are slow in the vaccination process, while education is most relevant for scaling up the campaign, and the economic strength of the economies drives them to higher vaccination rates. In comparison to North and Middle America, European and Asian countries vaccinated initially fast for 5% and 10% vaccination rate thresholds, but became rather slow reaching the 30% vaccination level and above. The findings are robust to various applied estimation methods and model specifications. CONCLUSIONS Democratic countries are much faster than authoritarian countries in their vaccination campaigns when controlling for other factors. This finding suggests that the quality of government and the political environment play a key role in popular support for government policies and programs. However, despite the early success of their vaccination campaigns, the democratic country group has been confronted with strong concerns of vaccine reluctance among their vast populations, indicating the two most potent variables explaining the speed of the COVID-19 vaccination campaign are education and economic conditions.
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Affiliation(s)
- Vu M Ngo
- University of Economics Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Global Labor Organization (GLO), Essen, Germany
| | - Klaus F Zimmermann
- Global Labor Organization (GLO), Essen, Germany.
- UNU-MERIT & Maastricht University, Maastricht, Netherlands.
- Centre for Economic Policy Research (CEPR), London, UK.
| | - Phuc V Nguyen
- Global Labor Organization (GLO), Essen, Germany
- Massey University, Palmerston North, New Zealand
| | - Toan L D Huynh
- University of Economics Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Global Labor Organization (GLO), Essen, Germany
| | - Huan H Nguyen
- University of Economics Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Global Labor Organization (GLO), Essen, Germany
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22
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Dai H, Barrington-Trimis JL, Unger JB, Baezconde-Garbanati L, Leventhal AM. Patterns and mediators of racial and ethnic disparities in COVID-19 vaccine hesitancy among young adults. Prev Med 2022; 159:107077. [PMID: 35526673 PMCID: PMC9072749 DOI: 10.1016/j.ypmed.2022.107077] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 04/19/2022] [Accepted: 05/02/2022] [Indexed: 11/25/2022]
Abstract
COVID-19 vaccines have been available for over a year, yet 26% of U.S. young adults remain unvaccinated. This study examines racial and ethnic disparities in young adult vaccine hesitancy and attitudes/beliefs that mediate disparities in vaccine hesitancy. Young adults (n = 2041;Mean[SD]:21.3[0.7] years-old) from a Los Angeles, CA, USA cohort were surveyed online in January-May 2021 and classified as vaccine hesitant (those who reported "Not at all likely"/"Not very likely" /"Slightly likely" to get vaccinated) versus non-hesitant (those who reported "Moderately likely"/"Very likely"/"Definitely likely" to get vaccinated or already vaccinated). Multivariable logistic regression was performed to examine racial/ethnic disparities in vaccine hesitancy. Factor analysis was conducted to create three subscales toward vaccination: positive, negative, and lack-of-access beliefs. Mediation analyses were performed to assess pathways from attitude/belief subscales to racial disparities in vaccine hesitancy. Overall 33.0% of respondents reported vaccine hesitancy. Black vs. White young adults had a higher prevalence of vaccine hesitancy (AOR[95%CI] = 4.3[2.4-7.8]), and Asians vs. Whites had a lower prevalence (AOR[95%CI] = 0.5[0.3-0.8]). Mediators explained 90% of the Black (vs. White) disparity in vaccine hesitancy, including significant indirect effects through positive belief-reducing (β = 0.23,p < .001) and negative belief-enhancing (β = 0.02,p = .04) effects. About 81% of the Asian (vs. White) disparity in vaccine hesitancy was explained by the three combined subscales, including significant positive belief-reducing (β = -0.18,p < .001) indirect effect. Substantial racial and ethnic disparities in young adult COVID-19 vaccine hesitancy were found, which were mediated by differences in attitudes and beliefs toward vaccination. Targeted education campaigns and messages are needed to promote equitable utilization of the effective vaccine.
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Affiliation(s)
- Hongying Dai
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4355, United States of America.
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 2001 N Soto Street, 302-C, Los Angeles, CA 90089, United States of America
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 2001 N Soto Street, 302-C, Los Angeles, CA 90089, United States of America
| | - Lourdes Baezconde-Garbanati
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 2001 N Soto Street, 302-C, Los Angeles, CA 90089, United States of America
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 2001 N Soto Street, 302-C, Los Angeles, CA 90089, United States of America
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23
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Nery N, Ticona JPA, Cardoso CW, Prates APPB, Vieira HCA, Salvador de Almeida A, Souza MMDS, Borba dos Reis O, Pellizzaro M, Portilho MM, Rosa da Anunciação R, Victoriano R, Oliveira dos Anjos R, Argibay HD, Carmo Lima DO, Mesquita IL, Conceição WM, Santana PM, Oliveira EC, Santana PSN, Brodskyn CI, Mothé Fraga DB, Solcà MDS, Reis MG, Costa F, Ribeiro GS. COVID-19 vaccine hesitancy and associated factors according to sex: A population-based survey in Salvador, Brazil. PLoS One 2022; 17:e0262649. [PMID: 35061811 PMCID: PMC8782400 DOI: 10.1371/journal.pone.0262649] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 01/03/2022] [Indexed: 11/19/2022] Open
Abstract
Vaccination is a major strategy to prevent the coronavirus disease 2019 (COVID-19). However, information about factors associated with men and women intention to be vaccinated are scarce. To determine COVID-19 vaccine acceptance and identify factors associated vaccine hesitancy according to sex, we performed a cross-sectional population-based random survey in Salvador, Brazil between Nov/2020-Jan/2021. Participants were interviewed to obtain data on intention to receive and pay for a COVID-19 vaccine, as well as on demographics, comorbidities, influenza vaccination history, previous diagnosis of COVID-19, and exposures and perception of COVID-19 risk. Among 2,521 participants, 2,053 (81.4%) reported willingness to use a COVID-19 vaccine and 468 (18.6%) hesitated to take it. Among those intending to get vaccinated, 1,400 (68.2%) would pay for the vaccine if necessary. Sex-stratified multivariable analysis found that men who were working and who had comorbidities were less likely to hesitate about using the vaccine. Among women, higher educational level and high perception of COVID-19 risk were associated with less vaccine hesitancy. In both groups, reporting influenza vaccination in 2020 reduced the chance of COVID-19 vaccine hesitancy. COVID-19 vaccine campaigns targeting to reduce vaccine hesitancy are urgently needed. These campaigns should consider gender differences in order to be successful.
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Affiliation(s)
- Nivison Nery
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | | | - Cristiane W. Cardoso
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Secretaria Municipal de Saúde de Salvador, Salvador, Brazil
| | | | | | | | | | | | - Maysa Pellizzaro
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | - Deborah Bittencourt Mothé Fraga
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia, Salvador, Brazil
| | - Manuela da Silva Solcà
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia, Salvador, Brazil
| | - Mitermayer Galvão Reis
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
- Yale School of Public Health, New Haven, CT, United States of America
| | - Federico Costa
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
- Yale School of Public Health, New Haven, CT, United States of America
| | - Guilherme S. Ribeiro
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
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24
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Demirci I, Haymana C, Salman S, Tasci I, Corapcioglu D, Kirik A, Yetkin İ, Altay M, Sabuncu T, Bayram F, Satman I, Sonmez A, TEMD Study Group. Rates and associates of influenza and pneumococcus vaccination in diabetes mellitus: A nationwide cross-sectional study (TEMD vaccination study). World J Diabetes 2021; 12:2107-2118. [PMID: 35047124 PMCID: PMC8696642 DOI: 10.4239/wjd.v12.i12.2107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/13/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Vaccination against influenza and pneumococcus is effective in reducing morbidity and mortality in patients with diabetes.
AIM To investigate the prevalence of influenza and pneumococcal vaccinations and to search for the independent associates of vaccination in Turkish patients with diabetes.
METHODS In this cross-sectional, nationwide, multicenter study, adult patients with type 1 diabetes (T1DM) (n = 454) and type 2 diabetes (T2DM) (n = 4721), who were under follow-up for at least a year in the outpatient clinics, were consecutively enrolled. Sociodemographic, clinical, and laboratory parameters of patients were recorded. Vaccination histories were documented according to the self-statements of the patients.
