Flu Immunization Research Articles

Abstract 16409: Prevalence of Annual Influenza (flu) Vaccination Among Young Adults (18-44 Years) With Cardiovascular Diseases: BRFSS 2018

Introduction: Influenza (flu) immunization is one of the major goals in Healthy People 2020 and recommended by AHA and ACC as secondary prophylaxis in a person with coronary and other cardiovascular diseases. However, little is known about flu vaccine coverage in young adults with cardiovascular disease (CVD). We aim to take a broader view by assessing the prevalence of flu vaccine by different CVDs among young adults in 2018. Methods: We included 117,978 young adults aged between age 18 to 44 years from BRFSS 2018 with information on the history of flu vaccination and CVD. Flu vaccination was defined as having a flu shot or a vaccine within the past 12 months. CVD was defined as having a history of either heart attack/myocardial infarction (MI), angina/congestive heart disease (CHD), or stroke. We used separate weighted univariate analyses to calculate prevalence for a different set of samples based on age groups (18-34 years, 35-44 years). Results: Overall flu vaccine rate in 2018 remained higher among adults aged 35-44 years compared to younger adults (18-34 years). The flu vaccination rate was comparatively lower among adults aged 35-44 with any CVD (26.7% vs. 28%) than those without any known CVD. In contrast, the vaccine rate was similar among younger adults aged 18-34 regardless of CVD history. Prevalence of flu vaccination was lower (19.5%) among adults aged 18-34 years with MI compared to those without MI (24.5%). Similarly, adults aged 35-44 years with MI reported lower flu vaccine prevalence (22.3% vs. 28.1%) compared to those without MI. Overall individuals with CHD reported higher vaccination rate than those without CHD. Stroke survivors aged 35-44 years reported significantly lower flu vaccine rate than those without stroke. In contrast, the rate was higher among younger stroke survivors (27.3% vs. 24.5%). Conclusions: There is a dire need to increase the annual flu vaccine rate among young adults with CVD to decrease overall morbidity and mortality.

How involvement of community pharmacies improves accessibility to and awareness about flu vaccination? – An example from Estonia

ABSTRACT Background In Estonia, seasonal influenza vaccination coverage is poor, being in recent years the lowest in the older age groups. In 2018 the flu vaccination was first provided at community pharmacies in Estonia. The aims of this study were to evaluate the experience of flu vaccination at community pharmacies by pharmacy customers and to learn about the perception of community pharmacists regarding the immunization service. Method Two cross-sectional surveys: among pharmacy customers after receiving flu vaccination (n = 257), and for pharmacy professionals (n = 209). Descriptive statistics were calculated in both studies. Results In the pharmacy customers` study, 54.9% received flu vaccination for the first time. Most of the respondents (96.8%) were satisfied with the quality of service. In both studies, community pharmacies were described as an accessible and convenient setting for immunization. Age and working experience of pharmacy professionals influenced the readiness to provide flu immunization, with younger pharmacists (<36 years) keener to be involved in vaccination services (p < 0.01). Expert Opinion Increasing influenza vaccination in high-risk patient groups is crucial. The involvement of other healthcare professionals, such as community pharmacists, could be key to reaching these patient groups and improving access to vaccination services in general. The development of the pharmacy profession has also shifted from pharmaceutical product based to patient oriented approach with provision of more clinical services. This enables to use professional competency of pharmacists in healthcare more widely. Lack of resources (financial, healthcare professionals, etc.) and an aging population are driving new ways to deliver healthcare more efficiently with the pharmacist working with other healthcare providers taking greater responsibility for patient health outcomes. Conclusion Vaccination service at community pharmacy has a great potential to expand flu immunization coverage in Estonia. Despite on pharmacy professionals are not allowed to provide vaccination service at the moment, their contribution to increase public awareness about flu vaccination is significant.

