Seasonal Influenza Vaccination Rates Research Articles

Association between asthma and influenza vaccine uptake among US adolescents: a retrospective survey study

Objective Despite longstanding recommendations for children with asthma to receive the influenza vaccine, vaccine uptake in this population remains low. We used the nationally representative National Immunization Survey-Teen to analyze the impact of asthma on adolescent influenza vaccination rates. Methods Adolescents ages 13–17 years with provider-reported data on vaccine coverage were included in the analysis. The primary outcome was being up-to-date on influenza vaccination, defined as receiving the seasonal influenza vaccine in at least one of the past 3 years, and was analyzed using logistic regression. Asthma was defined by parent report of whether the adolescent has ever been told by a health professional that he or she has asthma. Data were collected in 2016–2017 and analyzed in 2020. Results Of 36,655 adolescents in the analytic sample (mean age 15 years, 49% female), 55% were up-to-date on influenza vaccination, and 21% had been diagnosed with asthma. On bivariate analysis, vaccination was more common among adolescents who had been diagnosed with asthma compared to those who were not (60% vs. 53%, P < 0.001). On multivariable analysis, asthma diagnosis was associated with greater likelihood of being up-to-date on seasonal influenza vaccination (adjusted odds ratio: 1.29; 95% confidence interval: 1.22, 1.36; P < 0.001). Conclusions Seasonal influenza vaccination rates remain low among adolescents. Despite concerns about vaccine effectiveness in children with asthma, this diagnosis was associated with increased likelihood of influenza vaccination, possibly in relation to increased health care use (and exposure to vaccine encouragement) among adolescents with asthma.

Impfen gegen Influenza – Internationale Bestandsaufnahme und Perspektiven für Deutschland

BackgroundThe current SARS-CoV-2 pandemic requires high influenza vaccination rates for the chronically ill in order to avoid additional strain on the health care system. Despite clear evidence of the safety and effectiveness of influenza vaccination, vaccination coverage has internationally remained at inadequate levels in recent years. The general practitioner is of central importance for the care of this population. Therefore, the aim of this systematic review was to evaluate various measures in general practice to increase seasonal influenza vaccination rates for the chronically ill, taking into account various international health systems. MethodsA systematic literature search was carried out in MEDLINE, CENTRAL, EMBASE and ERIC as well as manually in trial registers and literature lists. Only randomized controlled studies were taken into account. The methodology was defined in advance in a study protocol and published (PROSPERO CRD42018114163). ResultsA total of 14 studies within the framework of a national health service (United Kingdom), a state (Australia) and social (Switzerland) health insurance system and a private health care system (USA) were included in our review. Analog patient reminders and automated physician reminders as well as changes in professional roles have led to a significant increase in influenza vaccination rates, but only in the private health care system. In the national health service, none of the interventions we analyzed achieved a significant increase in vaccination rates, although the National Health Service in the United Kingdom documented relatively good basic influenza vaccination rates before the studies were carried out, regardless of the intervention. Good results were achieved in the social and state health insurance systems of Switzerland and Australia by training events for practice teams and SMS reminders. ConclusionsIn Germany, training events for medical teams and centrally organized invitation and monitoring systems might improve vaccination rates among the chronically ill. That the federal government pays for the vaccination costs seems to ensure a good basic influenza vaccination coverage for indicated patients in various health systems.

Seasonal Influenza Vaccine in Pregnant Women: Views and Experiences of Obstetrician-Gynecologists.

Background: Seasonal influenza vaccination rates among pregnant women remain well below the Healthy People 2020 target of 80%. Obstetrician-gynecologist (OB/GYN) recommendations are a critical means of encouraging pregnant women to get vaccinated, but there are limited data about their views. Materials and Methods: A nationally representative survey of 506 practicing OB/GYNs was completed between October 26, 2015, and May 8, 2016. Analyses included univariate distributions and comparisons based on age, size of practice, and academic affiliation using all-pairs, dependent t-tests. Results: A majority of OB/GYNs report they "strongly recommend" seasonal influenza vaccination for their pregnant patients in the first (79%) or second and third trimesters (81%). Among those who do not strongly recommend the flu vaccine in the first trimester, many say this is because of their own concerns (28%) or their patients' concerns (44%) about safety. Older OB/GYNs, those in smaller practices, and those without academic affiliation were less likely to recommend the vaccine and more likely to have safety concerns. For example, 72% of those age 60+ strongly recommended the vaccine in the second and third trimester, compared with 86% of those ages 30-44 and 83% of those ages 45-59 (p < 0.05 for all comparisons). Conclusions: OB/GYNs across the country largely support seasonal flu vaccination among pregnant women. Nonetheless, safety is a concern for them and their patients. Outreach to support clinician decisions and conversations with pregnant patients may be most needed among older physicians, those in smaller practices, and those without academic affiliation.