RESULTS Patients with T1DM and T2DM had similar vaccination rates for influenza (23.6% vs 21.2%; P = 0.240) and pneumococcus (8% vs 7%; P = 0.451) vaccinations. Longer diabetes duration and older age were the common independent associates of having vaccination for both types of diabetes patients. Higher education level, using statin treatment, and having optimal hemoglobin A1c levels were the common independent associates of influenza and pneumococcal vaccination in patients with T2DM.
CONCLUSION TEMD Vaccination Study shows that patients with T1DM and T2DM had very low influenza and pneumococcal vaccination rates in Turkey. The lower rates of vaccination in certain populations urges the necessity of nationwide vaccination strategies targeting these populations.
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Affiliation(s)
- Ibrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara 06190, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara 06190, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Liv Hospital, Istanbul 34000, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, University of Health Sciences, Gulhane Faculty of Medicine, Ankara 06018, Turkey
| | - Demet Corapcioglu
- Department of Endocrinology and Metabolism, Ankara University, Faculty of Medicine, Ankara 06560, Turkey
| | - Ali Kirik
- Department of Internal Medicine, Balıkesir University, Faculty of Medicine, Balikesir 10145, Turkey
| | - İlhan Yetkin
- Department of Endocrinology and Metabolism, Gazi University, Faculty of Medicine, Ankara 06190, Turkey
| | - Mustafa Altay
- Department of Endocrinology and Metabolism, Kecioren Training and Research Hospital, Ankara 06190, Turkey
| | - Tevfik Sabuncu
- Department of Endocrinology and Metabolism, Harran University, Faculty of Medicine, Sanliurfa 63050, Turkey
| | - Fahri Bayram
- Department of Endocrinology and Metabolism, Erciyes University, Faculty of Medicine, Kayseri 38000, Turkey
| | - Ilhan Satman
- Department of Endocrinology and Metabolism, Istanbul University, Faculty of Medicine, Istanbul 34000, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane Faculty of Medicine, Ankara 06190, Turkey
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Sanders-Jackson A, Gonzalez M, Adams RB, Rhodes N. Social determinants of flu vaccine uptake among racial/ethnic minorities in the United States. Prev Med Rep 2021; 24:101516. [PMID: 34976601 PMCID: PMC8683944 DOI: 10.1016/j.pmedr.2021.101516] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/06/2021] [Accepted: 08/08/2021] [Indexed: 12/25/2022] Open
Abstract
Research on the social determinants of vaccine uptake often occur between racial/ethnic groups and not within groups. Though minoritized individuals face inequalities across the board, these are also not evenly distributed amongst minoritized individuals within groups. Using the National Health Interview Survey data, we examined disparities in flu vaccine uptake across racial/ethnic groups in the United States (US). We examined (a) NH (non-Hispanic) White (n = 32,655), (b) NH Asian (n = 2335), (c) NH African American (n = 5137), and (d) Hispanic (n = 5718) respondents who lived in the United States using the combined 2017 and 2018. We used multivariable logistic regression to predict flu vaccination (yes/no) both in models comparing racial/ethnic groups and within groups. Less than 50% of any of the four major racial/ethnic groups in the US received a flu vaccination in 2017–18. Flu vaccine uptake varied within racial and ethnic groups. These results suggest that increasing vaccination may require a complex, multi-faceted perspective that considers subgroups more directly.
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Affiliation(s)
- Ashley Sanders-Jackson
- Dept. of Advertising and Public Relations, Michigan State University, 404 Wilson Road, East Lansing, MI 48823, USA
| | - Mariaelena Gonzalez
- Department of Public Health, University of California, Merced, 5200 Lake Road, Merced, CA 95343, USA.,Health Science Research Institute, University of California, Merced, 5200 Lake Road, Merced, CA 95343, USA
| | - Robyn B Adams
- Dept. of Advertising and Public Relations, Michigan State University, 404 Wilson Road, East Lansing, MI 48823, USA
| | - Nancy Rhodes
- Dept. of Advertising and Public Relations, Michigan State University, 404 Wilson Road, East Lansing, MI 48823, USA
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26
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Scherrer JF, Salas J, Wiemken TL, Hoft DF, Jacobs C, Morley JE. Impact of herpes zoster vaccination on incident dementia: A retrospective study in two patient cohorts. PLoS One 2021; 16:e0257405. [PMID: 34788293 PMCID: PMC8597989 DOI: 10.1371/journal.pone.0257405] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 08/31/2021] [Indexed: 12/31/2022] Open
Abstract
Background Herpes zoster (HZ) infection increases dementia risk, but it is not known if herpes zoster vaccination is associated with lower risk for dementia. We determined if HZ vaccination, compared to no HZ vaccination, is associated with lower risk for incident dementia. Methods and findings Data was obtained from Veterans Health Affairs (VHA) medical records (10/1/2008–9/30/2019) with replication in MarketScan® commercial and Medicare claims (1/1/2009-12/31/2018). Eligible patients were ≥65 years of age and free of dementia for two years prior to baseline (VHA n = 136,016; MarketScan n = 172,790). Two index periods (either start of 2011 or 2012) were defined, where patients either had or did not have a HZ vaccination. Confounding was controlled with propensity scores and inverse probability of treatment weighting. Competing risk (VHA) and Cox proportional hazard (MarketScan) models estimated the association between HZ vaccination and incident dementia in all patients and in age (65–69, 70–74, ≥75) and race (White, Black, Other) sub-groups. Sensitivity analysis measured the association between HZ vaccination and incident Alzheimer’s dementia (AD). HZ vaccination at index versus no HZ vaccination throughout follow-up. VHA patients mean age was 75.7 (SD±7.4) years, 4.0% were female, 91.2% white and 20.2% had HZ vaccination. MarketScan patients mean age was 69.9 (SD±5.7) years, 65.0% were female and 14.2% had HZ vaccination. In both cohorts, HZ vaccination compared with no vaccination, was significantly associated with lower dementia risk (VHA HR = 0.69; 95%CI: 0.67–0.72; MarketScan HR = 0.65; 95%CI:0.57–0.74). HZ vaccination was not related to dementia risk in MarketScan patients aged 65–69 years. No difference in HZ vaccination to dementia effects were found by race. HZ vaccination was associated with lower risk for AD. Conclusions HZ vaccination is associated with reduced risk of dementia. Vaccination may provide nonspecific neuroprotection by training the immune system to limit damaging inflammation, or specific neuroprotection that prevents viral cytopathic effects.
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Affiliation(s)
- Jeffrey F. Scherrer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States of America
- Harry S. Truman Veterans Administration Medical Center, Columbia, MO, United States of America
- The AHEAD Institute, Saint Louis University School of Medicine, St. Louis, MO, United States of America
- * E-mail:
| | - Joanne Salas
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States of America
- Harry S. Truman Veterans Administration Medical Center, Columbia, MO, United States of America
- The AHEAD Institute, Saint Louis University School of Medicine, St. Louis, MO, United States of America
| | - Timothy L. Wiemken
- The AHEAD Institute, Saint Louis University School of Medicine, St. Louis, MO, United States of America
- Department of Health and Clinical Outcomes Research, School of Medicine, Saint Louis University, Saint Louis, MO, United States of America
- Division of Infectious Diseases, Allergy, and Immunology, Department of Internal Medicine, Department of Medicine, School of Medicine, Saint Louis University, Saint Louis, MO, United States of America
- Saint Louis University Systems Infection Prevention Center, Center for Specialized Medicine, St. Louis, MO, United States of America
| | - Daniel F. Hoft
- Division of Infectious Diseases, Allergy, and Immunology, Department of Internal Medicine, Department of Medicine, School of Medicine, Saint Louis University, Saint Louis, MO, United States of America
- Saint Louis University Systems Infection Prevention Center, Center for Specialized Medicine, St. Louis, MO, United States of America
- Department of Molecular Microbiology & Immunology, Saint Louis University, Saint Louis, MO, United States of America
| | - Christine Jacobs
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States of America
- The AHEAD Institute, Saint Louis University School of Medicine, St. Louis, MO, United States of America
| | - John E. Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States of America
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27
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La EM, Garbinsky D, Hunter S, Poston S, Novy P, Ghaswalla P. National and State-Level Composite Completion of Recommended Vaccines Among Adolescents in the United States, 2015-2018. J Adolesc Health 2021; 69:762-768. [PMID: 34518068 DOI: 10.1016/j.jadohealth.2021.07.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/05/2021] [Accepted: 07/14/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Routine adolescent vaccination recommendations in the United States include tetanus, diphtheria, and acellular pertussis, quadrivalent meningococcal conjugate vaccine, and human papillomavirus vaccines. Although coverage for these individual vaccines is known, limited data are available on composite completion for all three vaccines. METHODS This cross-sectional analysis of pooled 2015-2018 National Immunization Survey-Teen data used logistic regression to estimate model-adjusted composite vaccination completion nationally and by state among United States adolescents aged 17 years. National Immunization Survey-Teen data were combined with state-level data to estimate a multilevel model identifying factors associated with composite vaccination completion. RESULTS The pooled model-adjusted composite vaccination completion was 30.6% (95% confidence interval [CI], 30.13%-31.04%) nationally, varying from 11.3% in Idaho (6.91%-17.95%) to 56.4% (49.81%-62.82%) in Rhode Island. Individual-level factors with the greatest impact on composite completion were having a provider's recommendation for human papillomavirus vaccination (odds ratio, 3.24; 95% CI, 2.76-3.80) and a check-up visit at age 16-17 years (odds ratio, 2.35; 95% CI, 1.80-3.07), with other individual-level factors associated with completion including being Medicaid insured, female, Hispanic, or non-Hispanic black. State-level quadrivalent meningococcal conjugate vaccination mandates were also associated with an increased likelihood of composite vaccination completion (odds ratio, 1.64; 95% CI, 1.16-2.33). CONCLUSIONS Fewer than one-third of 17-year-old individuals have completed all three recommended vaccines, with rates varying by state. Although this study identified implementable strategies to improve composite completion, additional research is needed to further understand factors associated with adolescent vaccination completion.
