Prevalence Of Influenza Vaccination Research Articles

Low prevalence of influenza vaccination in hospitalized patients, in a General Hospital in Buenos Aires, Argentina

Background: Seasonal influenza is an acute respiratory infection caused by influenza viruses. It is relevant for Public Health because it can cause severe illness or death in certain risk groups. During seasonal epidemics, health services can become overloaded and there is a social and economic impact related to work absenteeism. The most effective way to prevent the disease is annual vaccination. Since 2011, the annual vaccination for influenza it is included in the National Vaccination Program for high-risk groups. The goal set by the Ministry of Health is a 95-100% coverage for this group. There is no data about coverage in adult people in Buenos Aires. Methods & Materials: This is an observational, transversal study. The objective is to describe the prevalence of influenza vaccination in patients in a general ward who belonged to high risk group, in Hospital Ramos Mejia, a public general hospital in Buenos Aires. As influenza vaccination should take place between March and June each year, patients were included between July and December 2016. Results: We included 91 patients in our study, 69,2% were women (n = 63), with a mean age of 57 years. The most frequent cause for hospitalization were respiratory infections (24%). Risk factors for influenza were age (≥65 years), in 28%, COPD (13%), corticosteroid use or immunosuppression (12% each). Some patients had at least two risk factors (24%). Only 35% of high-risk patients had received flu-vaccine, significantly inferior to national recommendations. In those patients who had at least one health checkup during the previous year, the chance of vaccination was greater (48% versus 14%, OR 5.5). Despite this, only half of the patients who had a heath checkup received the corresponding vaccine, although they did have an indication. The most frequent referred reason for not receiving influenza-vaccine was the lack of information about the recommendation. Conclusion: Although the study has some limitations related to the small sample size and the descriptive design, we found a low prevalence of influenza vaccination in this group of high risk patients. It is important to reinforce in the community and among health professionals the importance of annual influenza vaccination in high-risk groups.

Prevalence of influenza vaccination in adults and elderly with chronic respiratory diseases.

The objective was to estimate the prevalence of influenza vaccination in adults and elderly with chronic respiratory diseases (CRDs). The sample included individuals 20 to 59 years of age (n = 23,329) and ≥ 60 years (n = 9,019) that participated in the Brazilian National Survey on Access, Utilization, and Promotion of Rational Use of Medicines (PNAUM) in 2013-2014. We estimated influenza vaccination prevalence rates and respective 95% confidence intervals (95%CI). Associations were verified with the Rao-Scott chi-square test, with significance set at 5%. For all adults and elderly with CRD, prevalence of vaccination was 42.1% (95%CI: 37.2-47.1), with a statistically difference between the two age groups (p < 0.001). The adult population showed significant differences according to marital status (p < 0.05), and the elderly population showed higher vaccination prevalence in the South of Brazil compared to the Northeast (p < 0.05). For the sample as a whole, chronic bronchitis was the most frequently reported disease (43.5%). Considering each specific disease, the percentage of vaccinated adults was low, varying from 25% (other respiratory diseases) to 42% (chronic bronchitis), without a statistically significant difference (p = 0.330). Individuals with respiratory diseases and the elderly in general (≥ 60 years) are priority groups for influenza vaccination; in general, in all the subgroups, prevalence rates were below the target set by the Brazilian Ministry of Health. The recommendation that the vaccine should be applied by a health professional may explain this low adherence to vaccination by the elderly.

Effect of dementia on receipt of influenza vaccine: a cohort study in French older adults using administrative data: 2007–2012