Interventions on health care providers to improve seasonal influenza vaccination rates among patients: a systematic review and meta-analysis of the evidence since 2000.

BackgroundSeasonal influenza vaccination (SIV) rates remain suboptimal in many populations, even in those with universal SIV.ObjectiveTo summarize the evidence on interventions on health care providers (physicians/nurses/pharmacists) to increase SIV rates.MethodsWe systematically searched/selected full-text English publications from January 2000 to July 2019 (PROSPERO-CRD42019147199). Our outcome was the difference in SIV rates between patients in intervention and non-intervention groups. We calculated pooled difference using an inverse variance, random-effects model.ResultsWe included 39 studies from 8370 retrieved citations. Compared with no intervention, team-based training/education of physicians significantly increased SIV rates in adult patients: 20.1% [7.5–32.7%; I2 = 0%; two randomized controlled trials (RCTs)] and 13.4% [8.6–18.1%; I2 = 0%; two non-randomized intervention studies (NRS)]. A smaller increase was observed in paediatric patients: 7% (0.1–14%; I2 = 0%; two NRS), and in adult patients with team-based training/education of physicians and nurses together: 0.9% (0.2–1.5%; I2 = 30.6%; four NRS). One-off provision of guidelines/information to physicians, and to both physicians and nurses, increased SIV rates in adult patients: 23.8% (15.7–31.8%; I2 = 45.8%; three NRS) and paediatric patients: 24% (8.1–39.9%; I2 = 0%; two NRS), respectively. Use of reminders (prompts) by physicians and nurses slightly increased SIV rates in paediatric patients: 2.3% (0.5–4.2%; I2 = 0%; two RCTs). A larger increase was observed in adult patients: 18.5% (14.8–22.1%; I2 = 0%; two NRS). Evidence from both RCTs and NRS showed significant increases in SIV rates with varied combinations of interventions.ConclusionsLimited evidence suggests various forms of physicians’ and nurses’ education and use of reminders may be effective for increasing SIV rates among patients.

U.S. COVID-19 Vaccination Challenges Go Beyond Supply.

A trio of current Annals articles each takes a different route to the same conclusion, which is the use initial supplies of coronavirus disease 2019 (COVID-19) vaccines to immunize as many persons as possible with a single-dose regimen may achieve more benefit than a more effective 2-dose regimen in a smaller population The model of Paltiel et al makes the case for a single-dose vaccine, even if it is somewhat less effective than a 2-dose regimen of another vaccine Barnabas and Wald argue for single-dose immunization campaigns involving the Pfizer/BioNTech and Moderna vaccines, despite the absence of long-term efficacy data from clinical trials The model from Tuite et al questions the practice of reserving the second dose for every person immunized Supported by strong public health systems, rapid vaccine production, and equitable vaccine distribution within the US and around the world, vaccination strategies driven by data can bring an end to COVID-19

Public Knowledge, Attitudes, and Practices toward Seasonal Influenza Vaccine in Saudi Arabia: A Cross-Sectional Study.

Objectives: Increasing national influenza vaccination rates continues to be a challenge for Saudi Arabia. Therefore, the purpose of this study was to explore the Saudi public perceptions toward seasonal influenza vaccination and their association with the rate of vaccination. Methods: Individuals aged 15 years and older were surveyed about their knowledge, attitudes, and practices toward the seasonal influenza vaccine using a previously developed and validated 19-item online questionnaire. The impact of the participants’ perceptions toward the seasonal influenza vaccine on their past influenza vaccination history was assessed using multiple linear regressions. Results: The rate of regular vaccination among the 790 surveyed participants was 12.65%, and those who were aged <24 years had the highest rate (57%). The vast majority of the participants with chronic diseases (>90%) reported irregular vaccination histories against seasonal influenza. Participants who believed that the influenza vaccine is safe (β = 3.27; 95% CI: 2.067 to 5.171; p <0.001), efficacious (β = 2.87; 95% CI: 1.834 to 4.498; p <0.001), should be given during a specific time in the year (β = 1.821; 95% CI: 1.188 to 2.789; p = 0.0059), and were aware of their need to get vaccinated against the seasonal influenza (β = 2.781; 95% CI: 1.254 to 6.188; p = 0.0119) were more likely to have received the vaccine. Conclusion: The findings of this study suggest that the rate of seasonal influenza vaccination is low among the Saudi population, which necessitates the launching of public awareness campaigns about the importance of the seasonal influenza vaccine.