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Affiliation(s)
| | - Diana Garbinsky
- RTI Health Solutions, Research Triangle Park, North Carolina
| | - Shannon Hunter
- RTI Health Solutions, Research Triangle Park, North Carolina
| | - Sara Poston
- GlaxoSmithKline, Philadelphia, Pennsylvania.
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28
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Pan Y, Du L, Gan Q, Ma W, Wang M, Lu Z, Luo Y. Meta-analysis of whether influenza vaccination attenuates symptom severity in vaccinated influenza patients. Public Health Nurs 2021; 39:509-516. [PMID: 34614241 DOI: 10.1111/phn.12985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Influenza vaccination has been associated with decreased risk of influenza-related infections. However, associations between influenza vaccination and the severity of influenza cases have not been systematically summarized. We conducted a meta-analysis to evaluate whether influenza vaccination could attenuate symptom severity in vaccinated influenza patients. METHODS A systematic literature search was performed using the PubMed, Web of Science, EMBASE, and Scopus databases. A quantitative synthesis of the data was conducted using a fixed/random effects model in the meta-analysis. RESULTS A total of seven studies, involving 6342 vaccinated and 7036 non-vaccinated patients were included. Compared with non-vaccinated, vaccinated patients were significantly less likely to develop a fever (OR = 0.66, 95% CI: 0.43-0.89), be admitted to the ICU (OR = 0.79, 95% CI: 0.64-0.97), suffer mortality (OR = 0.55, 95% CI: 0.34-0.89), stay in the ICU (WMD = -1.37, 95% CI: -2.15 to -0.60) or stay in the hospital (WMD = -0.32, 95% CI: -0.61 to -0.04). CONCLUSION Those benefits that could be highlighted in the communication material to enhance the uptake of influenza vaccination among both the public health nurses and the community as a whole.
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Affiliation(s)
- Ye Pan
- Department of Infectious Disease, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, 362000, PR China
| | - Lijiang Du
- Department of Infection, Kunming Children's Hospital, Kun Ming, Yunnan, 224200, PR China
| | - Quan Gan
- Department of Infection, Kunming Children's Hospital, Kun Ming, Yunnan, 224200, PR China
| | - Wei Ma
- Department of Infection, Kunming Children's Hospital, Kun Ming, Yunnan, 224200, PR China
| | - Meifen Wang
- Department of Infection, Kunming Children's Hospital, Kun Ming, Yunnan, 224200, PR China
| | - Zhiying Lu
- Department of Infection, Kunming Children's Hospital, Kun Ming, Yunnan, 224200, PR China
| | - Yunjiao Luo
- Department of Infection, Kunming Children's Hospital, Kun Ming, Yunnan, 224200, PR China
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29
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Bhagianadh D, Arora K. COVID-19 Vaccine Hesitancy Among Community-Dwelling Older Adults: The Role of Information Sources. J Appl Gerontol 2021; 41:4-11. [PMID: 34365856 DOI: 10.1177/07334648211037507] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite high enthusiasm surrounding the rollout of the COVID-19 vaccine, some older adults continue to remain hesitant about its receipt. There is limited evidence on vaccine hesitancy among community-dwelling older adults. In this study, we examine the prevalence and predictors (particularly the role played by information sources) of vaccine hesitancy in this group. We use the Medicare Current Beneficiary Survey and employ multivariable logistic regression models to explore this. Relative to those relying on regular news, those depending on health care providers (HCPs), social media, other internet/webpages, and family/friends as the main information source on COVID-19 expressed higher negative vaccine intent. The high negative intent with HCPs as the main information source should be interpreted with caution. This could be reflective of the timing of the survey and changing attitude toward the vaccine among HCPs themselves.
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30
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Roller-Wirnsberger R, Lindner S, Kolosovski L, Platzer E, Dovjak P, Flick H, Tziraki C, Illario M. The role of health determinants in the influenza vaccination uptake among older adults (65+): a scope review. Aging Clin Exp Res 2021; 33:2123-2132. [PMID: 33587270 PMCID: PMC7882864 DOI: 10.1007/s40520-021-01793-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/11/2021] [Indexed: 02/06/2023]
Abstract
Background Although the burden of influenza infection is the highest in older adults, vaccination coverage remains low, despite this age group being more vulnerable than others. Aims Given the current pandemic of SARS-CoV-2, it was the aim of this scope review to update knowledge on factors affecting seasonal influenza vaccine uptake among older adults to strengthen prevention approaches in the context of an overall burden of infectious diseases. Methods We searched bibliographic databases from 2012 to 2019. All studies reviewed one or more social determinant of health listed by WHO, or factors affecting the decision-making process whether to accept influenza vaccine or not. Results Overall, 44 studies were included, 41 determinants were extracted and summarized into six categories. Older age and constitutional factors including multiple chronic diseases as well as preventive lifestyle and frequent routine healthcare utilization positively affected vaccination uptake (VU). Living and working conditions are also researched determinants of influenza vaccine uptake. A small number of studies explored the role of social inclusion and system-based interventions. Discussion and conclusions This scope review provides a comprehensive overview on factors affecting seasonal influenza vaccination uptake among older citizens. The review also clearly shows gaps for evidence on system-based level or political strategies to improve vaccination uptake. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01793-3.
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Bhugra P, Grandhi GR, Mszar R, Satish P, Singh R, Blaha M, Blankstein R, Virani SS, Cainzos-Achirica M, Nasir K. Determinants of Influenza Vaccine Uptake in Patients With Cardiovascular Disease and Strategies for Improvement. J Am Heart Assoc 2021; 10:e019671. [PMID: 34315229 PMCID: PMC8475658 DOI: 10.1161/jaha.120.019671] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Influenza infection is associated with an increased risk of cardiovascular events (myocardial infarction, stroke, and heart failure exacerbation) and mortality, and all‐cause mortality in patients with CVD. Infection with influenza leads to a systemic inflammatory and thrombogenic response in the host body, which further causes destabilization of atherosclerotic plaques. Influenza vaccination has been shown to be protective against cardiovascular and cerebrovascular events in several observational and prospective studies of at‐risk populations. Hence, many international guidelines recommend influenza vaccination for adults of all ages, especially for individuals with high‐risk conditions such as CVD. Despite these long‐standing recommendations, influenza vaccine uptake among US adults with CVD remains suboptimal. Specifically, vaccination uptake is strikingly low among patients aged <65 years, non‐Hispanic Black individuals, those without health insurance, and those with diminished access to healthcare services. Behavioral factors such as perceived vaccine efficacy, vaccine safety, and attitudes towards vaccination play an important role in vaccine acceptance at the individual and community levels. With the ongoing COVID‐19 pandemic, there is a potential threat of a concurrent epidemic with influenza. This would be devastating for vulnerable populations such as adults with CVD, further stressing the need for ensuring adequate influenza vaccination coverage. In this review, we describe a variety of strategies to improve the uptake of influenza vaccination in patients with CVD through improved understanding of key sociodemographic determinants and behaviors that are associated with vaccination, or the lack thereof. We further discuss the potential use of relevant strategies for COVID‐19 vaccine uptake among those with CVD.
