Few studies have examined potential factors that contribute to low influenza vaccination rates among minority children. This study aimed to assess the prevalence of early childhood influenza vaccination among young black and Latino children, living in inner-city neighborhoods, and examine the effects of child, caregiver and health system factors. Secondary data analysis was performed using a survey about medical home experiences conducted from May 2007-June 2008. The study sample was limited to children ≥6 months in any influenza season prior to the 2006-2007 influenza season. Bivariate analyses and multivariable logistic regression tested associations between influenza vaccination receipt and socio-demographic and health system characteristics. One-third of children received an influenza vaccination by the end of 2006-2007 season, while only 11% received a vaccination within their first season of eligibility. Black children were more likely than Latino children to have been vaccinated (50% vs. 31%, P<0.01) during their first few eligible seasons. Children whose mothers were older, proficient in English, and frequent users of healthcare were more likely to obtain vaccination. Child attendance at healthcare settings with immunization reminder systems was also positively correlated with influenza vaccination. Our findings suggest that initial vaccination receipt among minority children from inner-city communities might be improved by expanded influenza promotion activities targeting younger mothers or those with limited English proficiency. Strategies to increase the frequency of child's actual contact with the medical home, such as reminder systems, may be useful in improving uptake of influenza vaccination among inner-city, minority children.
"Efficient and effective methods for vaccinating large numbers of children in primary care offices are essential. Previous research in this arena has been limited geographically to one or a few offices, to offices in a localized area [5-10], or to practices in three diverse U.S. counties . The purpose of this study was to describe influenza vaccination activities in 174 pediatric offices across the U.S. in a variety of settings and examine the relationships of office characteristics and those activities to influenza vaccination coverage and two-dose compliance. "
[Show abstract][Hide abstract] ABSTRACT: In the United States, influenza vaccination is recommended for all children 6 months and older; however, vaccination rates are below target levels. A broad sample of U.S. pediatric offices was assessed to determine factors that influence in-office influenza vaccination rates.
Offices (N = 174) were recruited to participate in an observational study over three influenza seasons (2008--2009, 2009--2010, 2010--2011). Only data from the first year of an office's participation in the study were used. Associations of coverage and 2-dose compliance rates with office characteristics and selected vaccination activities were examined using univariate regression analyses and linear regression analyses using office characteristics identified a priori and vaccination activities with P values <=0.10 in univariate analyses.
Influenza vaccination coverage for children 6 months to 18 years of age averaged 25.2% (range: 2.0%--69.1%) and 2-dose compliance for children <9 years of age averaged 53.4% (range: 5.4%--96.2%). Factors associated with increased coverage were non-rural site (P = 0.025), smaller office size (fewer than 5000 patients; P < 0.001), use of evening and weekend hours to offer influenza vaccine (P = 0.004), a longer vaccination period (P = 0.014), and a greater influenza vaccine coverage rate among office staff (P = 0.012). Increased 2-dose compliance was associated with smaller office size (P = 0.001) and using patient reminders (P = 0.012) and negatively related to use of electronic provider reminders to vaccinate (P = 0.003).
To maximize influenza vaccine coverage and compliance, offices could offer the vaccine during evening and weekend hours, extend the duration of vaccine availability, encourage staff vaccination, and remind patients that influenza vaccination is due. Additional efforts may be required in large offices and those in rural locations.
[Show abstract][Hide abstract] ABSTRACT: Cervical cancer is one of the most important disease burdens experienced by Vietnamese-American women. Human papillomavirus (HPV) is the etiological agent in almost all cases of cervical cancer. We surveyed Vietnamese-American women to determine receipt of HPV vaccine and assessed if limited English proficiency and knowledge related to HPV vaccine were associated with HPV vaccine uptake. Of the 113 Vietnamese-American women who participated in the study, 58 % (n = 68) was born in Vietnam. The mean years of residency in the United States was 12.75 years. Only 16 (14 %) reported receiving HPV vaccine and 11 (9 %) reported receiving all three shots. Thirteen women responded that they are not at all likely to receive HPV vaccine. Of the whole sample, 47 % (n = 53) reported proficiency in spoken and written English. English proficiency was significantly associated with receipt of HPV vaccine (OR = 4.4; confidence interval (95 % CI) = 1.2; 16.50; p = 0.03). Of the knowledge items, 70 % (n = 79) responded correctly that HPV increases the risk for cervical cancer. However, as many as 60 % responded incorrectly, that HPV infection can be cured with medication. The item, "People infected with HPV can be cured with medication," was the most important variable associated with receipt of HPV vaccine. Specifically, those with correct response were 3.8 times more likely to report receiving the HPV vaccine (OR = 3.8; 95 % CI = 1.1; 13.5; p = 0.04). Important public health needs are the development and evaluation of educational programs on HPV and cervical cancer that are designed for Vietnamese-American women.
Journal of Community Health 03/2013; 38(5). DOI:10.1007/s10900-013-9680-2 · 1.28 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Immunization is an important and cost-effective public health intervention to protect the population from illness. In Poland, in addition to free of charge vaccines, listed in the national program on immunization, self-paid vaccinations for pneumococcal, meningococcal, rotavirus, varicella, influenza infections and combination vaccines are recommended. The study objective was to measure the coverage and influencing determinants of self-paid vaccinations in 0-5-year-old children seen between June 2009 and January 2010 at 3 randomly selected GP practices located in one region in the south-western part of Poland. Parents of the children who were seen consecutively were invited to participate and complete questionnaires on socio-demographic data and other factors related to paid vaccination. The response rate: 93.3%. Among the 308 parents (18-50 years old, median 31 years) who agreed to participate, 77.9% (95%CI: 73.0-82.2%) had their child vaccinated with at least one paid vaccine. Combination vaccines were most commonly chosen (62.3%), followed by a pneumococcal (36.4%), influenza (14.7%), meningococcal (13.3%), and rotavirus (12.7%) vaccine. Most parents admitted that their decision was based on a healthcare worker's initiative informing them about the topic. The multi-variable regression model revealed that parent's factors: age≥25 years, high socio-economic status, having one child, and health system factor, i.e. practice location were each associated with greater odds of child immunization The high cost of a vaccine was associated with more than five times lower chance to immunize a child. Observed high coverage rate regarding self-paid vaccines among young children was influenced mostly by combination vaccines. As the cost of a vaccine was an important barrier for the immunization, the gradual introduction of some of currently self-paid vaccines in a national program would be of value. Future interventions on self-paid vaccination coverage should be more tailored, focusing especially on young parents with low income who have more than one child.
Marie Smithgall, Celibell Y. Vargas, Carrie Reed, Lyn Finelli, Philip LaRussa, Elaine Larson, Lisa Saiman, Melissa S Stockwell
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