Despite guidelines stating the vaccine benefit in this population, older adults with dementia may be less likely to receive influenza vaccine than cognitively intact older adults. But no study has yet reported on vaccine uptake in patients newly diagnosed with dementia or whether years since dementia diagnosis influences vaccine uptake. We conducted a cohort study in the French Health Insurance database (Echantillon Généraliste de Bénéficiaires) which contains hospital data and claims for a 1/97th random sample of the French population. Diseased subjects were ≥65years and had a new record of dementia diagnosis between September 1, 2007, and August 31, 2008. Vaccine receipt was measured via influenza vaccine dispensing in community pharmacies. We described influenza vaccination rates up to 2011-2012 and estimated adjusted relative risks (aRR) for vaccine receipt each year using multivariate modified Poisson models controlling for sociodemographics, comorbidities, and health resources use. Four hundred and seven subjects with dementia (mean age 81.8years, 69.3% females) and 4862 subjects (mean age 75.2years, 61.3% females) without dementia were included. In 2008-2009, influenza vaccination prevalence was 70.0% (95% CI=[65.3-74.4]) and 70.2% (95% CI=[68.9-71.4]) in subjects with and without dementia, respectively (aRR=0.93; 95% CI=[0.87-1.00]). In 2009-2010, the aRR was of the same magnitude (aRR=0.96, 95% CI=[0.90-1.03]), but in 2010-2011 and 2011-2012, the aRR was 1.02 (95% CI=[0.94-1.11]) and 1.05 (95% CI=[0.96-1.14]), respectively. Subjects with dementia had a slightly nonsignificant lower receipt of influenza vaccine in the year following dementia diagnosis than subjects without dementia. In subsequent years, divergent trends were observed in vaccine uptake according to dementia status.

Design of the New York City Macroscope: Innovations in Population Health Surveillance Using Electronic Health Records.

Introduction:Electronic health records (EHRs) have the potential to offer real-time, inexpensive standardized health data about chronic health conditions. Despite rapid expansion, EHR data evaluations for chronic disease surveillance have been limited. We present design and methods for the New York City (NYC) Macroscope, an EHR-based chronic disease surveillance system.This methods report is the first in a three part series describing the development and validation of the NYC Macroscope. This report describes in detail the infrastructure underlying the NYC Macroscope; indicator definitions; design decisions that were made to maximize data quality; characteristics of the population sampled; completeness of data collected; and lessons learned from doing this work. The second report describes the methods used to evaluate the validity and robustness of NYC Macroscope prevalence estimates; presents validation results for estimates of obesity, smoking, depression and influenza vaccination; and discusses the implications of our findings for NYC and for other jurisdictions embarking on similar work. The third report applies the same validation methods to metabolic outcomes, including the prevalence, treatment and control of diabetes, hypertension and hyperlipidemia.Methods:We designed the NYC Macroscope for comparison to a local “gold standard,” the 2013–14 NYC Health and Nutrition Examination Survey, and the telephonic 2013 Community Health Survey. NYC Macroscope indicators covered prevalence, treatment, and control of diabetes, hypertension, and hyperlipidemia; and prevalence of influenza vaccination, obesity, depression and smoking. Indicators were stratified by age, sex, and neighborhood poverty, and weighted to the in-care NYC population and limited to primary care patients. Indicator queries were distributed to a virtual network of primary care practices; 392 practices and 716,076 adult patients were retained in the final sample.Findings:The NYC Macroscope covered 10% of primary care providers and 15% of all adult patients in NYC in 2013 (8–47% of patients by neighborhood). Data completeness varied by domain from 98% for blood pressure among patients with hypertension to 33% for depression screening.Discussion:Design and validation efforts undertaken by NYC are described here to provide one potential blueprint for leveraging EHRs for population health monitoring. To replicate a model like NYC Macroscope, jurisdictions should establish buy-in; build informatics capacity; use standard, simple case defnitions; establish documentation quality thresholds; restrict to primary care providers; and weight the sample to a target population.

Can Electronic Health Records Be Used for Population Health Surveillance? Validating Population Health Metrics Against Established Survey Data.