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Affiliation(s)
| | | | - Reed Mszar
- Center for Outcomes Research and EvaluationYale New Haven Health New Haven CT
| | - Priyanka Satish
- Department of CardiologyHouston Methodist Hospital Houston TX
| | - Rahul Singh
- Department of Internal Medicine Houston Methodist Hospital Houston TX
| | - Michael Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Baltimore MD
| | - Ron Blankstein
- Cardiovascular Imaging Program, Cardiovascular Division and Department of Radiology Brigham and Women's Hospital Boston MA
| | - Salim S Virani
- Michael E. DeBakey Veterans Affairs Medical Center Houston TX.,Baylor College of Medicine Houston TX
| | - Miguel Cainzos-Achirica
- Division of Cardiovascular Prevention and Wellness Department of CardiologyHouston Methodist DeBakey Heart & Vascular Center Houston TX.,Center for Outcomes Research Yale University New Haven CT
| | - Khurram Nasir
- Division Health Equity & Disparities Research Center for Outcomes Research Houston Methodist Hospital Houston TX.,Division of Cardiovascular Prevention and Wellness Department of Cardiovascular MedicineHouston Methodist DeBakey Heart & Vascular Center Houston TX.,Center for Cardiovascular Computational & Precision Health (C3-PH) Department of Cardiovascular Medicine Houston Methodist DeBakey Heart & Vascular Center Houston TX.,Division of Cardiology Yale University New Haven CT
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Han AL. Factors associated with influenza vaccine coverage among patients with diabetes: Korea National Health and Nutrition Examination Survey 2016-2018. Int J Diabetes Dev Ctries 2021; 42:297-304. [PMID: 34334977 PMCID: PMC8313670 DOI: 10.1007/s13410-021-00977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 07/04/2021] [Indexed: 11/26/2022] Open
Abstract
Background Although the influenza vaccine has been proven to be effective, this common disease has high morbidity and mortality rates. Moreover, adults with diabetes are at a high risk of influenza-mediated morbidity and mortality. Purpose of the study With the increasing prevalence of diabetes, influenza is more lethal in diabetics; thus, we aimed to investigate the factors associated with influenza vaccination coverage in patients with diabetes. Methods Cross-sectional data were obtained from the Korea National Health and Nutrition Examination Survey (2016–2018). We retrospectively analyzed whether sociodemographic, health-related, and medical factors are associated with influenza vaccination coverage in patients with diabetes. We performed a complex sample logistic regression analysis and estimated the odds ratios (ORs) by adjusting for statistically significant factors. Results The number of survey subjects was 18,553. The vaccine coverage rate among patients with diabetes was 60.6%. In the univariate analysis, sex, educational level, smoking, exercise, drinking, marital status, private health insurance, activity limit, economic activity, age, and EuroQol-5 Dimension scores, which were used to assess health-related quality of life, were associated with vaccination coverage. In the multivariate analysis, only age and economic activity were associated with vaccination coverage. The vaccination coverage rate was higher for people who did not undertake economic activities and who were older (OR 1.512 (1.087–2.105), OR 2.212 (1.822–2.686), respectively, p < 0.001). Conclusion National interventions involving public health centers are necessary to encourage influenza immunization for patients with diabetes, especially younger patients and those who work or undertake economic activities.
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Affiliation(s)
- A. Lum Han
- Department of Family Medicine, Wonkwang University Hospital, Sinyong-dong 344-2, Iksan, Jeollabuk-do 54538 South Korea
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Karafillakis E, Francis MR, Paterson P, Larson HJ. Trust, emotions and risks: Pregnant women's perceptions, confidence and decision-making practices around maternal vaccination in France. Vaccine 2021; 39:4117-4125. [PMID: 34099326 DOI: 10.1016/j.vaccine.2021.05.096] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 12/24/2022]
Abstract
Maternal vaccination is an important strategy to reduce maternal and newborn mortality and morbidity. Yet, vaccination uptake is suboptimal in many countries, including France. This mixed-method study aimed to identify factors influencing maternal vaccination, exploring pregnant women's perceptions, confidence, and decision-making processes in France. Maternal vaccination uptake was positively associated with awareness of maternal vaccines, confidence in vaccine effectiveness and receiving a recommendation from a healthcare professional. A trusting relationship with healthcare professionals was observed as crucial for women during pregnancy. Even if women considered themselves as sole decision-makers, healthcare professionals' role in decision-making was viewed as substantial. Pregnancy can be a complex time for assessing risks, which was evident in the strong emotional reactions to maternal vaccination and anxieties about safety. As new maternal vaccines are developed, it is crucial to consider women's values, risk perceptions and emotions in the development of strategies to support acceptance of maternal vaccination.
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Affiliation(s)
- E Karafillakis
- Vaccine Confidence Project, Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, UK.
| | - M R Francis
- Vaccine Confidence Project, Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, UK
| | - P Paterson
- Vaccine Confidence Project, Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, UK
| | - H J Larson
- Vaccine Confidence Project, Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, UK
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Wang M, Li M, Dong X. The Associations Between Sociodemographic Characteristics and Trust in Physician With Immunization Service Use in U.S. Chinese Older Adults. Res Aging 2021; 44:164-173. [PMID: 33938299 DOI: 10.1177/01640275211011048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated sociodemographic factors for immunization care use and the relationship between trust in physician (TIP) and immunization service use in older Chinese Americans. Data were collected through the Population Study of Chinese Elderly, including survey information of 3,157 older adults in the Greater Chicago area. Regression results showed that the odds of getting vaccinated were higher for those who were older, female, and had higher education and income. After adjusting for the covariates, higher TIP was associated with greater immunization service use. The highest tertile of TIP was associated with higher odds of using immunization service (OR 2.19, 95% CI [1.76, 2.72]), especially for flu and pneumonia vaccines. Findings suggests that immunization service use may be increased by improving TIP and promoting targeted health care management plans for racial/ethnic minorities, which is highly relevant to increase the vaccination rate and contain the pandemic as the COVID-19 vaccine is available.
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Affiliation(s)
- Mengxiao Wang
- School of Public Administration, 12603Southwestern University of Finance and Economics, Chengdu, China
| | - Mengting Li
- Institute for Health, Health Care Policy and Aging Research, 242612Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.,School of Nursing, 242612Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, 242612Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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35
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Scherrer JF, Salas J, Wiemken TL, Jacobs C, Morley JE, Hoft DF. Lower Risk for Dementia Following Adult Tetanus, Diphtheria, and Pertussis (Tdap) Vaccination. J Gerontol A Biol Sci Med Sci 2021; 76:1436-1443. [PMID: 33856020 DOI: 10.1093/gerona/glab115] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Adult vaccinations may reduce risk for dementia. However, it has not been established whether tetanus, diphtheria, pertussis (Tdap) vaccination is associated with incident dementia. METHODS Hypotheses were tested in a Veterans Health Affairs (VHA) cohort and replicated in a MarketScan medical claims cohort. Patients were at least 65 years of age and free of dementia for 2 years prior to index date. Patients either had or did not have a Tdap vaccination by the start of either of the 2 index periods (2011 or 2012). Follow-up continued through 2018. Controls had no Tdap vaccination for the duration of follow-up. Confounding was controlled using entropy balancing. Competing risk (VHA) and Cox proportional hazard (MarketScan) models estimated the association between Tdap vaccination and incident dementia in all patients and age subgroups (65-69, 70-74, and ≥75 years). RESULTS VHA patients were, on average, 75.6 (SD ± 7.5) years of age, 4% female, and 91.2% were White. MarketScan patients were 69.8 (SD ± 5.6) years of age, on average and 65.4% were female. After controlling for confounding, patients with, compared to without, Tdap vaccination had a significantly lower risk for dementia in both cohorts (VHA: hazard ratio [HR] = 0.58; 95% confidence interval [CI]:0.54-0.63 and MarketScan: HR = 0.58; 95% CI:0.48-0.70). CONCLUSIONS Tdap vaccination was associated with a 42% lower dementia risk in 2 cohorts with different clinical and sociodemographic characteristics. Several vaccine types are linked to decreased dementia risk, suggesting that these associations are due to nonspecific effects on inflammation rather than vaccine-induced pathogen-specific protective effects.
