Social determinants of health and seasonal influenza vaccination in adults ≥65 years: a systematic review of qualitative and quantitative data

Abstract

BackgroundVaccination against influenza is considered the most important public health intervention to prevent unnecessary hospitalizations and premature deaths related to influenza in the elderly, though there are significant inequities among global influenza vaccine resources, capacities, and policies. The objective of this study was to assess the social determinants of health preventing adults ≥65 years old from accessing and accepting seasonal influenza vaccination.MethodsA systematic search was performed in January 2011 using MEDLINE, ISI – Web of Science, PsycINFO, and CINAHL (1980–2011). Reference lists of articles were also examined. Selection criteria included qualitative and quantitative studies written in English that examined social determinants of and barriers against seasonal influenza vaccination among adults≥65 years. Two authors performed the quality assessment and data extraction. Thematic analysis was the main approach for joint synthesis, using identification and juxtaposition of themes associated with vaccination.ResultsOverall, 58 studies were analyzed. Structural social determinants such as age, gender, marital status, education, ethnicity, socio-economic status, social and cultural values, as well as intermediary determinants including housing-place of residence, behavioral beliefs, social influences, previous vaccine experiences, perceived susceptibility, sources of information, and perceived health status influenced seasonal influenza vaccination. Healthcare system related factors including accessibility, affordability, knowledge and attitudes about vaccination, and physicians’ advice were also important determinants of vaccination.ConclusionsOur results demonstrate that the ability of adults ≥65 years to receive seasonal influenza vaccine is influenced by structural, intermediate, and healthcare-related social determinants which have an impact at the health system, provider, and individual levels.

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

“…18,25 Moreover, our results concur with the concern that accessibility for older adults is not limited to free-of-cost access and includes several dimensions, such as the distance to the health care center, means of transport, and health literacy. 26 The success of vaccination campaigns in the country is supported by the credibility of the Brazilian National Immunization Program. This is recognized by the population due to its results in infant vaccination that led to control and eradication of several diseases.…”

“…12,36,37 Finally, as previously observed, 4,12,18,36-38 vaccine uptake was more prevalent among individuals with chronic diseases. According to the evidence, 26,36 having comorbidities may increase the severity of influenza, possibly making this group more motivated to seek vaccination. In addition, those affected by chronic diseases may have a more intense interaction with health services, which increases the likelihood of being appropriately informed of the beneficial effects of vaccination.…”

Fatores associados à adesão à vacinação anti-influenza em idosos não institucionalizados, São Paulo, Brasil

“…Individuals with chronic diseases may thus have more access to information on vaccination campaigns for the elderly and are more prone to come for vaccination. According to the literature, influenza vaccine uptake in the elderly is related to recommendation by health care professionals and ease of access to health services 10,30,31,34,35 . In Spain, Jiménes-García et al 36 identified higher influenza vaccination rates in elderly with chronic obstructive pulmonary disease who had consulted a physician in the previous year, due to the greater odds of receiving recommendations to be vaccinated.…”

Yaşlıda ruh sağlığını koruma-pozitif psikoloji ve müdahale yöntemleri

“…Bu amaç doğrultusunda, mutluluk ve iyi oluş kavramlarına ayrıca önem verilmektedir (3,4). Bu konularla ilgili pek çok çalışmaya zemin hazırlarken, aynı zamanda da elde edilen sonuçlara dayanarak ruh sağlığını korumaya yönelik çeşitli uygulamalar, müdahale yöntemleri geliştirilmektedir (5,6).Bu nedenle müdahale yaklaşımlarından önce mutluluk ve iyi-oluş kavramlarını açıklamakta yarar vardır.…”

“…Yapılan çalışmalara bakıldığında, mutluluk ve iyi oluş kavramlarının beraber kullanımının yaygın olduğu görülmektedir (3,4,13,14). Diener'in "İyi Oluş Modeli"nde kişinin mutluluğu; kendi hayatını, çevresini ve duygularını nasıl adlandırdığı ile açıklanmaktadır (14).…”