Flu Immunization Linked to Lower Alzheimer’s Risk

Back to table of contents Previous article Next article Clinical & ResearchFull AccessFlu Immunization Linked to Lower Alzheimer’s RiskTerri D'ArrigoTerri D'ArrigoSearch for more papers by this authorPublished Online:24 Sep 2020https://doi.org/10.1176/appi.pn.2020.9a6AbstractLower risk may be tied to averting inflammation caused by infection and chronic disease.Patients who receive at least one influenza immunization over the course of their lives may be less likely to develop Alzheimer’s disease compared with those who are never vaccinated, according to research presented at the virtual Alzheimer’s Association International Conference in July.“Getting vaccinated may keep the immune system in shape.” —Albert AmranAlbert Amran, a fourth-year medical student at McGovern Medical School at the University of Texas Health Science Center at Houston, and colleagues analyzed data from 9,600 electronic medical records drawn from more than 600 hospitals and clinics. They found that compared with patients who had never received an influenza immunization, men who received one influenza immunization had a 27% lower likelihood of developing Alzheimer’s disease, and women had a 22% lower likelihood of developing Alzheimer’s disease. The researchers also found that influenza immunization was associated with a 28% lower likelihood in patients with diabetes.Although the study was not designed to determine exactly how influenza immunization might lower risk, it may be that vaccination affects known risk factors for Alzheimer’s disease, such as chronic conditions that cause inflammation, Amran told Psychiatric News. This may be why vaccination appeared to lower Alzheimer’s risk in patients with diabetes, as diabetes is associated with inflammation, he added.“Inflammation in the brain is thought to be a key player in the development of Alzheimer’s disease. The amyloid plaques that are the hallmark of this disease can induce neuroinflammatory responses themselves, and a strong immune reaction to these plaques is thought to drive cellular death,” Amran explained. “Controlling risk factors that are related to inflammation throughout the body is currently one of the focuses of research on how to prevent Alzheimer’s disease.”Infections also cause inflammation, so avoiding the flu via immunization may help, Amran said.“As people get older, the immune system is less able to control infection, which is what we’re currently seeing in the [COVID-19] pandemic with the virus affecting older people more than younger people,” Amran said. “Getting vaccinated may keep the immune system in shape.”Amran said that further research is necessary, but in the meantime, patients should be counseled to get immunized.“Although we can’t say that preventing Alzheimer’s is another reason to get a flu shot, it certainly won’t increase the risk,” Amran said. “Patients who haven’t gotten flu shots before should get one this year anyway. It’s more important than ever because of the pandemic.” ■ ISSUES NewArchived

Seasonal flu, vaccinations and COVID-19

Seasonal flu, vaccinations and COVID-19

2019-20 influenza coverage among healthcare workers: how a Northern-Italian Region tackles hesitancy

Abstract Introduction WHO stresses the need to implement multi-component interventions to raise coverage among healthcare workers (HCWs). We investigated different HCWs influenza immunization programs within Friuli Venezia Giulia (FVG) Region hospitals (Italy) during 2019-20 flu season with the aim of identifying the most effective strategies to tackle hesitancy. Methods In December 2019 we collected from FVG hospitals: number of employed HCWs, vaccination strategies against flu and refusers management during 2019-20 flu season. We obtained data about HCWs flu vaccination coverage from the regional database; Chi-square test was used to find correlation between strategies and coverage. Results We collected data from 7/7 hospitals for a total of employed HCWs of 12,557 (average 1,794; range 467-3,922); 2 hospitals being academic centers and 2 research institutions. All hospitals promoted flu vaccination using emails, notice on hospital website and posters display; 3/7 organized training courses. Vaccination was always provided within the hospital in a dedicated easy and free access room; most hospitals (5/7) also offered ward on-site sessions, some allowing ward self-administration (3/7) or organizing on demand extra-sessions (2/7). No countermeasures were taken in case of refusal. Regional HCWs flu vaccination coverage resulted to be 24.9% (range 17-33.3). Multi-component intervention including passive and active offer, communication and education activities was confirmed to be significantly associated with higher HCWs flu coverage (OR 1.7; CI 1.6-1.9; p &amp;lt; 0.01), as well as being the hospital an academic center or a research institution (OR 1.3; CI 1.2-1.5; p &amp;lt; 0.01). Conclusions Different strategies to foster HCWs vaccination were adopted in FVG Region during 2019-20 flu season. The multi-component approach producing the best results should be further analyzed in order to identify the most effective recipe to be shared both nationally and internationally. Key messages Investigating the relation between HCWs flu immunization strategies and their effect is crucial to identify best practices. A multi-component approach including passive and active offer, communication and education activities seems the most effective way to tackle influenza vaccine hesitancy among HCWs.