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Affiliation(s)
- Jeffrey F Scherrer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, Missouri, USA.,Harry S. Truman Veterans Administration Medical Center, Columbia, Missouri, USA.,The AHEAD Institute, Saint Louis University School of Medicine, Missouri, USA
| | - Joanne Salas
- Department of Family and Community Medicine, Saint Louis University School of Medicine, Missouri, USA.,Harry S. Truman Veterans Administration Medical Center, Columbia, Missouri, USA.,The AHEAD Institute, Saint Louis University School of Medicine, Missouri, USA
| | - Timothy L Wiemken
- The AHEAD Institute, Saint Louis University School of Medicine, Missouri, USA.,Department of Health and Clinical Outcomes Research, Saint Louis University School of Medicine, Missouri, USA.,Division of Infectious Diseases, Allergy, and Immunology, Department of Internal Medicine, Saint Louis University School of Medicine, Missouri, USA.,Saint Louis University Systems Infection Prevention Center, Center for Specialized Medicine, Missouri, USA
| | - Christine Jacobs
- Department of Family and Community Medicine, Saint Louis University School of Medicine, Missouri, USA.,The AHEAD Institute, Saint Louis University School of Medicine, Missouri, USA
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, Missouri, USA
| | - Daniel F Hoft
- Division of Infectious Diseases, Allergy, and Immunology, Department of Internal Medicine, Saint Louis University School of Medicine, Missouri, USA.,Saint Louis University Systems Infection Prevention Center, Center for Specialized Medicine, Missouri, USA.,Departments of Internal Medicine and Molecular Microbiology and Immunology, Saint Louis University, Missouri, USA
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36
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La EM, Garbinsky D, Hunter S, Poston S, Novy P, Ghaswalla P. Meningococcal B vaccination coverage among older adolescents in the United States. Vaccine 2021; 39:2660-2667. [PMID: 33849722 DOI: 10.1016/j.vaccine.2021.03.071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/19/2021] [Accepted: 03/21/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Serogroup B meningococcal (MenB) vaccination recommendations for adolescents in the United States (US) include routine vaccination for all individuals at increased risk and vaccination for individuals not at increased risk aged 16-23 years (preferred age 16-18 years) based on shared clinical decision-making. The two licensed MenB vaccines require administration of ≥2 doses. METHODS This cross-sectional study analyzed 2017-2018 National Immunization Survey-Teen (NIS-Teen) data to evaluate ≥1 dose and ≥2 dose MenB vaccination coverage among adolescents aged 17 years. Multivariable logistic regression was used to further evaluate determinants of MenB vaccination. RESULTS Nationally, MenB vaccination coverage among 17-year-olds increased from 14.5% in 2017 to 17.2% in 2018 for ≥1 dose and from 6.3% to 8.4% for ≥2 doses. MenB vaccination coverage (2017-2018) was the lowest in the South (≥1 dose: 14.6%; ≥2 doses: 6.3%) and highest in the Northeast region (18.3% and 9.3%), with variation observed by census division. Adolescents were more likely to have received ≥1 dose of MenB vaccine if they had any Medicaid insurance (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.32-2.39) or had received human papillomavirus (OR, 1.94; 95% CI, 1.41-2.67) or meningococcal A, C, W, and Y (OR, 4.03; 95% CI, 2.92-5.56) vaccinations. CONCLUSIONS MenB first-dose coverage in the US is low, and even lower for a second dose, with regional variation. Being up to date with other routinely administered vaccines increased the likelihood of receiving MenB vaccination.
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Affiliation(s)
- Elizabeth M La
- RTI Health Solutions, 3040 E. Cornwallis Road, Research Triangle Park, NC 27709, USA.
| | - Diana Garbinsky
- RTI Health Solutions, 3040 E. Cornwallis Road, Research Triangle Park, NC 27709, USA.
| | - Shannon Hunter
- RTI Health Solutions, 3040 E. Cornwallis Road, Research Triangle Park, NC 27709, USA.
| | - Sara Poston
- GSK, 5 Crescent Drive, Philadelphia, PA 19112, USA.
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Frew PM, Schamel JT, Randall LA, King AR, Holloway IW, Burris K, Spaulding AC, HBOU Project Team. Identifying Missed Opportunities for Routine Vaccination among People Who Use Drugs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1447. [PMID: 33557231 PMCID: PMC7913920 DOI: 10.3390/ijerph18041447] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/28/2021] [Accepted: 01/30/2021] [Indexed: 01/08/2023]
Abstract
In the US, adult immunization coverage remains low, especially among vulnerable populations, as recent hepatitis A outbreaks have demonstrated. We studied the vaccination history variation among the US adults who use drugs by implementing a community-engaged research survey to identify reported immunization coverage, missed opportunities (MO), and places where immunizations might be delivered. Our analysis of a sample of 1127 participants recruited at community syringe exchanges in three cities identified higher overall vaccination receipt in Los Angeles compared to Atlanta or Las Vegas (e.g., HAV receipt 52.2% LA, 42.1% LV, 41.4% Atlanta). Overall, fewer participants reported having received HAV (45.9%), HBV (47.5%), or influenza (47.6%) vaccines than MMR (57.1%) or Td/Tdap (61.1%). Across sites, HAV receipt was higher for participants incarcerated ≥ 5 years (54.2% vs. 43.6% for those incarcerated < 5 years, 49.4% no incarceration history, p = 0.02). HBV receipt was higher among participants who were not intravenous drug users (56.1% vs. 46.0%, p = 0.03). Additionally, income >$20k predicted higher rates of MMR receipt (67.0% vs. 56.5%, p = 0.009), as did stable housing (62.8% vs. 54.3%, p = 0.01). To address the need to expand vaccine coverage among vulnerable adults, delivering vaccine at sites where persons who use drugs access services, or in correctional facilities, may be warranted.
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Affiliation(s)
- Paula M. Frew
- UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA; (P.M.F.); (J.T.S.); (L.A.R.); (A.R.K.); (K.B.)
| | - Jay T. Schamel
- UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA; (P.M.F.); (J.T.S.); (L.A.R.); (A.R.K.); (K.B.)
| | - Laura A. Randall
- UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA; (P.M.F.); (J.T.S.); (L.A.R.); (A.R.K.); (K.B.)
| | - Adrian R. King
- UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA; (P.M.F.); (J.T.S.); (L.A.R.); (A.R.K.); (K.B.)
| | - Ian W. Holloway
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA 90095, USA;
| | - Katherine Burris
- UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA; (P.M.F.); (J.T.S.); (L.A.R.); (A.R.K.); (K.B.)
| | - Anne C. Spaulding
- Department of Epidemiology, Emory University, Atlanta, GA 30322, USA
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Ko YM, Ko SH, Han K, Park YM, Choi JY, Kim SY, Song SH, Kim CH, Kim SK. Importance of Awareness and Treatment for Diabetes in Influenza Vaccination Coverage of Diabetic Patients under 65 Years: A Population-Based Study. Diabetes Metab J 2021; 45:55-66. [PMID: 32602274 PMCID: PMC7850874 DOI: 10.4093/dmj.2019.0189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/21/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Influenza is a global public health problem causing considerable morbidity and mortality. Although vaccination is the most effective way to prevent infection, vaccination coverage is insufficient in people with chronic disease under 65 years, especially diabetes. The purpose of this study was to evaluate influenza vaccination coverage and identify factors associated with influenza vaccination in Korean diabetic adults under 65 years. METHODS Data were obtained from 24,821 subjects in the Korea National Health and Nutrition Examination Survey (2014 to 2017). Socioeconomic, health-related, and diabetic factors were investigated for their relations with influenza vaccination in diabetic patients under 65 years using univariate and multivariate analyses. RESULTS Among 24,821 subjects, 1,185 were diabetic patients under 65 years and their influenza vaccination rate was 36.5%. Socioeconomic (older age, female gender, non-smoker, light alcohol drinker, lower educational level, and employed status), health-related factors (lower fasting glucose and glycosylated hemoglobin level, good self-perceived health status, more comorbidities, recent health screening, more outpatient visits, and diet therapy), and diabetic factors (more awareness and getting treated) were associated with influenza vaccination. In multivariate analysis, more awareness and getting treated for diabetes were associated with influenza vaccination in diabetic patients under 65 years (odds ratio, 1.496 and 1.413; 95% confidence interval, 1.022 to 2.188 and 1.018 to 2.054, respectively). CONCLUSION Influenza vaccination rate was low in diabetic patients under 65 years, especially in those with unawareness and not getting treated for diabetes. Active screening and treatment for diabetes may be helpful to improve the influenza vaccination rate in these patients.