Introduction:Electronic health records (EHRs) offer potential for population health surveillance but EHR-based surveillance measures require validation prior to use. We assessed the validity of obesity, smoking, depression, and influenza vaccination indicators from a new EHR surveillance system, the New York City (NYC) Macroscope. This report is the second in a 3-part series describing the development and validation of the NYC Macroscope. The first report describes in detail the infrastructure underlying the NYC Macroscope; design decisions that were made to maximize data quality; characteristics of the population sampled; completeness of data collected; and lessons learned from doing this work. This second report, which addresses concerns related to sampling bias and data quality, describes the methods used to evaluate the validity and robustness of NYC Macroscope prevalence estimates; presents validation results for estimates of obesity, smoking, depression and influenza vaccination; and discusses the implications of our findings for NYC and for other jurisdictions embarking on similar work. The third report applies the same validation methods described in this report to metabolic outcomes, including the prevalence, treatment and control of diabetes, hypertension and hyperlipidemia.Methods:NYC Macroscope prevalence estimates, overall and stratified by sex and age group, were compared to reference survey estimates for adult New Yorkers who reported visiting a doctor in the past year. Agreement was evaluated against 5 a priori criteria. Sensitivity and specificity were assessed by examining individual EHR records in a subsample of 48 survey participants.Results:Among adult New Yorkers in care, the NYC Macroscope prevalence estimate for smoking (15.2%) fell between estimates from NYC HANES (17.7 %) and CHS (14.9%) and met all 5 a priori criteria. The NYC Macroscope obesity prevalence estimate (27.8%) also fell between the NYC HANES (31.3%) and CHS (24.7%) estimates, but met only 3 a priori criteria. Sensitivity and specificity exceeded 0.90 for both the smoking and obesity indicators. The NYC Macroscope estimates of depression and influenza vaccination prevalence were more than 10 percentage points lower than the estimates from either reference survey. While specificity was > 0.90 for both of these indicators, sensitivity was < 0.70.Discussion:Through this work we have demonstrated that EHR data from a convenience sample of providers can produce acceptable estimates of smoking and obesity prevalence among adult New Yorkers in care; gained a better understanding of the challenges involved in estimating depression prevalence from EHRs; and identified areas for additional research regarding estimation of influenza vaccination prevalence. We have also shared lessons learned about how EHR indicators should be constructed and offer methodologic suggestions for validating them.Conclusions:This work adds to a rapidly emerging body of literature about how to define, collect and interpret EHR-based surveillance measures and may help guide other jurisdictions.

Prevalence of influenza vaccination and its association with health conditions and risk factors among Kansas adults in 2013: a cross-sectional study.

BackgroundAccording to the Centers for Disease Control and Prevention, approximately 5-20 % of people are affected by influenza annually, and influenza causes more than 200,000 hospitalizations each year. The purpose of this study is to estimate the prevalence of influenza vaccination among high risk adults in Kansas.MethodsThe 2013 Kansas BRFSS data (n = 20,712) were analyzed to assess the prevalence of receiving influenza vaccination among Kansas adults, overall and for selected demographic characteristics within the past 12 months. Crude and adjusted prevalence rate ratios were computed using univariate logistic regression models with influenza vaccination as the dependent variable and health conditions or high risk groups as the main independent variables; these models were then adjusted for potential confounding.ResultsOverall, influenza vaccination rate was lower than the Healthy People 2020 target (42.2 % vs. 80 %). The prevalence of receiving influenza vaccination was higher among adults 65 years and older compared to adults 64 years and younger after adjusting for gender, annual household income, education, marital status, insurance status, and race/ethnicity. Similarly, the prevalence of receiving influenza vaccination was higher among adults who have current asthma, or have ever been diagnosed with diabetes, high blood pressure, cancer (excluding skin), and COPD compared to those who did not have these health conditions, as well as pregnant women compared to women who were not pregnant.ConclusionsAlthough high risk groups have higher rates of influenza vaccination compared to low risk groups, more concerted efforts are needed to improve seasonal influenza vaccination in Kansas.

Association of influenza, influenza vaccination and cardiovascular risk

Cardiovascular risk and related medical burden due to influenza in patients with chronic disease were higher than those of healthy subjects. As a result, influenza vaccination is recommended as a strategy for secondary prevention in cardiovascular disease by major cardiovascular organizations, but the prevalence of influenza vaccination in these population is still low. Whether influenza vaccine can prevent cardiovascular events such as myocardial infarction and death is still controversial based on current evidences from observational studies and case-control studies, which may result from study desion,subjects selection,outcome definition and sample size issues. Recent meta-analysis showed that influenza vaccination may reduce cardiovascular risk, but large-scale random controlled trials with adequately power should be conducted to confirm these findings as well as the target population for this strategy further.

