Influenza Vaccination Status in Korean Adult Population in Relation with Socioeconomic and Medical Factors

Abstract

Background: Influenza causes morbidity and mortality, resulting in the medical and socioeconomic costs. We aimed to analyse whether socioeconomic and medical factors may affect influenza vaccination status divided into 2 groups; one aged 19 to 64 years old and the other aged 65 or over who are eligible for free vaccination. Methods: The study included 1,412 individuals aged 19 and over who responded to influenza vaccination survey, based on 2013 National Health and Nutrition Examination Survey. Related factors were categorized into socioeconomic factors and medical factors. Univariate analyses were conducted to examine the correlations between vaccination rate and each variables. Multivariate analysis was obtained after adjusting variables which were statistcally significant. Results: Influenza vaccination rate was significantly different in the population aged 19 to 64 (24.9%) and the population aged 65 or over (80.5%). In the former population, high vaccination rate was associated with healthcare usage (odds ratio [OR]=1.37, 95% confidence interval [CI]=1.03-1.83), underlying chronic diseases (OR=2.21, 95% CI=1.43-3.40), and public assistance recipient households (OR＝2.21, 95% CI=1.03-4.78), while low vaccination rate was correlated with no use of medical check up (OR＝0.70, 95% CI=0.52-0.94) and heavy alcoholics (OR＝0.41, 95% CI=0.24-0.70). In the latter population aged 65 or over, high vaccination rate was associated with healthcare usage (OR＝1.82, 95% CI=1.28-2.59), and underlying malignancies (OR＝ 4.79, 95% CI=1.07-21.54), whereas low vaccination rate was associated with public assistance recipient households (OR＝0.33, 95% CI=0.14-0.76), and no use of medical check up (OR＝0.37, 95% CI=0.19-0.73). Conclusions: In the population below 65 years old, vaccination rate would be expected to rise by the recommendation of medical care providers and expanding the coverage of free vaccination. In elderly, individualized care for those who have less access to medical care and high susceptibility is highly recommended.

Factors affecting influenza vaccination in adults aged 50-64 years with high-risk chronic diseases in South Korea

“…14,19 However, the majority of studies, which included education level as a variable in multivariate analyses did not show significant correlations with influenza vaccination. 9,11,14,15,18,19 Income was not a significant factor for influenza vaccination in this study, and many other studies supported these findings based on inconsistent results. 9,11,15,16,18,19 However, Lee et al…”

“…Interestingly, many previous studies have also reported a positive association between increasing age and influenza vaccination uptake. 9,11,12,[14][15][16]18,19 In this study, a higher level of education was associated with a lower vaccination rate. This result was supported by previous studies in South Korea which showed similar results following bivariate analyses.…”

“…14 The region where the participants lived had no association with vaccination rates in our study, however, in two previous studies in South Korea, it was reported that rural areas had significantly higher vaccination rates than urban regions. 14,15 A potential reason for these differing results may be that previous studies included individuals aged ≥65 years in the study population who usually have different price sensitivity and accessibility to public health centres by region. Furthermore, nation-wide, free vaccination programmes were only provided in private health care centres after 2015, potentially causing biases between socioeconomic factors such as income and region.…”

“…9,11,12 However, studies from other Asian countries, including South Korea, Hong Kong and Singapore, showed higher vaccination rates in women than in men. [13][14][15][16] Husaini et al found that women used health care services more often than men and were also more likely to follow preventive healthcare recommendations. 17 Age was significantly associated with influenza vaccination in our bivariate analysis, but it was only significant in the non-high-risk group in our multivariate analysis.…”

“…We selected questions following a literature review for behavioural vaccination studies. 4,[13][14][15][16][18][19][20][21][22] Based on the healthbelief model and literature review, we identified seven factors that can also be defined as the model's independent variables 1) perceived susceptibility, 2) perceived severity, 3) perceived benefits, 4) perceived barriers, 5) cues to action, 6) socioeconomic factors and, 7) knowledge of vaccination ( Figure 2). 18,23 Each factor included two to five questions on knowledge, attitude (belief), and practice (KAP) experience.…”