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Affiliation(s)
- Yu Mi Ko
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Seung Hyun Ko
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Kyoungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Yong-Moon Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Joon Young Choi
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Shin Young Kim
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - So Hyang Song
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Chi Hong Kim
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Sung Kyoung Kim
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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Kaneko M, Aoki T, Goto R, Ozone S, Haruta J. Better Patient Experience is Associated with Better Vaccine Uptake in Older Adults: Multicentered Cross-sectional Study. J Gen Intern Med 2020; 35:3485-3491. [PMID: 32939665 PMCID: PMC7728885 DOI: 10.1007/s11606-020-06187-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Older adults' uptake of influenza and pneumococcus vaccines is insufficient worldwide. Although patient experience of primary care is associated with vaccine uptake in children, this relationship remains unclear for older adults. OBJECTIVE This study examined the association between patient experience of primary care and influenza/pneumococcal vaccine uptake in older adults. DESIGN AND METHODS We conducted a multicentered cross-sectional survey involving 25 primary care institutions in urban and rural areas in Japan. Participants were outpatients aged ≥ 65 years who visited one of the participating institutions within the 1-week study period. We assessed patient experience of primary care using the Japanese version of the Primary Care Assessment Tool (JPCAT), which includes six domains: first contact (accessibility), longitudinality (continuity of care), coordination, comprehensiveness (services available), comprehensiveness (services provided), and community orientation. We used a generalized linear mixed-effects model to adjust for clustering within institutions and individual covariates. KEY RESULTS One thousand participants were included in the analysis. After adjusting for clustering within institutions and other possible confounders, influenza and pneumococcal vaccine uptake was positively associated with JPCAT total scores (odds ratio per 1 standard deviation increase: 1.19, 95% confidence interval: 1.01-1.40 and odds ratio: 1.26, 95% confidence interval: 1.08-1.46, respectively). Of the JPCAT domains, coordination and community orientation were associated with influenza vaccine uptake and longitudinality, coordination, and comprehensiveness were associated with pneumococcal vaccine uptake. CONCLUSIONS Influenza and pneumococcal vaccine uptake were positively associated with patient experience of primary care in older adults. Consideration of patient experience, particularly longitudinality, coordination, comprehensiveness, and community orientation, could improve vaccine uptake.
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Affiliation(s)
- Makoto Kaneko
- Department of Family and Community Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
- Shizuoka Family Medicine Program, Shizuoka, Japan.
- Primary Care Research Unit, Graduate School of Health Data Science, Yokohama City University, Yokohama, Kanagawa, Japan.
| | - Takuya Aoki
- Division of Clinical Epidemiology, Jikei University School of Medicine, Tokyo, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryohei Goto
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Sachiko Ozone
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Junji Haruta
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
- Medical Education Center, School of Medicine, Keio University, Tokyo, Japan
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40
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Khatana SAM, Groeneveld PW. Health Disparities and the Coronavirus Disease 2019 (COVID-19) Pandemic in the USA. J Gen Intern Med 2020; 35:2431-2432. [PMID: 32462564 PMCID: PMC7251802 DOI: 10.1007/s11606-020-05916-w] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 05/06/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Sameed Ahmed M Khatana
- Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. .,The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
| | - Peter W Groeneveld
- The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.,Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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41
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Tian C, Wang H, Wang W, Luo X. Characteristics associated with influenza vaccination uptake among adults. J Public Health (Oxf) 2020; 41:e267-e273. [PMID: 30346577 DOI: 10.1093/pubmed/fdy189] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 09/12/2018] [Accepted: 10/04/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Annual influenza vaccination has been recommended for all adults since 2010. This study aimed to identify characteristics associated with influenza vaccination among adults. METHODS Data from the National Health Interview Survey from 2011 to 2016 were analyzed. RESULTS Influenza vaccination coverage among adults increased from 38.28% in 2011 to 44.75% in 2016 (1.50% per year on average). In multivariate analysis, the largest magnitude of association was found with pneumococcal vaccine (lowest and highest odds ratios from 2011 to 2016: 3.37-3.78), followed by physician visits ≥4 in the past 12 months (2.33-3.03), age ≥65 years (1.69-2.07), having a usual place for sick care (1.41-1.94), insurance coverage (1.52-1.79), hepatitis B vaccine (1.48-1.71), ratio of family income to the poverty threshold ≥4 (1.19-1.54), race of Asian (1.24-1.47), number of years on the job ≥21 (1.21-1.41), class of worker (Federal government: 1.23-1.32, State government: 1.15-1.38), high-risk conditions (1.13-1.26), physical activity ≥5 times/week (1.11-1.25) and being female (1.13-1.20). However, adults living in West, and adults of Black/African American, never married, high school education, self-employed and current smokers had lower vaccine uptake. CONCLUSIONS Several characteristics were identified to be associated with influenza vaccination uptake, which could be useful for targeted efforts to improve influenza vaccination coverage among adults.
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Affiliation(s)
- Changwei Tian
- Department of Infectious Disease Control, Kunshan Centers for Disease Control and Prevention, Kunshan, Jiangsu Province, China
| | - Hua Wang
- Department of Infectious Disease Control, Kunshan Centers for Disease Control and Prevention, Kunshan, Jiangsu Province, China
| | - Wenming Wang
- Department of Infectious Disease Control, Kunshan Centers for Disease Control and Prevention, Kunshan, Jiangsu Province, China
| | - Xiaoming Luo
- Department of Infectious Disease Control, Kunshan Centers for Disease Control and Prevention, Kunshan, Jiangsu Province, China.,Department of Public Health, Soochow University, Suzhou, China
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Seasonal influenza vaccination in older people: A systematic review and meta-analysis of the determining factors. PLoS One 2020; 15:e0234702. [PMID: 32555628 PMCID: PMC7302695 DOI: 10.1371/journal.pone.0234702] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/02/2020] [Indexed: 11/30/2022] Open
Abstract
Background/Objectives Despite influenza vaccination programs in various jurisdictions, seasonal influenza vaccine (SIV) uptake remains suboptimal among older people (≥65years old), an important subpopulation for influenza vaccination. We sought to summarize determinants of SIV uptake (any vaccine receipt) and vaccination adherence (receipt of vaccine in two or more seasons in sequence) among older people. Methods We searched for population-based studies conducted in community-dwelling older people (irrespective of their health status) from 2000–2019. Two reviewers independently selected publications for inclusion. One reviewer extracted data from the included studies; a second checked the extracted data for errors. Disagreements were resolved by discussion and consensus, or a third reviewer. We were interested in the determinants of SIV uptake and vaccination adherence. Where appropriate, we pooled adjusted results using the inverse variance, random-effects method and reported the odds ratios (OR) and their 95% confidence intervals (CI). Results Out of 11,570 citations screened, we included 34 cross-sectional studies. The following were associated with increased SIV uptake: being older (OR 1.52, 95%CI 1.38–1.67 [21 studies]), white (1.30, 1.14–1.49 [10 studies]), married (1.23, 1.17–1.28 [9 studies]), non-smoker (1.28, 1.11–1.47 [7 studies]), of a higher social class (1.20, 1.06–1.36 [2 studies]), having a higher education (1.12, 1.04–1.21 [14 studies]), having a higher household income (1.11, 1.05–1.18 [8 studies]), having a chronic illness (1.53, 1.44–1.63 [16 studies]), having poor self-assessed health (1.23, 1.02–1.40 [9 studies]), having a family doctor (2.94, 1.79–4.76 [2 studies]), and having health insurance (1.58, 1.13–2.21 [6 studies]). The influence of these factors varied across geographical regions. Being older (1.26, 1.11–1.44 [2 studies]) was also associated with increased vaccination adherence. Conclusions Several factors may determine SIV uptake and vaccination adherence among older people. More studies are needed to provide a stronger evidence base for planning more effective influenza vaccination programs.