Prevalence of Influenza Vaccination in Chronic Obstructive Pulmonary Disease Patients and Impact on the Risk of Severe Exacerbations

ObjectiveTo determine the prevalence of influenza vaccination in chronic obstructive pulmonary disease (COPD) patients, and the effectiveness of the procedure. MethodsRetrospective population-based cohort study. On 31 December 2011, influenza vaccination history was retrieved from 899 patients with confirmed COPD selected by simple random sampling from all COPD patients in Cantabria (northern Spain). Severe exacerbations (hospitalization due to COPD exacerbation) and overall mortality during 2012 were treated as dependent variables. Odds ratios (OR) were estimated by logistic regression, adjusting for age, sex, smoking status, severity of COPD, and frequency of exacerbations during the previous year. Prevented fraction among the exposed (PFe-adjusted) was determined as a measure of impact. ResultsOverall prevalence of influenza vaccination was 62.7%, but this rate fell in patients classified as more severe according to FEV1 (52.0%). Influenza vaccination showed a statistically significant protective effect against severe exacerbations in the following year: aOR: 0.54 (95% CI: 0.35–0.84); FPe-adjusted: 0.46 (95% CI: 0.16–0.65). A non-significant protective effect for overall mortality was observed: aOR: 0.76 (95% CI: 0.41–1.40). When stratified according to COPD severity (FEV1), the protective effect against risk of hospitalization was higher in more severe COPD patients: aOR: 0.23 (95% CI: 0.11–0.48); FPe-adjusted: 0.77 (95% CI: 0.52–0.89). ConclusionsWe found that influenza vaccination has a protective effect and reduces the risk of hospitalization due to exacerbations in the following year. Despite the evidence for protection, prevalence of vaccination was not optimal, especially in more severe COPD patients.

Vaccination against influenza in the elderly: data from FIBRA, Campinas, São Paulo, Brazil.

The vaccine against influenza is the main preventative intervention in public health for this disease. The aim of this study was to establish the prevalence of influenza vaccination in senior citizens according to indicators for their functional capacity, frailty, social support and involvement and state of health. This cross-sectional study was conducted in Campinas in 2008-2009 (FIBRA network, Unicamp center) with a probability sampling of the elderly population(≥ 65 years old).The dependent variable was immunization against influenza in the twelve months prior to the research. The adjusted prevalence ratios were estimated by means of Poisson multiple regression analysis. Of the six hundred and seventy-nine senior citizens involved, 74.4% stated they had been vaccinated during the previous year. The prevalence of the vaccination was significantly higher among men and lower among those with a higher level of education. Slow gait speed is positively associated with immunization, as are most of the social involvement indicators. This can contribute towards improving immunization adherence against seasonal influenza and should be widely acknowledged in order to broaden immunization coverage in Campinas.

Prevalencia de vacunación antigripal en pacientes con enfermedad pulmonar obstructiva crónica e impacto en el riesgo de agudizaciones graves

ObjectiveTo determine the prevalence of influenza vaccination in chronic obstructive pulmonary disease (COPD) patients, and the effectiveness of the procedure. MethodsRetrospective population-based cohort study. On 31 December 2011, influenza vaccination history was retrieved from 899 patients with confirmed COPD selected by simple random sampling from all COPD patients in Cantabria (northern Spain). Severe exacerbations (hospitalization due to COPD exacerbation) and overall mortality during 2012 were treated as dependent variables. Odds ratios (OR) were estimated by logistic regression, adjusting for age, sex, smoking status, severity of COPD, and frequency of exacerbations during the previous year. Prevented fraction among the exposed (PFe-adjusted) was determined as a measure of impact. ResultsOverall prevalence of influenza vaccination was 62.7%, but this rate fell in patients classified as more severe according to FEV1 (52.0%). Influenza vaccination showed a statistically significant protective effect against severe exacerbations in the following year: Ora: 0.54 (95%CI: 0.35-0.84); FPe-adjusted: 0.46 (95%CI: 0.16-0.65). A non-significant protective effect for overall mortality was observed: Ora: 0.76 (95%CI: 0.41-1.40). When stratified according to COPD severity (FEV1), the protective effect against risk of hospitalization was higher in more severe COPD patients: Ora: 0.23 (95%CI: 0.11-0.48); FPe-adjusted: 0.77 (95%CI: 0.52-0.89). ConclusionsWe found that influenza vaccination has a protective effect and reduces the risk of hospitalization due to exacerbations in the following year. Despite the evidence for protection, prevalence of vaccination was not optimal, especially in more severe COPD patients.

