Association between health insurance coverage and uptake of seasonal influenza vaccine in Brazos County, Texas

Akpalu, Yao; Sullivan, Seth J.; Regan, Annette K.

doi:10.1016/j.vaccine.2020.01.029

Cited by 8 publications

(7 citation statements)

References 8 publications

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“…Against this backdrop, we examined sociodemographic factors that are associated with positive VC. Previous VC-related studies with diverse populations have suggested that social determinants of health such as educational attainment, 88 insurance status, 81 , 89 , 90 healthcare access, 91 employment status, 92 and income bracket 93 may be associated with the favorable VC and consequent immunization behavior in the larger population. Our findings are consistent with previous global studies that have identified populations who are housing- and/or food-insecure as less likely to have positive vaccination attitudes and to obtain immunization.…”

Section: Discussionmentioning

confidence: 99%

Vaccine confidence among people who use drugs: A cross-sectional survey

Frew

Schamel

Randall

et al. 2022

Human Vaccines & Immunotherapeutics

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Adult immunization coverage remains low in the US, particularly for people who use drugs (PWUD), a population that experiences a disproportionate burden of vaccine-preventable diseases. The extent of and characteristics associated with vaccine confidence (VC) held by PWUD is poorly understood. As VC strongly correlates with vaccine uptake, this cross-sectional study identifies mutable factors associated with VC and quantifies its relationship to immunization status within a highly vulnerable, underimmunized population of PWUD. Using a community-engaged research strategy with select partner organizations hosting syringe exchange programs in Atlanta, Los Angeles, and Las Vegas, USA, we surveyed participants ages 18–69 years served by these organizations from 2019 to 2020. Survey measures included sociodemographics, health behavior including immunization receipt, and vaccine confidence in adult vaccinations using a modified Emory Vaccine Confidence Index (EVCI). The findings reflect relatively low VC among the 1,127 recruited participants, with 56% expressing low VC (EVCI 0–12), 35% medium (EVCI 13–20) and 10% high (EVCI 21–24). EVCI varied by city, with lowest confidence in Atlanta and highest in Las Vegas. VC was associated with past receipt of specific vaccines, including hepatitis A, MMR, Tdap, and influenza. VC varied by specific sociodemographic correlates such as housing insecurity (reduced confidence) and receipt of public benefits or disability (increased confidence). This study identified correlates associated with VC based on site and sociodemographic characteristics for this priority population, highlighting the need for specific interventions to raise VC among PWUD, especially among those experiencing housing insecurity and without public benefits.

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Section: Discussionmentioning

confidence: 99%

Vaccine confidence among people who use drugs: A cross-sectional survey

Frew

Schamel

Randall

et al. 2022

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

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“…One third of the individuals reported enrolment in a health insurance (in the form of a Community-Based Health Insurance, CBHI). CBHI members may display an elevated valuation of preventive health care [ 41 ], which may explain the association with this augmented willingness to take the vaccine variable. Although we control for income, it could also be an asset effect driven by a positive link between household wealth and health insurance status.…”

Section: Discussionmentioning

confidence: 99%

Willingness to take COVID-19 vaccination in low-income countries: Evidence from Ethiopia

et al. 2022

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Background In low-income countries, vaccination campaigns are lagging, and evidence on vaccine acceptance, a crucial public health planning input, remains scant. This is the first study that reports willingness to take COVID-19 vaccines and its socio-demographic correlates in Ethiopia, Africa’s second most populous country. Methods The analysis is based on a nationally representative survey data of 2,317 households conducted in the informal economy in November 2020. It employs two logistic regression models where the two outcome variables are (i) a household head’s willingness to take a COVID-19 vaccine or not, and (ii) if yes if they would also hypothetically pay (an unspecified amount) for it or not. Predictors include age, gender, education, marital status, income category, health insurance coverage, sickness due to COVID-19, chronic illness, trust in government, prior participation in voluntary activities, urban residence. Results Willingness to take the vaccine was high (88%) and significantly associated with COVID-19 cases in the family, trust in government and pro-social behavior. All other predictors such as gender, education, income, health insurance, chronic illness, urban residence did not significantly predict vaccine willingness at the 5% level. Among those willing to take the vaccine, 33% also answered that they would hypothetically pay (an unspecified amount) for it, an answer that is significantly associated with trust in government, health insurance coverage and income. Conclusion The results highlight both opportunities and challenges. There is little evidence of vaccine hesitancy in Ethiopia among household heads operating in the informal economy. The role played by trust in government and pro-social behavior in motivating this outcome suggests that policy makers need to consider these factors in the planning of COVID-19 vaccine campaigns in order to foster vaccine uptake. At the same time, as the willingness to hypothetically pay for a COVID-19 vaccine seems to be small, fairly-priced vaccines along with financial support are also needed to ensure further uptake of COVID-19 vaccines.

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“… [46] Compared to private health insurance, public health insurance and no insurance were associated with worse access to care, less routine health visits, leading to lower influenza vaccination. [47] Given that racial/ethnic minorities, low-income, and low-education groups are less likely to have private insurance coverage, we can expect disparities in the general population to be more severe.…”

Section: Discussionmentioning

confidence: 99%