Gender, Socioeconomic, and Health Characteristics Associated with Influenza Vaccination Coverage (VC) among Italian Healthcare Workers: Secondary Analysis of a National Cross-Sectional Survey.

Influenza epidemics pose a great overload over health-care facilities with an increase in the burden of disease for patients and healthcare costs. Despite a well-established amount of research in the area, vaccination rates show room for improvement and more research is needed in finding systematic interventions useful in improving healthcare workers (HCWs) vaccination coverage (VC). The purpose of this study was to describe the self-reported frequency of influenza immunization in HCWs and to identify demographic, socioeconomic, lifestyle, and health factors associated with this practice in Italy. Data about 5823 workers participating in the Italian national survey about health and healthcare services utilization are analyzed in the present study. Overall, 18.8% of HCWs reported being vaccinated against seasonal flu. In the multilevel regression, older workers had a higher likelihood of vaccine uptake (OR: 6.07; 95% CI 4.72–7.79), similar to those with chronic conditions or poor self-perceived health status (OR: 2.18 95% CI 1.17–4.09). On the other hand, the results highlighted a lower rate of VC in female HCWs (OR: 0.73 95% CI 0.61–0.86). Data confirm the low compliance towards flu immunization among Italian HCWs and highlight an important gap to be investigated in women.

Effect of depression on health behavior among myocardial infarction survivors in the United States.

IntroductionThe purpose of this study was to evaluate the effect of depression on health behavior among myocardial infarction (MI) survivors.MethodsThis retrospective, cross-sectional study used publicly available 2015 Behavioral Risk Factor Surveillance System (BRFSS) data. Our study sample includes adults aged 50 years or older who completed the 2015 BRFSS survey and reported having MI. The BRFSS participants with a yes response to the question, Has a doctor, nurse, or other health care professional ever told you that you had a heart attack, also called a myocardial infarction? were identified as MI survivors. The presence or absence of depression among MI survivors was identified using a similar question. Health behaviors, the dependent variable of this study, included physical activity, smoking status, alcohol use, body mass index, last flu immunization, last physical checkup, last blood cholesterol check, heavy drinking, and vegetable and fruit consumption. Univariate (χ2 tests) and multivariable (binomial logistic regression) analyses were used to assess the differences in health behaviors between MI survivors with or without depression.ResultsOur final study sample consists of 20 483 older adults with MI among whom 5343 (26.19%) reported having depression. Multivariable analyses reveal MI survivors with depression are more overweight, have less physical activity, and have higher likelihood of smoking but less odds of consuming alcohol compared to MI survivors without depression.DiscussionIn this nationally representative sample of adults aged over 50 years in the United States, MI survivors with depression exhibited poorer health behaviors compared to those without depression.

A Campaign to Improve Seasonal Influenza Immunization Compliance in a University Nursing Health and Wellness Clinic: A Case Study

Seasonal influenza can result in enormous physical and economic burdens. Healthy People 2020 report that substantially fewer than the recommended 70% in most age groups actually receive the immunization (Bekkat-Berkani &amp; Romano-Massotti, 2018). The purpose of this study was to ascertain whether the WTAMU Nursing Health and Wellness Clinic seasonal flu campaign was considered effective and advantageous to those who received it on campus. A brief survey was developed for distribution to those who received the influenza immunization during the 2018-2019 flu seasons. Making the flu vaccine convenient and inexpensive/free has been an effective mechanism to improve immunization acceptance in our community. Response rate for the survey was 61% or 106 individuals with 44%, reporting that they would not have sought out the seasonal flu immunization had it not been made available on the university campus. More importantly, when the 106 participants were asked where on campus they received their immunization, only 41% physically came to the nursing clinic, while 59% were provided the vaccine in their office or departmental workplace. Of those individuals receiving immunization in their office or workplace, 38% reported that had it not been provided in this setting, they would not have gone to the nursing clinic or elsewhere to be immunized. Of those responding to the survey, 61% reported having received an influenza immunization during the 2017-2018 seasons. The remaining 39% of respondents either could not recall or denied receiving the vaccine. However, when asked about their intentions to be immunized in the 2019-2020 season, 90% of the participants related positive intention to receive the seasonal flu immunization.

