Factors Associated to Vaccination against Influenza among Elderly in a Large Brazilian Metropolis

Abstract

BackgroundThis study aimed to estimate coverage and identify factors associated to vaccination against influenza in the elderly population.MethodsThe study design was cross-sectional and population based. Data was collected in 2010 by the Health, Well-Being and Aging Study. Sample consisted of 1,341 community-dwelling elderly, in São Paulo, Brazil. Association between vaccination and covariates was evaluated by means of prevalence ratios estimated by Poisson regression models.ResultsSelf-reported vaccination coverage was 74.2% (95% confidence interval: 71.3–76.9). Remaining physically active and having had recent interaction with health services, mainly with public units of healthcare, were the main incentives to increase vaccination coverage among the elderly; whereas lower age, living alone and absent interaction with health services were the main constraints to influenza vaccination at the community level. These covariates had already been reported to influence influenza vaccination of elders in previous years.ConclusionPrevious knowledge already available on the main constraints to influenza vaccination has not allowed to remove them. Influenza campaigns should be strengthened to increase vaccination coverage, especially in the group more reticent to vaccination. Instructing healthcare providers to recommend vaccine uptake is an important piece of this puzzle.

Correlates of influenza vaccine uptake among community-dwelling older adults in Brazil

“…27 Regarding the factors associated with vaccine uptake, several studies have shown that it is related to individual characteristics, 4,12,25,28,29 such as gender, 13,29 socioeconomic conditions, 4,25 and general health status. 4,12,13 The adjusted analysis confirmed the importance of current life style, use of health care, and socioeconomic determinants.…”

“…The role of current lifestyle in predicting vaccine uptake has been reported earlier 4,12,18 in studies highlighting a higher prevalence of vaccination among older adults who practice physical activities and who did not smoke and drink. These associations may be explained by the fact that these individuals are more committed to healthy behaviors and have more access to health care facilities.…”

“…These associations may be explained by the fact that these individuals are more committed to healthy behaviors and have more access to health care facilities. 12 Health literacy may have made them more likely to receive advice on vaccination.…”

“…In addition to reducing the risk of hospitalization and death, influenza vaccination may benefit older adults by preventing secondary complications (e.g., severe respiratory infections and cardiopulmonary disease). 9,10 Although factors related to vaccine uptake have been widely investigated, 4,[11][12][13] continuous research is needed to evaluate whether the knowledge previously acquired has impacted on subsequent vaccination campaigns or the factors that have been identified as constraints to vaccination still continue influencing this outcome. The Advisory Group of the World Health Organization for Influenza Vaccines stated that the policymaking process demands studies assessing how attitudes are shaped and identifying the factors that are related to the decision to vaccinate.…”

“…11 In Brazil, previous studies have reported evidence on vaccination coverage in specific sites [16][17][18] or in the biggest city of the country. 12,19 However, no previous study has reported information regarding either the national level or its macroregions. This study aimed at assessing the factors associated with vaccine uptake in a representative sample of community-dwelling Brazilian older adults and evaluating the differences in the uptake related to socioeconomic factors among the country regions.…”