Poor adherence to influenza vaccination guidelines in spinal cord injury: results from a community-based survey in Switzerland.

Abstract

Cross-sectional survey. To evaluate the annual influenza vaccination coverage rate (IVCR) among community-dwelling individuals with spinal cord injury (SCI). SCI community in Switzerland. Participants were responders to the influenza vaccination question (n = 492) in the 2012 community survey of the Swiss Spinal Cord Injury (SwiSCI) cohort study. IVCR of SwiSCI participants were compared to the normative Swiss population, sampled in the Swiss Health Survey of 2012 using direct standardization, logistic regression standardization, and a genetic matching approach to control for differences in age, sex, and quarterly period of survey response. Individuals with SCI showed higher crude (26%, 95% confidence interval (CI): 22-30%) and age- and sex-standardized (24%, CI: 23-24%) IVCR than observed in the general population (15% CI, 14-15%). The adjustment for age and sex as well as quarterly period of survey response showed that the standardized IVCR of individuals with SCI (17%; CI: 12-23%) approached that of the general population. Low IVCR of about 10% were found among individuals with SCI younger than 45 years. IVCR were similar between men and women and between individuals with incomplete and complete paraplegia and tetraplegia. The IVCR in individuals with chronic SCI was not higher than in the general population and much lower than guidelines recommend. The improvement of the IVCR is an important target of health policy in SCI in Switzerland as to reduce the evidenced excess burden in respiratory-disease related morbidity and mortality.