Associations between the prevalence of influenza vaccination and patient's knowledge about antibiotics: a cross-sectional study in the framework of the APRES-project in Austria.

BackgroundThis study aimed to identify associations between GP patient’s knowledge about the spectrum of effectiveness of antibiotics and the probability of vaccination against influenza. The underlying hypothesis was that individuals with an understanding that antibiotics are ineffective against viruses, common colds, and flu were more likely to be vaccinated than persons lacking this knowledge.MethodsThis cross-sectional study was conducted within the context of the European APRES project in Austria. Between November 2010 and July 2011, patients were recruited from GP practices to complete questionnaires about their knowledge about antibiotics and their influenza vaccination status. Statistical analyses included subgroup analyses and logistic regression models.ResultsData of 3224 patients was analyzed, demonstrating that patients with better knowledge concerning antibiotics had a significantly higher likelihood of being vaccinated (OR 1.35, CI 95 % 1.18–1.54). While the overall vaccination rate was low (18.6 % in 2009/2010 and 14.0 % in 2010/2011), elderly compared to younger adults (OR 0.06 CI 95 % 0.03–0.13) and healthcare workers (OR 2.24, CI 95 % 1.42–3.54) demonstrated higher likelihood of vaccination. Additionally, female GPs had significantly more vaccinated patients than male GPs (OR 2.90, CI 95 % 1.32–6.40).DiscussionThere has been little prior study on the association between a patient’s knowledge of the effectiveness spectrum of antibiotics and influenza vaccination status. Given the public health imperative to increase annual prevalence of influenza vaccination, understanding this educational gap can improve specificity in counseling as well as vaccination rates. Ultimately, we found that those with a better knowledge on about antibiotics had a significantly higher likelihood of being vaccinated.ConclusionsThe results of this study demonstrate that vaccination prevalence is associated with patient’s knowledge about antibiotics. It can be concluded that one strategy to improve the overall low vaccination rates for seasonal influenza in Austria would be, particularly for male GPs, to have a specific discussion with patients about these circumstances by focusing on younger patients. Further, public health efforts could supplement in-office strategies to improve this area of health literacy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2297-x) contains supplementary material, which is available to authorized users.

Self-reported influenza vaccination uptake in people with chronic diseases: data from Progressi delle Aziende Sanitarie per la Salute in Italia (PASSI)

