Analysis of influenza vaccination coverage among the elderly living in Rome, based on a deprivation index, 2009-13

Drivers of and barriers to routine adult vaccination: A systematic literature review

“…Studies of select population groups and communities (terms to present results for these groups are derived from the original studies) generally found that immigrant populations, resident foreigners, and ethnic minority groups had lower vaccination uptake than native-born citizens or ethnic majority groups. 33 , 35 , 49 , 51 , 56 , 60 , 65 , 70 , 74 A series of four studies from Italy found that the percentage of “foreigners and stateless persons” residing in a census district was associated with lower influenza vaccine coverage among adults aged 65 or older. 51 , 56 , 60 , 65 A national-level study from Italy found that African immigrants (but not immigrants from Europe, Asia and Oceania, or America) had a lower influenza vaccine coverage ratio than Italian citizens.…”

“… 33 , 35 , 49 , 51 , 56 , 60 , 65 , 70 , 74 A series of four studies from Italy found that the percentage of “foreigners and stateless persons” residing in a census district was associated with lower influenza vaccine coverage among adults aged 65 or older. 51 , 56 , 60 , 65 A national-level study from Italy found that African immigrants (but not immigrants from Europe, Asia and Oceania, or America) had a lower influenza vaccine coverage ratio than Italian citizens. 35 Similarly, among adults aged 65 or older in Spain, the “foreigner” population was less likely than those of Spanish nationality to be vaccinated against influenza.…”

“… 33 , 37 , 38 , 47 , 50 , 72 , 78 In contrast, four studies found a negative relationship between higher levels of education and vaccination. 44 , 53 , 61 , 65 In South Korea, a high school or college-level education (vs. middle school) was negatively associated with influenza vaccination for individuals aged 50–64. 53 In Spain, lower levels of education (none vs. any primary, secondary, or university education) were positively associated with vaccination, 44 and in France, having a bachelor’s degree (but not a master’s or higher degree, and not a high school education) was positively associated with vaccine hesitancy (hesitancy was defined as refusal or delay of vaccination, or vaccination despite having doubts about efficacy).…”

“…40 , 41 , 53 , 73 Conversely, two studies conducted at a local level in Italy found a negative correlation between living in an area with an increasing unemployment rate and vaccination rates of individuals aged ≥65. 52 , 65 One study from Korea noted a negative association of vaccination with blue-collar vs. white-collar positions. 53 …”

“… 36 , 40 , 41 , 49 , 50 , 54–56 , 60 , 75 , 78 Seven studies found the opposite – that higher economic status was associated with decreased likelihood of vaccination. 32 , 38 , 39 , 44 , 51 , 52 , 65 One study analyzed data separately for men and women of different age groups (50–64 and ≥65) 53 and found that, among men aged 50–64, moderate-high (vs. low) family income had a statistically significant negative association with influenza vaccination. The results in women differed by age group, with moderate-high (vs. low) family income being negatively associated with influenza vaccination among women aged 50–64, but high family income (vs. low) having a positive association with vaccination among women aged ≥65.…”