Influenza vaccination and absenteeism among healthy working adults: a cost-benefit analysis.

Seasonal influenza is a highly contagious infection that might lead to serious clinical complications and incurs a conspicuous socio-economic impact. Influenza vaccination is currently recommended only for specific groups of healthy adults (such as healthcare workers) even though it was demonstrated to be effective in reducing absenteeism and decreased workers' productivity during flu epidemic period. The main purpose of this study is to analyse the extent of absences due to illness following a voluntary flu immunization program among the Komatsu Italia Manufacturing company's personnel during the flu season 2017-2018. Secondly, we aimed at performing a cost-benefit analysis of the vaccination campaign from the company's perspective. This is an observational cohort study conducted during the period between the 14th week of 2017 and the 13th week of 2018 (from 03/04/2017 to 01/04/2018). The study population was the personnel of Komatsu Italia Manufacturing S.p.A. on duty during the study period. For each subject the following data were collected: sex, date of birth, professional profile, seasonal influenza immunization status and sick-leave days. Sick-leave days were compared among the influenza epidemic period and the previous one between vaccinated and unvaccinated and any difference in days of absence was considered to be caused by seasonal influenza. Out of 408 employees, 60 (14.7%) accepted the voluntary influenza vaccination. In multivariate analysis (logistic model) an age ≥ 50 years was the only predictor for vaccination acceptance (ORM 3.11 p<0.001). During the flu period, the monthly mean of sick-leave days per employee was significantly lower among the vaccinated than the unvaccinated, respectively of 0.328 days/person vs 0.752 days/person (p = 0.022). Unvaccinated employees reported a higher average of sick-leave days during the flu period compared to the previous non-influenza period (0.752 days/month/person vs 0.337 days/month/person p <0.001). The monthly mean cost for sickness absences per employee was significantly higher for an unvaccinated subject compared to one vaccinated, respectively € 129.00 and € 54.00 (p = 0.028). The overall net saving estimated was € 314.00 per person vaccinated. Influenza vaccination proved to be an extraordinary preventive tool and a cost-effective intervention. However, influenza immunization seems to be unappealing among healthy adults and higher flu vaccination coverages could be achieved through educational interventions possibly addressing young employees who showed little interest in vaccination. Finally, among health promotion interventions, companies should point out the importance of flu vaccination both for the individual wellbeing and the company environment.

ASSISTED LIVING IMMUNIZATION PROJECT

Influenza immunization rates in the United States hover around 60% for people 65 years of age and older. Healthy People 2020 set a target rate of 90% for flu immunization. The influenza vaccine can reduce disease and expense with approximately 7 million flu related diseases, 109,000 hospital admissions, and 8,000 deaths prevented. A local assisted living had an unusually low influenza immunization rate last year of 40%. The goal of the quality improvement project was to increase the rate of influenza immunizations in this facility. The rational was that by providing education, promoting the event, and increasing direct communication with families and residents through phone call and emails the rate would improve. A collaborative project was begun in the summer of 2018. Approval was received by IRB and the facility administrators. Plans were made for two presentations to family and residents, promotional advertisement, family communication, and a scheduled flu day with the pharmacy. The presentation provided flu history and facts and myths about the immunization. Correct answers were rewarded with bookmarks with flu information. The assisted living director provided follow-up immunization data. Compared to the previous year, the immunization rate increased to 90%, counting immunizations on flu shot day and records of outside immunizations. Data concerning flu incidence from the 2017-2018 and 2018-2019 seasons will be requested to determine project impact. A partnership between primary care providers and long term care facilities focused on improving standards or meeting metrics can enhance care for your patient and the community.