BackgroundInfluenza is an important public health problem, with potential severe consequences among people with chronic diseases. The aim of this study was to obtain reliable measures of seasonal influenza vaccine uptake in this population, otherwise not available in Italy. MethodsProgressi delle Aziende Sanitarie per la Salute in Italia (PASSI) is a nationwide surveillance system of health-related behaviours and acceptance of preventive interventions (including influenza immunisation) offered by the Italian National Health Service. Data are collected with telephone interviews at local health unit level for supporting local activities. The survey sample is randomly selected from local health unit lists of adult residents. The trend of annual vaccine coverage since 2008 was estimated for people aged 18–64 years who reported having at least one chronic disease. To obtain a sufficient sample size in subgroups, we analysed the characteristics of vaccinated people in the 2010–13 cumulative dataset. Univariate, multivariate, and logistic regression analyses were undertaken. FindingsIn 2008–13, 13 659 individuals with at least one chronic disease were interviewed. Vaccination coverage fell significantly from 29·7% (95% CI 27·2–32·4) in 2007–08 to 19·9% (18·0–22·1) in 2012–13. During 2010–13, the overall proportion of vaccinated people with a chronic disease was 25·6% (24·5–26·7). Vaccine coverage of people with diabetes (34·3%, 31·7–36·9) or cardiovascular diseases (31·8%, 29·6–34·2) was greater than that of people affected by renal failure, respiratory diseases, tumours, or chronic liver diseases (26·5% [22·5–30·7], 24·9% [23·2–26·7], 22·2% [20·0–24·6], and 20·6% [17·5–24·6], respectively). Vaccination coverage increased with age (from 13·1% [11·0–15·5] in the 18–34 year age group to 33·4% [31·9–35·1] in people aged 50–64 years); it was higher among people with a low educational level than among those with a high educational level, higher in those having economic difficulties than in those with no economic difficulties, and higher among Italian citizens than among non-citizens. InterpretationIn the past few years, prevalence of influenza vaccination in Italian adults with at least one chronic disease was well below the Ministry of Health's goal (75% minimum) and showed a downward trend. A major reason of this evolution is probably the changing public perception of the benefits and risks of vaccines. PASSI is a source of useful data not otherwise available for public health intervention. FundingItalian Ministry of Health.

Prevalence of Influenza Vaccination and Associated Factors in Chinese Nursing Home Healthcare Workers

Prevalence of Influenza Vaccination and Associated Factors in Chinese Nursing Home Healthcare Workers

Influenza vaccination in adults with chronic obstructive pulmonary disease: the impact of a diagnostic breathing test on vaccination rates.

IntroductionInfluenza vaccination rates are low in adults with chronic obstructive pulmonary disease (COPD). A diagnostic breathing test in adults with COPD may increase vaccination rates; however, research has not demonstrated this relationship. The purpose of this research was to determine if adults with COPD diagnosed by a breathing test were more likely to have had an influenza vaccination during the past 12 months when compared to those with COPD diagnosed without a breathing test.MethodsThis was a cross-sectional study using data from the 2011 Behavioral Risk Factor Surveillance System. Logistic regression examined the relationship between influenza vaccination among adults with COPD diagnosed with a breathing test (n = 13,201) compared to those diagnosed without a breathing test (n = 3,108), after controlling for all potential confounders.ResultsOverall, 49% of respondents with COPD received an influenza vaccination within the past 12 months and 78% reported their COPD was diagnosed by a breathing test. The prevalence of influenza vaccination in the past 12 months was greater in those with COPD diagnosed by a breathing test (53%) compared to those diagnosed without a breathing test (36%). In adjusted analysis, adults with COPD who had a breathing test were 31% (confidence interval 1.1, 1.6) more likely to have received an influenza vaccination in the past 12 months compared to those without a breathing test.DiscussionA diagnostic breathing test for COPD was associated with increased likelihood of having had an influenza vaccination in the past 12 months. This may be an indicator of the relationship between knowledge of lung function and the need for preventative care, a sign of quality healthcare, or good health-seeking behaviors in patients with COPD. This research is the first to use a nationally representative sample to suggest that spirometry diagnosis of COPD may increase rates of influenza vaccination.

Impfstatus von Erwachsenen in Deutschland

In the absence of an immunisation register, vaccination coverage in Germany must be estimated. Ten years after the German National Health Interview and Examination Survey 1998 (GNHIES98), the population survey DEGS1 is one of the data sources to be used for monitoring vaccination coverage. In the survey, data on vaccination history were obtained from vaccination cards and self-reports. The prevalence of immunisation for tetanus and diphtheria was higher compared to the prevalence estimated ten years previously in GNHIES98. Nonetheless, 28.6 % of adults have not been vaccinated against tetanus and 42.9 % have not been vaccinated against diphtheria within the last ten years. Vaccination is especially low among the elderly, among adults with low socio-economic status and in western Germany. During the last ten years, only 11.8 % of women and 9.4 % of men were vaccinated against pertussis in western Germany; vaccination coverage was twice as high in eastern Germany. In 2009, recommendations were published to combine the next tetanus immunisation with a pertussis immunisation; therefore pertussis vaccination coverage might improve in the coming years. The lifetime prevalence of influenza vaccination obtained in DEGS1 is higher than the annual vaccination rate for influenza. However, the lifetime prevalence among adults aged 60 years or older is still below the annual rate of 75 % recommended by the WHO. An English full-text version of this article is available at SpringerLink as supplemental.