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Thewjitcharoen Y, Butadej S, Malidaeng A, Yenseung N, Nakasatien S, Lekpittaya N, Kittipoom W, Krittiyawong S, Himathongkam T. Trends in influenza and pneumococcal vaccine coverage in Thai patients with type 2 diabetes mellitus 2010-2018: Experience from a tertiary diabetes center in Bangkok. J Clin Transl Endocrinol 2020; 20:100227. [PMID: 32395432 PMCID: PMC7212954 DOI: 10.1016/j.jcte.2020.100227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/28/2020] [Accepted: 05/07/2020] [Indexed: 12/17/2022] Open
Abstract
Trends in influenza and pneumococcal vaccine coverage in Thai patients with type 2 diabetes mellitus 2010-2018: Experience from a tertiary diabetes center in Bangkok. BACKGROUND Routine vaccination is an important part of preventive services in treating patients with type 2 diabetes (T2DM). There are no available data in temporal trends of vaccination coverage rates in both influenza and pneumococcal vaccines among Thai patients with T2DM. AIM This study aimed to elucidate influenza and pneumococcal vaccination trends and to identify factors that affect vaccination rates in those patients. METHOD A retrospective study of randomly medical records stratified by 13 diabetologists was conducted in patients with T2DM from 2010 to 2018 at Theptarin Hospital, a private multi-disciplinary diabetes center in Bangkok. Adherence to influenza and pneumococcal vaccinations according to current guidance on adult immunization in Thailand had been studied. The rate of both vaccinations from each diabetologist had also been recorded. RESULTS A total of 2114 medical records (female 51.7%, mean age 65.2 ± 12.8 years, BMI 26.5 ± 4.6 kg/m2, A1C 7.1 ± 1.3%, median duration of diabetes 13 years) were retrospectively reviewed covering a 9-year period. We audited 3554 selected outpatient visits for influenza and pneumococcal vaccinations rates as key performance index in each year. The overall vaccination rate was 39.6% for influenza, 17.4% for the pneumococcal vaccine, and only 13.7%, for both vaccines. The trends of influenza vaccination rates increased from 32.9% in 2010 to 52.2% in 2018 but the trends of pneumococcal vaccination rates were relatively stable at less than 20%. The rate of both vaccinations varied considerably from 0 to 44% among our diabetologists. Age ≥ 65 years, duration of DM ≥ 15 years, the presence of chronic respiratory disease, and moderate to severe Charlson Comorbidity Index (CCI) score were positively associated with both received vaccinations. CONCLUSIONS The completeness and timeliness of influenza and pneumococcal vaccinations were unsatisfactory in Thai patients with T2DM. More efforts are needed to increase both influenza and pneumococcal vaccination rates.
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Affiliation(s)
| | - Siriwan Butadej
- Diabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand
| | - Areeya Malidaeng
- Diabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand
| | - Nalin Yenseung
- Diabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand
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Abstract
Background: The community college student is not currently armed with the resources or prevention information regarding influenza. Less than twenty percent of the college population receives influenza immunization annually.Purpose: The purpose of the project was to evaluate if an evidenced-based influenza and vaccine education intervention will affect nursing students' intent to vaccinate for influenza by increasing knowledge of the influenza vaccine using Zingg and Siegrist's Knowledge Scale.Methods: Participants were recruited voluntarily from their attendance at orientation for incoming nursing students on a specific date and time. Utilizing a computer survey, all seventy-seven participants completed an online pretest before an educational intervention, and then, the results were compared following the educational intervention with a posttest. Parametric tests such as a paired t-test, Pearson's correlation coefficient, one-way analysis of variance (ANOVA), and percent change were utilized to determine whether an educational intervention was effective in improving influenza knowledge and whether there was a change in vaccination intention.Outcomes and Results: The educational intervention in this project resulted in enhancement of influenza knowledge. The implications of this project demonstrated the value of providing an educational intervention to improve knowledge, intent, and willingness to vaccinate for influenza for nursing students at a community college.
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Affiliation(s)
- Sharon Valentino
- Department of Nursing, Joliet Junior College, Joliet, Illinois, USA
| | - Louise Suit
- Loretto Heights School of Nursing, Regis University, Denver, Colorado, USA
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45
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Does self-rated health status influence receipt of an annual flu vaccination? Prev Med 2020; 131:105949. [PMID: 31805314 DOI: 10.1016/j.ypmed.2019.105949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/26/2019] [Accepted: 11/30/2019] [Indexed: 01/05/2023]
Abstract
Despite 79,400 deaths due to the influenza (flu) virus during the 2017-18 season, <50% of US adults receive an annual flu vaccination (AFV). Self-rated health status (SRH) is associated with health behavior utilization. The current study aims to determine if an association exists between an individual's SRH and their receipt of an AFV. In the 2017 US Behavioral Risk Factor Surveillance System survey, 39.1% of respondents had received a flu vaccination within the last 12 months. There was a statistically significant difference (p < 0.0001) between the vaccination rates of men (35.7%) and women (42.4%). There was a significant positive association between SRH and AFV for individuals who self-reported an SRH of either "Fair" (AOR 1.19; 95% CI 1.12-1.27) or "Poor" (AOR 1.24; 95% CI 1.14-1.35), compared to those reporting a status of "Excellent". For those reporting an SRH status of "Fair", there was a significant positive association for both men (AOR 1.20; 95% CI 1.10-1.32) and women (AOR 1.17; 95% CI 1.08-1.28). An association was also found for men (AOR 1.203; 95% CI 1.09-1.39) and women (AOR 1.23; 95% CI 1.09-1.399) who reported their SRH as "Poor". Only women showed a significant association (AOR 1.12; 95% CI 1.04-1.20) among those whose SRH was "Good". No association was found for individuals who reported SRH as "Very Good". These findings are of interest to health policy makers as they show there is still work required to convince individuals with a high SRH that they too need to receive an AFV.
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The association between history of screening for cancer and receipt of an annual flu vaccination: Are there reinforcing effects of prevention seeking? Am J Infect Control 2019; 47:1309-1313. [PMID: 31253553 DOI: 10.1016/j.ajic.2019.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/03/2019] [Accepted: 05/04/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Receipt of an annual flu vaccination (AFV) is a preventative health measure that reduces the risk of infection with the flu. Screening for cancer (SC) is another recommended preventative health measure. The current study hypothesizes that people who have previously obtained a cancer screening are motivated to receive other preventative health measures. METHODS Testing the association between a history of SC and receipt of an AFV used data from the 2016 Behavioral Risk Factor Surveillance System survey. The association was investigated using weighted and adjusted multivariable logistic regression models on multiple age-based groups chosen according to cancer screening recommendations. RESULTS The odds of individuals with a history of SC receiving an AFV were significantly greater in women screened for colorectal cancer, breast cancer, and colorectal cancer, and men screened for colorectal cancer, when compared with those without a history of SC after adjusting for confounders of interest. It is notable that no association was found between screening for cervical cancer and the receipt of AFV for women aged 30-65 years (odds ratio: 1.06; 95% confidence interval: 0.92, 1.21), and 50-65 years (odds ratio: 1.14; 95% confidence interval: 0.93, 1.40). CONCLUSIONS More research is necessary to understand why cervical cancer screenings are not associated with receipt of an AFV.