HEALTHCARE EXPERIENCES OF NHOPI AND OTHER U.S. ASIAN MEDICARE BENEFICIARIES

Native Hawaiians and Other Pacific Islanders (NHOPI) and Asians are the fastest-growing US racial and ethnic group. Differences in healthcare experiences may contribute to the better health outcomes of Asian-Only adults than NHOPIs, but little is known about NHOPI healthcare experiences. Using data from 1067 NHOPI and 9361 Asian-Only Medicare beneficiaries responding to the 2017 Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, we investigated NHOPI and Asian-Only differences in flu vaccination and six case-mix adjusted composite measures of healthcare experiences (scaled 0-100), with and without adjustment for Medicare coverage type and state of residence. Compared with Asian-Only beneficiaries, NHOPI beneficiaries reported better experiences getting needed care (adjusted-difference of +7 points), customer service (+5 points), doctor communication (+5 points), getting care quickly (+4 points), care coordination (+4 points), and getting needed prescription drugs (+3 points). In contrast, NHOPI beneficiaries reported worse flu immunization (-7 points; p<0.05 for all reported differences). Adjustment for Medicare Advantage (MA) coverage and state of residence accounted for <25% of differences. NHOPI vs. Asian-Only care experience differences were similar for MA and Fee-for-Service beneficiaries. NHOPI were immunized for influenza less often than Asian-Only beneficiaries in MA (-15 points), but not Fee-for-Service; this did not differ by gender. NHOPI men reported better experiences than Asian-Only men for customer service (+11 points) and getting care quickly (+6 points). Patient experience does not explain worse health outcomes found elsewhere for NHOPI than Asian-Only. Further study may suggest means of improving Asian-Only healthcare experiences and NHOPI immunization.

2009-2017 RACIAL AND ETHNIC DISPARITIES IN MEDICARE PATIENT EXPERIENCE AND INFLUENZA IMMUNIZATION

We sought to understand the extent to which racial and ethnic disparities in the immunization rates and case-mix adjusted patient experiences of access (getting needed care and getting care quickly) of Black, Hispanic, and non-Hispanic White Medicare beneficiaries have changed over time. Accordingly, we analyzed 2009-2017 CAHPS data from 2,725,614 Medicare beneficiaries. In 2009, flu immunization rates for Black and Hispanic beneficiaries were lower than non-Hispanic White beneficiaries by 17 and 14 percentage points, respectively. Over 9 years, these gaps were reduced to 12 and 8 points, respectively (p<.01 for all comparisons). In 2009, Black beneficiaries had 2-point and 5-point disparities on getting needed care and getting care quickly (on a 0-100 scale) respectively, relative to non-Hispanic Whites. For getting needed care, there was no significant change over time in the gap between Blacks and non-Hispanic Whites. For getting care quickly, the gap between Blacks and non-Hispanic Whites narrowed to 3 points in 2017. In 2009, Hispanic beneficiaries had 2-point and 5-point disparities on getting needed care and getting care quickly, respectively, compared to non-Hispanic Whites. The gap on getting needed care widened by 1 point to a 2017 disparity of 3 points. For getting care quickly, there was no significant change over time in the gap between Hispanics and non-Hispanic Whites. These findings suggest that flu immunization rates for Black and Hispanic Medicare beneficiaries have improved significantly relative to non-Hispanic Whites; however, substantial disparities remain. For the patient experience measures, the findings are more mixed.

Influence of commissioned provider type and deprivation score on uptake of the childhood flu immunization.