Racial and Ethnic Disparities in Quality Measures for People With Alzheimer’s Disease and Related Dementias

Over 50% of nursing home residents have ADRD. Prior research has shown strong evidence that, compare to non-Hispanic White, African-Americans are more likely to admitted in low performing nursing homes characterized by severe deficiencies understaffing and poor care. However, it is unknown whether these experiences are similar for Hispanics with ADRD. We conducted a cross-sectional study using 2016 data from Medicare- certified providers. Our cohort included 1,425,220 short- (30%) and long-term (70%) beneficiaries with ADRD. Approximately 81% of residents were White, 13% African Americans, and 6% Hispanics. African Americans and Hispanics have lower rates of seasonal influenza vaccination (IV). However, they were also less likely to report pain, pressure ulcers and antipsychotic use compared to white residents. After including the facility fixed-effects in the model, it appears that these disparities are mostly due to between-facility level differences.

Racial and Ethnic Disparities in Seasonal Influenza Vaccination among Dialysis Facilities in the United States.

Racial and ethnic disparities in vaccination rates for seasonal influenza exist. Whether such disparities extend to patients with ESKD, who simultaneously are at risk for complications of infection and have extensive contact with health care providers, has not been investigated. To determine whether the proportion of patients vaccinated at a dialysis facility differs according to the facility's racial and ethnic composition, we examined dialysis facility data reported to the Centers for Medicare and Medicaid Services. The main outcome was the proportion of facility patients vaccinated for influenza among 6735 Medicare-certified facilities operating between 2014 and 2017. Among dialysis facilities, the mean percentage of patients vaccinated during the influenza season was 72.1%. Facilities with higher proportions of Black and Hispanic patients had significantly lower vaccination percentages than less diverse facilities. The average proportion of patients vaccinated at each facility decreased significantly from 2014 to 2017 (a decrease of 1.05% vaccinated per year) and decreased significantly more so among facilities with higher minority proportions. The share of vaccinated patients in facilities in the quartile with the highest proportion of Black patients decreased 1.21% per year compared with a decrease of 0.88% per year in facilities in the quartile with the lowest proportion of Black patients. We found similar trends for Hispanic patients. Rates of seasonal influenza vaccination are modestly but significantly lower among dialysis facilities with larger proportions of minority patients, and the gap seems to be widening over time. As wide-scale vaccination efforts grow more urgent amid the current COVID-19 pandemic, these disparities must be addressed to protect patients and communities equitably.

Varying Vaccination Rates Among Patients Seeking Care for Acute Respiratory Illness: A Systematic Review and Meta-analysis.

BackgroundComplications following influenza infection are a major cause of morbidity and mortality, and the Centers for Disease Control Advisory Committee on Immunization Practices recommends universal annual vaccination. However, vaccination rates have remained significantly lower than the Department of Health and Human Services goal. The aim of this work was to assess the vaccination rate among patients who present to health care providers with influenza-like illness and identify groups with lower vaccination rates.MethodsWe performed a systematic search of the PubMed and EMBASE databases with a time frame of January 1, 2010, to March 1, 2019 and focused on the vaccination rate among patients seeking care for acute respiratory illness in the United States. A random effects meta-analysis was performed to estimate the pooled seasonal influenza vaccination rate, and we used a time trend analysis to identify differences in annual vaccination over time.ResultsThe overall pooled influenza vaccination rate was 48.61% (whites: 50.87%; blacks: 36.05%; Hispanics: 41.45%). There was no significant difference among gender groups (men: 46.43%; women: 50.11%). Interestingly, the vaccination rate varied by age group and was significantly higher among adults aged >65 (78.04%) and significantly lower among children 9–17 years old (36.45%). Finally, we found a significant upward time trend in the overall influenza vaccination rate among whites (coef. = .0107; P = .027).ConclusionsIn conclusion, because of the significantly lower influenza vaccination rates in black and Hispanic communities, societal initiatives and community outreach programs should focus on these populations and on children and adolescents aged 9–17 years.