False positivity for the human immunodeficiency virus antibody after influenza Vaccination in a living donor for liver transplantation

Because of increased productivity and availability, more people have had the chance to undergo prophylactic influenza vaccination. It has been reported that influenza vaccination has cross-reactivity with human immunodeficiency virus (HIV) antibody assays, but this information is not well known in the field of transplantation.1 Recently, we experienced a case of living donor liver transplantation in which a healthy donor candidate was frightened and was further screened for the HIV antibody. The patient was a 43-year-old female who was a candidate for partial liver donation for her husband, who was suffering from hepatocellular carcinoma associated with hepatitis B liver cirrhosis. She had never undergone a blood transfusion or abused drugs before her screening for living partial liver donation. According to her laboratory results, she was positive for the HIV antibody (1.7 cut off index). Otherwise, all data, including hepatitis B antibody results, were within normal limits. It was found that she had undergone vaccination for influenza 1 week before the screening. She was referred to a specialist in HIV infection, and western blotting for all antibodies (GP160, GP110/120, P68/66, P55, P52/51, GP41, P40, P34/31, P24/25, and P18/17) was negative. HIV RNA was undetectable in her blood (<40 copies/mL). Thus, she was considered to be HIV-negative with a high level of confidence and subsequently donated the left lobe of her liver. The recipient remained negative for the HIV antibody even after living donor liver transplantation. With the prevalence of influenza vaccination and organ donation, physicians should keep in mind that recent inoculation with any brand of influenza vaccine is associated with a false-positive screening assay for HIV antibodies.2 Susumu Eguchi, M.D., Ph.D. Mitsuhisa Takatsuki, M.D., Ph.D. Akihiko Soyama, M.D., Ph.D. Yasuhiro Torashima, M.D., Ph.D. Ayumi Tsuji, R.N. Tamotsu Kuroki, M.D., Ph.D. Department of SurgeryNagasaki University Graduate School of Biomedical SciencesNagasaki, Japan

Influenza vaccination among cancer survivors: disparities in prevalence between blacks and whites

Cancer survivors are at increased risk for influenza-related complications. Racial disparities in preventive health services have not been extensively studied among cancer survivors. Our objective is to compare influenza vaccination prevalence among black and white cancer survivors We performed a secondary data analysis of 41,346 white and black cancer survivors (excluding non-melanoma skin cancer) from the 2009 Behavioral Risk Factor Surveillance System survey. Respondents were asked whether they had received an influenza vaccination in the previous year. Multivariable logistic regression was used to estimate the odds of having influenza vaccine by race. Sixty-five percent of whites reported receiving the vaccine in the last year compared to 50% of blacks. Blacks had significantly lower odds of vaccination after controlling for covariates significantly associated with the odds of influenza vaccination. Higher education, having health insurance, having a primary care provider, and having a routine check-up in the last year increased the odds of receiving an influenza vaccine. Our analysis supports that racial disparities in vaccine coverage persist among cancer survivors, a group strongly recommended to receive annual influenza vaccine, even when predictors significantly associated with increased vaccination are controlled for. As a nationally representative survey with a large sample size, our study provides a picture of self-reported vaccine coverage among cancer survivors in the USA and the disparity that exists between blacks and whites in this population. Care teams can use these findings to better target follow-up care for cancer survivors.