Since 2015/16 the UK seasonal influenza immunization programme has included children aged 5 and 6 years. In the South West of England school-based providers, GPs or community pharmacies were commissioned to deliver the vaccine depending on the locality. We aimed to assess variation in vaccine uptake in relation to the type of commissioned provider, and levels of socioeconomic deprivation. Data from the South West of England (2015-16 season) were analysed using multilevel logistic regression to assess variation in vaccine uptake by type of commissioned provider, allowing for clustering of children within delivery sites. Overall uptake in 5 and 6 year olds was 34.3% (37 555/109 404). Vaccine uptake was highest when commissioned through school-based programmes 50.2% (9983/19 867) and lowest when commissioned through pharmacies, 23.1% (4269/18 479). Delivery through schools resulted in less variation by site and equal uptake across age groups, in contrast to GP and pharmacy delivery for which uptake was lower among 6 year olds. Vaccine uptake decreased with increasing levels of deprivation across all types of commissioned provider. School-based programmes achieve the highest and most consistent rates of childhood influenza vaccination. Interventions are still needed to promote more equitable uptake of the childhood influenza vaccine.

PCV72 HEALTH BEHAVIORS AMONG MYOCARDIAL INFARCTION SURVIVORS IN THE UNITED STATES: A PROPENSITY SCORE MATCHED STUDY

The American College of Cardiology/American Heart Association (ACC/AHA) recommends health behavior for secondary prevention of myocardial infarction (MI). We compared health behaviors between MI survivors and propensity score matched non-MI controls. This study was a retrospective, cross-sectional, matched case-control study using publicly available Behavioral Risk Factor Surveillance System (BRFSS) 2015 data. The study included adults aged ≥ 50 years responding “yes” to the question, “has a doctor, nurse, or another health professional ever told you that you had a heart attack, also called a myocardial infarction?”. MI survivors were matched on propensity scores to non-MI controls (1:3) based on age, sex, race/ethnicity, and comorbidities using the greedy matching algorithm (8:1-digit match). Dependent variable (health behaviors) of this study consisted of physical activity, alcohol consumption, flu immunization, smoking status, body mass index (BMI), physical checkup, and fruits/vegetable consumption. Univariate (chi-squared test) and multivariable binomial logistic regression analyses were used to compare health behavior between MI survivors and propensity score matched non-MI controls. The final study sample consisted of 17,675 MI survivors and 53,025 non-MI controls after propensity score matching. Multivariable analyses of health behaviors comparing MI survivors and non-MI controls after propensity score matching revealed that MI survivors were more likely to have their cholesterol checked within the past 2 years compared to controls (AOR=1.37, 95% CI: 1.17-1.61). However, they were more likely to be current smokers (AOR=1.30, 95% CI: 1.15-1.47), less likely to have a physical checkup within the past 2 years (AOR=0.82, 95% CI: 0.69-0.96) and engage in physical activity of at least 150 minutes/week (AOR=0.87, 95% CI: 0.80-0.94). Based on this United States national-level survey, MI survivors exhibited poorer health behaviors compared to their propensity score matched non-MI controls. Despite ACC/AHA guidelines, health behaviors have continued to be suboptimal for secondary prevention of MI.

Flu vaccination among older persons: study of knowledge and practices

BackgroundSurveys of older adults’ knowledge relative to flu immunization have highlighted its relevance in the improvement of vaccination coverage. The purpose of this study was to estimate the proportion of older persons who have ever been immunized against seasonal flu in the municipality of Vračar (Belgrade, Serbia), assess their knowledge related to flu and flu vaccination, and to determine factors associated with flu immunization.MethodsIn the period November 2012–January 2013, 480 persons aged above 65 years were recruited at the Community Health Center, of which 354 persons were finally included in the study. Data were collected using a questionnaire. To assess the level of knowledge, correct answers were awarded 1 point. The total knowledge score ranged from 0 to 17 and was divided into three levels: poor (0–4 points), moderate (5–8 points), good (9–13 points), and excellent (14–17 points).ResultsThe proportion of ever vaccinated older persons was 47.7%. Of those, one third (29.1%) had been immunized regularly. Most seniors (61.9%) demonstrated good, whereas one third (29.8%) demonstrated excellent level of knowledge. In terms of reasons for non-compliance, the highest proportion of older persons declined vaccination because “they were in good health” (33.5%) and because “they did not believe that vaccine protects from flu” (31.5%). Independent predictors of being ever immunized against seasonal flu were having higher level of education, being more knowledgeable relative to flu vaccination, and taking more medications.ConclusionsOur results indicate that health care sector requires well-coordinated promotion campaigns to enhance acceptance of flu vaccination. Organized immunization counseling could provide accurate, evidence-based information in order to transform misbeliefs, prejudice, and negative attitude towards vaccination.

