In 2000, Ontario, Canada introduced a universal influenza immunization program (UIIP) to provide free vaccines to its residents, whose ages are six months or older. The current study sought to measure the effect of the UIIP on influenza vaccination uptake in Ontario compared with other provinces combined. Data from the 2007/2008 Canadian Community Health Survey (cycle 4.1) were used in the analyses. Logistic regression analyses were conducted to estimate the odds ratios for influenza vaccination 2007/2008 associated with province of residence (Ontario versus other provinces combined) and other factors including chronic disease status, age, gender, household income, smoking status, having a medical doctor, and self-perceived health status. Living in Ontario was positively associated with having an influenza vaccine during the 2007/2008 season [odds ratio (OR) 1.50, 95% confidence interval (CI) 1.45-1.55]. Increased age (OR 6.13, 95% CI 5.77-6.51), a positive chronic disease status (OR 1.70, 95% CI 1.63-1.77) and having a regular medical doctor (OR 1.95, 95% CI 1.85-2.07) also demonstrated a positive relationship with influenza vaccination in 2007/2008. A stratified analysis by province of residence suggested that having a chronic disease, old age and high income had less impact on the likelihood of receiving a vaccine in Ontario than other provinces. The results of this study may help to inform the development of strategies to increase vaccination coverage in Canada.
[Show abstract][Hide abstract] ABSTRACT: Background
Immunization offers the best protection from influenza infection. Little evidence describes disparities in immunization uptake among low-income individuals. Higher rates of chronic disease put this population at increased risk of influenza-related complications. This analysis examines if the type of main source of household income in low-income groups affects influenza immunization uptake. We hypothesized that individuals on social assistance have less access to immunization compared to those with employment earnings or seniors’ benefits.
Data was obtained from the Canadian Community Health Survey annual component 2009-2010. A total of 10,373 low-income respondents (<20,000$ Canadian per annum) were included. Logistic regression, stratified according to type of provincial publicly funded immunization program, was used to examine the association between influenza immunization (in the last 12 months) and main source of household income (employment earnings; social assistance as a combination of employment insurance or worker’s compensation or welfare; or seniors’ benefits).
Overall, 32.5% of respondents reported receiving influenza immunization. In multivariable analysis of universal publicly funded influenza immunization programs, those reporting social assistance (AOR 1.24, 95% CI 1.02-1.51) or seniors’ benefits (AOR 1.56, 95% CI 1.23-1.98) were more likely to be immunized compared to those reporting employment earnings. Similar results were observed for high-risk programs.
Among the low-income sample, overall influenza immunization coverage is low. Those receiving social assistance or seniors’ benefits may have been targeted due to higher rates of chronic disease. Programs reaching the workforce may be important to attain broader coverage. However, CCHS data was collected during the H1N1 pandemic influenza, thus results may not be generalizable to influenza immunization in non-pandemic years.
BMC Public Health 07/2014; 14(1):740. DOI:10.1186/1471-2458-14-740 · 2.26 Impact Factor
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