Prevalence of influenza vaccination among physicians and related enhancing and preventing factors in Italy

Introduction: Several studies proved the convenience of vaccinating health care workers (HCWs), especially physicians, and vaccination is recommended by health authorities in many Countries. Nonetheless in Italy only a small part of HCWs get vaccinated. The aim of this study is to conduct a systematic review in order to estimate the pooled prevalence of influenza vaccinations among physicians in Italy and to investigate the enhancing/preventing factors associated with this kind of preventive tool.Methods: Relevant articles up to 1st May 2010 have been identified through Scopus, PubMed and Google Scholar; data extraction and quality assessment were performed independently by two researchers.The analysis was performed using StatsDirect 2.7.8.Results: Sixteen studies, performed between 1990 and 2008, reported vaccination rates with pooled prevalence among all HCWs. From nine of them data regarding physicians have been extracted and analysed, finding a pooled proportion of 23.18% (95% CI = 17.85-28.98%). One study allowed an analysis of the reasons encouraging and preventing influenza vaccination. The main ones are on one side self protection, and patients’ and family’s protection, and on the other side “not caring about influenza,” followed by “fear of adverse effects” and “belief that vaccine isn’t effective.”Discussion: Italy has a good overall influenza vaccination coverage, and national records are available for population aged over 65 years or with chronic illness. Unfortunately there isn’t any national record about HCWs or physicians vaccination, and from the data gathered from the studies examined in this analysis vaccination prevalence is low. The reasons brought from physicians are worrying because of their position in the society and in the health care system, in close contact with patients.This shows a great need for well-done information and educational campaigns stressing the importance of prevention.

Influenza vaccination among high-risk subgroups in eleven European countries: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE)

Background: The risk of influenza-related complications is elevated in older adults and in persons with one or more chronic diseases. Vaccination of such individuals is therefore recommended in Europe as a preventive measure. We aimed to compare between European countries 1) to what extent high-risk subgroups receive influenza vaccination and 2) how likely they are to receive vaccination compared to the non-risk group. Methods: We used data from the Survey of Health, Ageing and Retirement in Europe collected in 2004/05. Adults aged 50+ years from eleven countries (Austria, Belgium, Denmark, France, Germany, Greece, Italy, the Netherlands, Spain, Sweden, Switzerland) were asked whether they had received flu vaccination in the previous year. Using self-reported data from 16,182 individuals, we defined several high-risk subgroups (age 65+, presence of chronic lung disease [CLD], cardiovascular disease [CVD], diabetes/high glucose level). We calculated weighted and design-adjusted estimates of vaccination prevalence with 95% confidence intervals (CI) for each country. Country-specific multivariable logistic regression was used to explore associations between membership in a high-risk subgroup and vaccination uptake. Results: The prevalence of influenza vaccination in high-risk subgroups was generally highest in the Netherlands (e.g., 76.7% [95% CI: 73.6%, 79.8%] for those aged 65+ years and 74.6% [95% CI: 68.3%, 80.9%] for CLD) and was consistently lowest in Greece (26.3% [95% CI: 23.2%, 29.3%] and 18.5% [95% CI: 11.3%, 25.6%], respectively). Comparison of multivariable models suggested substantial cross-national variation in targeted influenza prevention. The adjusted odds of self-reported vaccination in those aged 65+ (versus &lt;65), for example, ranged from 2 (Austria and Germany) to more than 10 (Denmark and the Netherlands). Conclusions: Influenza vaccination coverage among high-risk subgroups varies considerably between European countries. Most countries did not achieve recommended coverage rates; some fell well below recommendations, raising questions about the effectiveness of national efforts in reaching high-risk individuals.

Mass commuting and influenza vaccination prevalence in New York City: Protection in a mixing environment

Objective Assess influenza vaccination among commuters using mass transit in New York City (NYC). Methods We used the 2006 NYC Community Health Survey (CHS) to analyze the prevalence of influenza immunization by commuting behaviors and to understand what socioeconomic and geographic factors may explain any differences found. Results Vaccination prevalence is significantly lower for New Yorkers who commute on public transportation compared to other New Yorkers. This difference is largely attenuated after adjusting for socio-demographic characteristics and neighborhood of residence. Conclusions The analysis identified a low prevalence of immunization among commuters, and given the transmissibility in that setting, targeting commuters for vaccination campaigns may impede influenza spread.