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Watson IW, Oancea SC. Does health plan type influence receipt of an annual influenza vaccination? J Epidemiol Community Health 2019; 74:57-63. [PMID: 31630119 DOI: 10.1136/jech-2019-212488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/28/2019] [Accepted: 09/28/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND The influenza virus caused 48.8 million people to fall ill and 79 400 deaths during the 2017-2018 influenza season, yet less than 50% of US adults receive an annual flu vaccination (AFV). Having health insurance coverage influences whether individuals receive an AFV. The current study aims to determine if an association exists between an individual's health plan type (HPT) and their receipt of an AFV. METHODS Data from the 2017 Behavioral Risk Factor Surveillance System and the optional 'Health Care Access' module were used for this study. The final study sample size was 35 684. Multivariable weighted and adjusted logistic regression models were conducted to investigate the association between HPT and AFV. RESULTS Medicare coverage was significantly associated with an increase in AFV for both men (adjusted OR (AOR) 1.62 (95% CI 1.28 to 2.06)) and women (AOR 1.28 (95% CI 1.00 to 1.53)). For men, other sources of coverage were also significantly positively associated with AFV (AOR 1.67 (95% CI 1.27 to 2.19)), while for women obtaining coverage on their own was significantly negatively associated with AFV (AOR 0.75 (95% CI 0.59 to 0.97)). CONCLUSION These findings are of interest to health policy makers as these show there are HPTs which are effective at improving vaccination rates. Adopting methods used by these HPTs could help the USA reach its Healthy People 2020 AFV coverage goal of 70%.
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Affiliation(s)
- Ian W Watson
- Population Health, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
| | - Sanda Cristina Oancea
- Population Health, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
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48
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Caffeine intake and the risk of recurrent kidney stones in adults, an analysis of 2007-2014 National Health and Nutrition Examination Surveys. Eur J Nutr 2019; 59:2683-2692. [PMID: 31637466 DOI: 10.1007/s00394-019-02115-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/11/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The association between caffeine intake and the risk of recurrent kidney stones is unknown. We examined the association between caffeine intake and the risk of recurrent kidney stones in adults. METHODS Individuals with history of passing at least one kidney stone were included from 2007 to 2014 National Health and Nutrition Examination Survey. Recurrent kidney stones were defined using a standard questionnaire and structured dietary recalls were used to determine caffeine intake. The weighted logistic regression was used to assess the association between caffeine intake and the risk of recurrent kidney stones, and the non-linear relationship was explored with restricted cubic splines. Caffeine and dietary confounders (minerals and vitamins) were adjusted for total energy intake with residual model. RESULTS The multivariate-adjusted odds ratios (95% confidence intervals) of recurrent kidney stones for per-quartile increment in caffeine intake were 1.15 (1.01-1.31) overall, 1.11 (0.96-1.29) for white race individuals, 1.33 (1.09-1.63) for non-white race individuals, 1.15 (0.97-1.36) for men, 1.24 (1.01-1.53) for women, 1.54 (1.08-2.19) for non-overweight individuals, 1.11 (0.97-1.28) for overweight/obese individuals, 1.13 (0.99-1.29) for caffeine from coffee, and 0.90 (0.79-1.03) for caffeine from non-coffee sources. A linear relationship was found between caffeine intake and the risk of recurrent kidney stones overall and in subgroup analyses. CONCLUSION Compared with those who reported passing only one kidney stone, caffeine intake was independently and linearly associated with a higher risk of recurrent kidney stones in adults, especially for women, individuals of non-white race and non-overweight subjects. The increased risk may arise from caffeine from coffee.
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Tan HY, Lai E, Kunasekaran M, Chughtai AA, Trent M, Poulos CJ, MacIntyre CR. Prevalence and predictors of influenza vaccination among residents of long-term care facilities. Vaccine 2019; 37:6329-6335. [PMID: 31526622 DOI: 10.1016/j.vaccine.2019.09.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/29/2019] [Accepted: 09/06/2019] [Indexed: 12/14/2022]
Abstract
Influenza is a respiratory illness which results in significant morbidity and mortality, especially in the older population. Older people living in Long-Term Care Facilities (LTCFs) have a significantly higher risk of infection and complications from influenza. Influenza vaccine is considered the best strategy to prevent infection in high-risk populations. In Australia, the Communicable Diseases Network Australia (CNDA) suggests a vaccination coverage rate of 95% in both staff and residents1. This study aims to measure the vaccination coverage rates for residents in LTCFs and identify predictors of vaccination uptake for these individuals. This study was conducted in nine LTCFs in four sites from March to September 2018. This was done via medical record reviews for residents over 65 years old in these LTCFs, collecting information such as vaccination status, age, gender, ethnicity and occupation. Simple and multivariable logistic regression was used to calculate the Odds Ratio (OR) to determine significant predictors of influenza vaccination uptake. The overall vaccination rate among LTCF residents was 83.6%. Significant predictors of vaccination were LTCF location, ethnicity and previous year vaccination status. Residents in LTCF Site D were less likely to be vaccinated compared to Site A (OR 0.11, 95% CI 0.02-0.61), non-Caucasians were less likely to get vaccinated (OR 0.09, 95% CI 0.01-0.67), and residents who refused the 2017 vaccine were less likely to be vaccinated (OR 0.04, 95% CI 0.01-0.15). Compared with previous Australian studies on LTCF vaccination rates, the overall vaccination rate was high in these LTCFs (83.6% versus 66-84%), but it varied across different sites. Reasons for varying vaccination rates should be explored further - for example, lower rates in non-Caucasians with diverse cultural backgrounds. Better understanding the causes of under-vaccination can help improve vaccination programs in LTCFs.
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Affiliation(s)
- Hao Yi Tan
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Elisa Lai
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Mohana Kunasekaran
- The Biosecurity Program, Kirby Institute, UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Abrar A Chughtai
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Mallory Trent
- The Biosecurity Program, Kirby Institute, UNSW Medicine, University of New South Wales, Sydney, Australia.
| | - Christopher J Poulos
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia; HammondCare, Sydney, Australia
| | - Chandini R MacIntyre
- The Biosecurity Program, Kirby Institute, UNSW Medicine, University of New South Wales, Sydney, Australia
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50
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Okoli GN, Abou-Setta AM, Neilson CJ, Chit A, Thommes E, Mahmud SM. Determinants of Seasonal Influenza Vaccine Uptake Among the Elderly in the United States: A Systematic Review and Meta-Analysis. Gerontol Geriatr Med 2019; 5:2333721419870345. [PMID: 31453267 PMCID: PMC6698992 DOI: 10.1177/2333721419870345] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/25/2019] [Accepted: 07/26/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Despite the availability of a universal influenza
vaccination program in the United States and Canada, seasonal influenza vaccine
(SIV) uptake among the elderly remains suboptimal. Understanding the factors
that determine SIV uptake in this important population subgroup is essential for
designing effective interventions to improve seasonal influenza vaccination
among the elderly. We evaluated the determinants of SIV uptake in the elderly in
the United States and Canada. Methods: We systematically searched
relevant bibliographic databases and websites from 2000 to 2017 for
population-based clinical trials or observational studies conducted in
community-based elderly individuals in the United States or Canada, irrespective
of health status. Two reviewers independently screened the identified citations
for eligibility using a two-stage sifting approach to review the title/abstract
and full-text article. We gathered data on determinants of uptake (any vaccine
receipt) and adherence (receipt of vaccine in more than one season) to seasonal
influenza vaccination. Where possible, we pooled the data using inverse variance
methods to minimize the variance of the weighted average. Results:
Five cross-sectional studies on SIV uptake (none on adherence) from the United
States met our eligibility criteria. Being older (pooled odds ratio [POR] =
1.44, 95% Confidence Interval [CI] = 1.11, 1.86); White (POR = 1.33, 95% CI =
[1.10, 1.64]); and having higher income (POR = 1.06, 95% CI = [1.04, 1.09]); and
health insurance (POR = 1.40, 95% CI = [1.25, 1.55]) were associated with
increased SIV uptake. Conclusion: Older, ethnically White, higher
income elderly individuals with access to health insurance coverage and a
regular health care provider have higher SIV uptake in the United States. There
was limited evidence for other socioeconomic and health-related determinants.
Further studies are needed to provide an evidence base for planning more
effective influenza vaccination programs in the United States.
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Affiliation(s)
- George N. Okoli
- University of Manitoba, Winnipeg,
Canada
- George N. Okoli, George & Fay Yee Centre
for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health
Sciences, University of Manitoba, 753 McDermot Avenue, Winnipeg, Manitoba,
Canada R3E 0T6.
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