Influenza vaccination in non-institutionalized elderly: a population-based study in a medium-sized city in Southern Brazil

Abstract

Vaccination is the most effective measure to prevent the complications of influenza. This population-based study aimed to estimate influenza vaccine coverage in non-institutionalized elderly, analyze the factors involved in lack of influenza vaccine uptake, and identify post-vaccination adverse effects. The study population lived in an urban neighborhood in Southern Brazil, and the sample consisted of 425 elderly. A total of 396 elderly individuals (age 60-95 years) were interviewed. Although 100% of the sample reported knowing about the vaccine, only 5.3% referred to their personal doctor as the source of information. Among elders that had not received the vaccine, 83.2% were explicit about not wanting to take it. The main reasons were fear of adverse effects and disbelief in the vaccine's effectiveness. However, the actual prevalence of adverse effects was low. Age, smoking, and lack of a doctor's appointment in the previous year were independently associated with vaccine non-compliance. The results show that improvements are needed in the immunization campaign, especially targeting elders less than 70 years of age and smokers.

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

“…The most prevalent motives for having not taken the vaccine reported here are consistent with previous studies. 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.…”

“…The expansion of health services and the decentralization process are also considered as factors that directly or indirectly contribute to an increased access to vaccination, thereby increasing the coverage. 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.…”

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

“…Other studies in Brazil have reported similar findings 9,10,11,12,13 , as have studies in other countries 23,24,25 . Previous studies attempted to associate this observation with better self-rated health in younger elderly 20,26 .…”

“…Lower vaccination coverage has been reported in younger elderly since the early years of the influenza vaccination campaign in various countries, confirming that the likelihood of being vaccinated increases with age 27,28,29 . Studies disagree on the association between vaccination and number of chronic diseases 9,10,11,12,13,30 . Contrary to the current study's results, other studies have failed to find an association between influenza vaccination and hypertension, diabetes, chronic lung disease, or cardiovascular disease 9 , or with the total number of chronic diseases 13 .…”

“…The city reached 70% coverage that year, decreasing in subsequent years (57.1% in 1999, 58. Several studies have shown a significant relationship between age, physical exercise, and comorbidities and influenza vaccine uptake 9,10,11,12,13,14 . However, given the variation in vaccination coverage between regions of Brazil, during each vaccination period studies on factors associated with vaccine uptake have become important tools for guiding interventions to expand coverage and improve protection for this population.…”