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

Abstract

This study aimed at assessing the factors associated with vaccine uptake in a representative sample of community-dwelling Brazilian older adults, specifically focusing on differences in socioeconomic factors among the country regions. We conducted a cross-sectional, population-based study, using a probabilistic household sample in 2013. Individuals aged 60 years or more answered a structured questionnaire informing on vaccination status and sociodemographic and behavioral covariates. Associations between variables were evaluated using prevalence ratios estimated by Poisson regression models. The overall vaccination coverage (72.6%) in older adults ranked lower than the goal of 80% stipulated by the Brazilian health authority; vaccine uptake differed significantly among the country regions. The prevalence of vaccination was lower in black individuals in Brazil than that in their white counterparts. The prevalence of vaccine uptake was significantly associated with covariates on current life style, use of health care, and socioeconomic determinants. Compared with individuals with 0-3 years of education, more schooled individuals had higher prevalence of vaccine uptake in the North, Northeast, and South regions of the country. This study showed that there is room for increasing vaccination coverage among the elderly in Brazil. The knowledge previously obtained on factors significantly associated with vaccine uptake has not prevented them to continue influencing this outcome. The socioeconomic inequality in vaccination in some Brazilian regions reinforces the need of targeting the intervention toward the most vulnerable groups.

Influenza vaccination prevalence among the elderly and individuals with chronic disease, and factors affecting vaccination uptake

“…The most frequent reasons for the participants to not receive the influenza vaccine in our study were as follows: not knowing it was necessary to get an influenza vaccine, specifying that it was not necessary to have an influenza vaccine because they were healthy, and not being recommended the vaccine by a physician. Thus, in our study, the reasons for not receiving a vaccination were similar to those reported in the world literature (15,18,20,21). We think that increasing the knowledge level and awareness of the adult population about the risk groups and the efficiency and adverse effects of the vaccine will contribute to increasing vaccination rates.…”

“…The WHO and the European Union (EU) state that the minimum influenza vaccination target for adults is 75%. However, troubles in achieving the targeted vaccination rates are reported by health authorities (17)(18)(19). It was disclosed that the 75% target vaccination rate against influenza was reached in only two member states of the EU (the United Kingdom and the Netherlands) (19).…”

Cobertura vacinal e fatores associados à vacinação contra influenza em pessoas idosas do Município de São Paulo, Brasil: Estudo SABE 2015

“…Nationwide studies revealed a scenario in which vaccine coverage was lower among black Brazilians and those with less than 4 years of schooling in 2013 7 , and that the rates did not differ in 2015-2016 8 . Studies in the city of São Paulo showed that influenza vaccination was associated positively with older age, married/with partner marital status, chronic diseases, regular physical activity, and interaction with health services, especially public services, but that they did not differ between social strata 5,6 .…”

“…However, administrative data based on number of doses applied are known to be less accurate than data from vaccination surveys 4 . Nationwide and São Paulo city surveys show vaccine coverage rates of 70%-75% in 2006-2016 5,6,7,8 .…”

Cost-effectiveness of introducing national seasonal influenza vaccination for adults aged 60 years and above in mainland China: a modelling analysis

“…The World Health Assembly set a target of attaining vaccination coverage of 75% in this group by 2010 [3]. Most highincome countries and many upper middle-income countries, like Thailand and Brazil, have incorporated seasonal influenza vaccination for older adults into their National Immunization Program, which has significantly increased vaccination uptake [4][5][6].…”