Abstract
BackgroundFlu vaccination is recommended annually for high risk groups. However, in Ireland, free access to vaccination is not universal for those in high risk groups; the vaccine and consultation are only free for those with a medical card, a means tested scheme. Few private health insurance policies cover the cost of attendance for vaccination in general practice. The aim was to examine the influence of this reimbursement policy on vaccination coverage among older adults.MethodsCross-sectional wave 1 data from The Irish Longitudinal Study on Ageing (TILDA) were analysed (2009–2011). TILDA is a nationally representative prospective cohort study of adults aged ≥50, sampled using multistage stratified clustered sampling. Self-reported entitlement to healthcare was categorised as 1) medical card only 2) private health insurance only, 3) both and 4) neither. The outcome was responses to ‘have you ever had a flu shot’. Multivariate logistic regression was used, adjusting for age and need.Results68.6% of those defined as clinically high-risk received the flu vaccination in the past (95% CI = 67-71%). Those with a medical card were almost twice as likely to have been vaccinated, controlling for age and chronic illness (OR = 1.9, 95% CI = 1.5-2.5, p = <0.001).ConclusionsHaving a medical card increased the likelihood of being vaccinated, independent of age and need. The mismatch between vaccination guidelines and reimbursement policy is creating unequal access to recommended services among high risk groups.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1356-7) contains supplementary material, which is available to authorized users.
Highlights
Flu vaccination is recommended annually for high risk groups
We examined coverage among those in the ‘total high risk group’ recommended for vaccination according to guidelines from the Royal College of Physicians [12]: those aged ≥65 years, those with a longterm condition requiring follow-up, those classified as morbidly obese (≥40 kg/m2) and those in receipt of state-provided carers’ allowance
In terms of coverage for health services within the sample, 36.4% had a medical card only and 16.1% had both a medical card and private health insurance
Summary
Flu vaccination is recommended annually for high risk groups. Seasonal influenza (flu) vaccination is a cornerstone of preventive health care Older people and those with certain chronic conditions are considered a ‘high risk’ group as they are at increased risk of severe illness, hospitalisation or death if infected with influenza [1]. As in most other developed countries [10,11], in Ireland annual flu vaccination is recommended for older people (≥65 years), and those with underlying health conditions including chronic respiratory disease, chronic. Mc Hugh et al BMC Public Health (2015) 15:83 heart disease, diabetes and chronic liver disease Groups such as carers and those considered morbidly obese (≥40 kg/m2) are recommended to receive the vaccine in Ireland [12]. The vaccine is administered in a primary care setting by a General Practitioner (GP), by a practice nurse or, since 2011, in community pharmacies
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