Predictors of flu vaccination among urban Hispanic children and adults

Columbia University School of Nursing, 630 West 168th Street, New York, NY 10032, USA.
Journal of epidemiology and community health (Impact Factor: 3.5). 09/2010; 66(3):204-9. DOI: 10.1136/jech.2009.099879
Source: PubMed


Flu vaccination is effective for preventing infection, but coverage levels in the USA remain low-especially among racial/ethnic minorities. This study examines factors associated with flu vaccination in a predominantly Hispanic community in Manhattan, New York.
Households were recruited during the 2006-2007 and 2007-2008 flu seasons. Primary household respondents were interviewed to determine knowledge of flu transmission/treatment and vaccination status and demographic information for all household members.
Vaccination coverage was 47.3% among children <5, 39.3% among 5-17-year-olds, 15.3% among 18-49-year-olds, 31.0% among 50-64-year-olds and 37.1% among adults ≥65 in year 1; and 53.1% among children <5, 43.6% among 5-17-year-olds, 19.5% among 18-49-year-olds, 34.1% among 50-64-year-olds and 34.3% among adults ≥65 in year 2. For children, younger age, having a chronic respiratory condition (eg, asthma), and greater primary respondent knowledge of flu were positively associated with vaccination. Among adults, female gender, older age, higher education, greater primary respondent knowledge of flu, having been born in the USA and having a chronic respiratory condition were positively associated with vaccination. The most common reasons cited for not being vaccinated were the beliefs that flu vaccination was unnecessary or ineffective.
Possible methods for increasing vaccination levels in urban Hispanic communities include improving health literacy, making low-cost vaccination available and encouraging providers to use other office visits as opportunities to mention vaccination to patients. REGISTRATION NUMBER: This study is registered at (NCT00448981).

Download full-text


Available from: Stephen S. Morse, Oct 14, 2015
10 Reads
  • Source
    • "With the exception of the maximum number of ship-to sites, a factor that was also associated with overall adult coverage [3], factors associated with coverage of children and of high-risk adults did not overlap. Additionally, factors not related to program decisions such as health-seeking behaviors and population characteristics were also associated with state-to-state variation, as would be expected given baseline variation in vaccination coverage for recommended vaccines [4] and the variety of factors associated with vaccinations, both for high-risk individuals [15] [17] [18] [33] and children [13] [14]. Table 3 Regression results for predicting the state level vaccination coverage for the high-risk adult population, United States, End of January 2010. "
    [Show abstract] [Hide abstract]
    ABSTRACT: During the 2009-2010 H1N1 pandemic, children and high-risk adults had priority for vaccination. Vaccine in short supply was allocated to states pro-rata by population, but vaccination rates as of January 2010 varied among states from 21.3% to 84.7% for children and 10.4% to 47.2% for high-risk adults. States had different campaign processes and decisions. To determine program and system factors associated with higher state pandemic vaccination coverage for children and high-risk adults during an emergency response with short supply of vaccine. Regression analysis of factors predicting state-specific H1N1 vaccination coverage in children and high-risk adults, including state campaign information, demographics, preventive or health-seeking behavior, preparedness funding, providers, state characteristics, and surveillance data. Our modeling explained variation in state-specific vaccination coverage with an adjusted R-squared of 0.82 for children and 0.78 for high-risk adults. We found that coverage of children was positively associated with programs focusing on school clinics and with a larger proportion of doses administered in public sites; negatively with the proportion of children in the population, and the proportion not visiting a doctor because of cost. The coverage for high-risk adults was positively associated with shipments of vaccine to "general access" locations, including pharmacy and retail, with the percentage of women with a Pap smear within the past 3 years and with past seasonal influenza vaccination. It was negatively associated with the expansion of vaccination to the general public by December 4, 2009. For children and high-risk adults, coverage was positively associated with the maximum number of ship-to-sites and negatively associated with the proportion of medically underserved population. Findings suggest that distribution and system decisions such as vaccination venues and providers targeted can positively impact vaccination rates for children and high-risk adults. Additionally, existing health infrastructure, health-seeking behaviors, and access affected coverage.
    Vaccine 11/2013; 32(2). DOI:10.1016/j.vaccine.2013.11.018 · 3.62 Impact Factor
  • Journal of epidemiology and community health 03/2012; 66(3):193. DOI:10.1136/jech-2012-201040 · 3.50 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To assess influenza vaccination coverage and timeliness among children requiring two doses in a season. Methods: This study examined seasonal influenza vaccination of 17,800 children from five academically-affiliated clinics in New York City using hospital and city immunization registries. Eligible children were 6 months-8 years and needed two influenza vaccine doses in a given season between 2004-05 and 2009-10. Any (≥ 1 dose) and full (2 doses) vaccination coverage by December 15 and March 31 as well as interval between doses were calculated. Vaccination trends over time, determinants, and missed opportunities were assessed. Results: Children were primarily Latino and publicly insured. Full coverage by March 31 increased between the 2004-05 and 2009-10 seasons (9% vs. 29%, p<0.001). Few children received both doses by December 15 (2-13%). The interval between doses was almost twice as long as recommended and increased over time (2004-05: 52 days; 2009-10: 64 days; p<0.001). Older age and Latino ethnicity were negative predictors of full vaccination by March 31. Missed opportunities for the second dose were common. Conclusion: Despite improvements, low-income, minority children requiring two influenza vaccine doses remain at risk of incomplete and delayed vaccination. Barriers to and strategies for timely full vaccination should be explored.
    Preventive Medicine 12/2012; 56(3-4). DOI:10.1016/j.ypmed.2012.11.018 · 3.09 Impact Factor
Show more