Forgotten, but not forgiven: facing immunization challenges in the 21st century

The creator of several vaccines given to children around the world everyday, Maurice Hilleman, advised that at the same time that new vaccines would emerge in the 21st century due to technological advances, unfounded criticisms of vaccines would extended beyond spurious belief systems to actual anti-vaccine movements. He pointed out that these movements are aimed at disruption of vaccine programmes through use of public media including the press, television and the Internet in his response to the spurious association between autism and Crohn's disease with one of his main creations, MMR vaccine (1). Andrew Wakefield, author of an unsound scientific paper in 1998 proposing such association, was motivated by an undue agreement to support a lawsuit (2). Nevertheless, Wakefield remains as an outstanding voice in the anti-vaccine movement (3).&#x0D; Why the once feared diseases disappeared from collective memory? On the other hand, adverse events following immunization that we used to bear as a fair risk for the expected benefit are not accepted anymore? Why we have forgotten the benefits, but not forgiven the risks? How could we define new strategies to face the challenges of immunization programmes?&#x0D; The 1976 swine flu immunization programme in United States was a landmark on the questioning of risk-benefit ratio for vaccines. The concern on a new pandemic flu after triggered a large mass vaccination campaign. Pandemic flu cases did not appear, but serious adverse events did raise questions on public opinion (4). This contrasted with most of the vaccines where decreasing incidence of a preventable diseases compared with safety concerns seems to be acceptable for the society. On the other hand, efficacious vaccines, like whole-cell pertussis vaccine (wP), have been also on the spot due to relevant adverse events after immunization...

An evaluation of the ‘protect their future’ video intervention on parents’ intentions to immunize adolescents

ABSTRACTBackground: This study tested the influence of the ‘Protect Their Future’ video intervention on adult intentions to vaccinate their adolescents.Method: The study included 529 parents of 11- to 19-year-old adolescents in Appalachian Kentucky enrolled in group randomized controlled trial arms at 14 health clinic and community sites (seven in each arm) across eight counties. Approximately half the parents (n = 263) were enrolled in the full intervention. Participants in the intervention and control did not significantly differ by education, race, percentage working full-time or gender.Results: Individuals in the intervention were 3.2 times more likely (P = .005) to intend for their female adolescent to receive HPV immunization. However, there was no support for the multivariate model for male HPV immunization. Inconsistent reasoned action findings for HPV, meningitis and flu intentions are also discussed.Conclusions: This study suggests the importance of immunization-specific information motivating parents embedded in a general ‘adolescent vaccination platform’ promotion video may be most supportive in immunization contexts where the descriptive norms are well established parents, as is currently the case for meningitis, flu and female HPV immunization rates. Implications for male HPV parental education needs are discussed.

ВЛИЯНИЕ ИММУНИЗАЦИИ ПРОТИВОГРИППОЗНОЙ ВАКЦИНОЙ НА ТЕЧЕНИЕ И ИСХОДЫ ВНЕБОЛЬНИЧНОЙ ПНЕВМОНИИ

The community-acquired pneumonia (CAP) is a very widespread disease and one of frequent causes of death. The stable relation of seasonal dynamics of indicators of a case rate of CAP with incidence of acute respiratory viral infection and flu becomes perceptible. One of the modern trends of decreasing the incidence and mortality at CAP is immunization with anti-influenza vaccines. Flu immunizations are included in the National calendar of preventive immunization of the Russian Federation. According to official data of the Ministry of Health of the Amur region, in 2015, 2016 and 2017 there were vaccinated 39.7%, 45.4% and 46.2% of population, respectively. CAP case rate in the group immunized with anti-influenza vaccine and in the group not immunized were analyzed. The decrease of the case rate of CAP in patients immunized from flu by 2.4 times in comparison with the people who were not vaccinated from flu was revealed. Against the background of mass vaccination against flu there was a change of clinical implications of CAP: the number of people with mild forms of illness enlarged. Lethality decreased: from 179 immunized people only one patient died, whereas from 393 not immunized people 28 patients had a lethal outcome. The case rate of CAP in people of the senior age groups decreased from 32.2% in 2009-2014 till 21.7% in 2015, from 17.8% in 2016 till 15.9% in 2017. Thus, immunization against flu is followed by an essential decrease of indicators of a case rate of CAP, relief of a disease and improvement of a disease outcome.

