Comparison of the Use of H1N1 and seasonal influenza vaccinations between veterans and non-veterans in the United States, 2010

Abstract

BackgroundVeterans of the U.S. armed forces tend to be older and have more chronic health problems than the general adult population, which may place them at greater risk of complications from influenza. Despite Centers for Disease Control and Prevention (CDC) recommendations, seasonal influenza vaccination rates for the general adult population remain well below the national goal of 80%. Achieving this goal would be facilitated by a clearer understanding of which factors influence vaccination.MethodsUsing the 2010 U.S. National Health Interview Survey (NHIS), this study estimates models of two types of vaccinations (H1N1 and seasonal flu), assesses if the correlates differ for these vaccinations, and analyses the distribution of the correlates by veteran status.ResultsVeterans, women, non-Hispanic whites, non-smokers, those at high risk, educated, with health insurance, and who use clinics as a usual source of care were more likely to receive both types of vaccinations. Those who were older, married, and with higher income were more likely to get vaccinated for seasonal flu, but not for H1N1. Age and number of children living in the household were found to have different effects for H1N1 compared to seasonal flu.ConclusionVeterans are more likely to get vaccinated for seasonal influenza and H1N1 compared to the general population. This might be due to Veterans having better access to care or Veterans participating in better health care practices. Future studies should examine potential differences in flu vaccination use among Veterans using Veterans Affairs (VA) health care system vs. non-VA users.

The association between influenza vaccination and socioeconomic status in high income countries varies by the measure used: a systematic review

“…All of the studies in this category used more than one measure to capture SES and reported inconsistent results on the association between influenza and SES. Seven studies used two measures [27, 31, 32, 34, 35, 38, 42] and five studies used three measures or a composite measure combining three or more measures of SES [43–47].…”

“…Of the studies that employed three measures of SES to separately capture the effects of education, income, and employment or class, four reported mixed positive and negative associations and two reported consistent associations. Among US adults, Der-Martirosian et al (2013) found that education level was positively associated with H1N1 and seasonal influenza vaccination, while income was only associated with seasonal influenza vaccination, and employment status was associated with neither [43]. In Leuven, Belgium, a survey of pregnant women in their third trimester found that only education was positively and significantly associated with vaccination [44].…”

“…One US study found a negative association, where pregnant Medicaid beneficiaries were less likely to receive an influenza vaccine [29]. Nine other US studies and one Irish study reported a positive association between having insurance and being vaccinated among children and youth [18, 22, 28, 39], adults [43], pregnant women [19, 30], healthcare personnel [37, 38], the elderly [26, 40], and mental health patients [17]. Overall, the literature seems to show that in countries without universal publicly-funded insurance, persons with private insurance were more likely to be vaccinated than persons receiving public insurance through social programs, and, those with public insurance were more likely to be vaccinated than those without any coverage.…”

“…In 2011, Fox and Shaw (2014) found that higher income was associated with higher levels of vaccination [21]. In 2010, Der-Martirosian et al (2013) found an association between higher income and vaccination, but reported an association with only some levels of education, and no association with employment status [43]. It is possible that the 2011 study would have found similar findings, putting into question the potential influence of “SES,” had they expanded their analysis.…”

COVID-19 Vaccine Hesitancy and Its Determinants Among Adults with a History of Tobacco or Marijuana Use

“…These seemingly controversial findings, together with misleading information on social media, may confuse the public, particularly smokers, thus may influence their acceptance of a COVID-19 vaccine. Nonetheless, evidence for other vaccines such as influenza suggests that smokers may be less likely than others to be vaccinated [17,18]. Accordingly, understanding which subgroups of smokers might be more or less likely to be vaccinated for COVID-19 would permit the development of more targeted interventions aimed at boosting vaccine uptake among users of tobacco and perhaps marijuana.…”