PCV26 - Health Behaviors Among Stroke Survivors In The United States: A Propensity Score Matched Study

The American Heart Association/American Stroke Association (AHA/ASA) has specific recommendation for secondary stroke prevention. The aim of this study was to compare health behaviors engagement between stroke survivors and non-stroke matched controls. We conducted a retrospective, cross-sectional, matched case-control study using data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) survey. We included older adults (age ≥ 50 years) who participated and completed interviews in 2015 BRFSS survey. We identified stroke survivors if they responded “yes” to the question: “Has a doctor, nurse, or other health professional ever told you that you had stroke?”. We generated propensity scores based on age, gender, race/ethnicity, and presence of co-occurring chronic conditions. Each stroke survivor was matched to three non-stroke controls using greedy matching algorithm with 8 to 1 digit matching. Stroke survivors were compared with controls on their physical activity, smoking; alcohol use, body mass index (BMI), last flu immunization, last physical check-up, last blood cholesterol check, heavy drinking, vegetable and fruit consumption. We used binomial logistic regression to assess association of health behaviors among stroke survivors compared to controls. The final study sample consisted of 13,249 stroke survivors and 39,747 non-stroke controls after propensity score matching. Multivariable analyses revealed that stroke survivors had poor health behaviors in terms of BMI (Adjusted Odds Ratio (AOR): 0.78; 95%Confidence Interval (CI) 0.70-0.86; p<.0001), physical activity (AOR: 0.78; 95%CI 0.71-0.86; p<.0001), smoking status (AOR: 1.51; 95%CI 1.32-1.73; p <.0001), vegetable (AOR: 0.8; 95%CI 0.72-0.89; p<.0001) and fruit (AOR, 0.86; 95%CI 0.78-0.95; p<.0001) consumption but had lower likelihood of alcohol consumption (AOR, 0.86; 95%CI 0.78-0.95; p<.0001) compared to controls. In this nationally representative sample of older adults in US, stroke survivors exhibited poorer health behavior engagement compared to matched controls underscoring the need of developing appropriate interventions for secondary stroke prevention.

Health Behaviors among Stroke Survivors in the United States: A Propensity Score-Matched Study

The American Heart Association/American Stroke Association has specific recommendations for secondary stroke prevention. The aim of this study was to compare health behaviors engagement between stroke survivors and propensity score-matched controls. We conducted a retrospective, cross-sectional, matched case-control study using data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) survey. We included older adults aged 50 or older who participated in the 2015 BRFSS survey and completed the interview. Each case was matched to 3 controls (1:3) based on propensity scores to increase the power of the analyses. Stroke survivors were compared with controls on their physical activity, smoking, alcohol use, body mass index (BMI), last flu immunization, last physical checkup, last blood cholesterol check, heavy drinking, and vegetable and fruit consumption. We used binomial logistic regression to assess health behaviors among stroke survivors compared with controls. The final study sample consisted of 13,249 stroke survivors and 39,747 controls without stroke after propensity score matching. Multivariable analyses revealed that there were significant differences between stroke survivors and matched controls in terms of BMI, physical activity, smoking status, alcohol consumption, and vegetable and fruit consumption. For example, stroke survivors were 51% more likely to be smokers (adjusted odds ratio [AOR] 1.51, 95% confidence interval [CI], 1.32-1.73) and 14% less likely to consume alcohol (AOR .86, 95% CI .78-.95). Findings from our study indicate that compared with propensity score-matched controls, stroke survivors engage in poorer health behaviors with the exception of alcohol consumption.