A Comparison of the Seasonal Influenza Vaccination Rates and Related Factors

A Comparison of the Seasonal Influenza Vaccination Rates and Related Factors

Seasonal influenza vaccination in chronically ill children : the experience of a tertiary healthcare center

Kronik hastaligi olan cocuklarda mevsimsel influenza asilamasi :bir ucuncu basamak saglik merkezi deneyimi OZET Amac: Kronik hastaligi olan cocuklarda mevsimsel influenza asilamasi onemlidir. Bununla birlikte, bu grupta asilanma orani olmasi gerekenin altindadir ve halk sagligi hedefinden uzaktir. Bu calismanin amaci; kronik hastaligi olan cocuklarin mevsimsel influenza asilamasi ihtiyaclarinin merkezimizde daha yuksek oranda karsilanabilmesine yonelik calismalara katki saglamaktir. Gerec ve Yontem: Bu calisma Ankara Cocuk Sagligi ve Hastaliklari Hematoloji Onkoloji Egitim ve Arastirma Hastanesi'nde yapilmistir ve tek merkezli, retrospektif bir calismadir. Calisma Ekim 2015 ile Mayis 2018 tarihleri arasindaki ardisik 3 influenza sezonunu kapsamaktadir. Bulgular: Ardisik 3 influenza sezonunda 315 kronik hastaligi olan cocuga mevsimsel influenza asisi uygulandi. Hastanemize 1 Ekim 2015 ve 31 Mayis 2018 tarihleri arasindaki uc sezonda, asi uygulanan cocuklarla ayni tanilardaki 12.690 kronik hasta cocuk kabul edilmistir. Bu 315 cocugun %87'si Astim, %4.4'u Selektif IgA eksikligi, %2.2'si Nefrotik Sendrom, %1.6'si Diyabetes Mellitus, %1.3'u Kistik Fibrozis, %1.3'u Hematopoetik Kok Hucre Nakli yapilan hasta, %0.96'si Serebral Palsi hastasi, %0.64'u Duchenne Muskuler Distrofi hastasi ve %0.6'si Akut Lenfoblastik Losemi hastasidir. Sonuc: Bu calismada; kronik hastalikli cocuklarin mevsimsel influenza asilama oranlari bu 3 influenza sezonunda giderek artmistir. Ancak sayi halen dusuktur. Merkezimizde bu hasta grubunun asilama oranlarini artiracak planlar yapmamiz gerektigi aciktir. Anahtar kelimeler: asilama, cocuk, influenza, kronik hastalik Seasonal influenza vaccination in chronically ill children : the experience of a tertiary healthcare center. ABSTRACT Objective: Seasonal influenza vaccination is important in children with chronic disease. However, the vaccination rate in this group is sub-optimal and far from the public health goal. The aim of this study is to contribute to research addressing the need for a higher rate of seasonal influenza vaccination of chronically ill children at our center. Material and Methods: This study was conducted in Ankara Child Health and Diseases, Hematology Oncology Training and Research Hospital and is a single-center retrospective study. The study covers 3 consecutive flu seasons between October 2015 and May 2018. Results: Seasonal influenza vaccine was administered to 315 chronically ill children in 3 consecutive flu seasons. During three seasons between October 1, 2015 and May 31, 2018, 12,690 chronically ill children were admitted to our center in the same diagnoses as children who were vaccinated. Of these 315 children, 87.0% had asthma, 4.4% had selective deficiency of immunoglobulin A, 2.2% had nephrotic syndrome, 1.6% had diabetes mellitus, 1.3% had cystic fibrosis, 1.3% were hematopoietic stem cell transplantation patients, 0.96% had cerebral palsy, 0.64% had Duchenne muscular dystrophy, and 0.6% had acute lymphoblastic leukemia. Conclusion: In this study, seasonal influenza vaccination rates of chronically ill children increased gradually in these 3 influenza seasons. However, the number is still low. It is clear that we need to plan to increase the vaccination rates of this patient group at our center. Keywords: Influenza, vaccination, child, chronic illness

The Effect of Influenza Vaccination for the Elderly on Hospitalization and Mortality: An Observational Study With a Regression Discontinuity Design.

Observational studies using traditional research designs suggest that influenza vaccination reduces hospitalizations and mortality among elderly persons. Accordingly, health authorities in some countries prioritize vaccination of this population. Nevertheless, questions remain about this policy's effectiveness given the potential for bias and confounding in observational data. To determine the effectiveness of the influenza vaccine in reducing hospitalizations and mortality among elderly persons by using an observational research design that reduces the possibility of bias and confounding. A regression discontinuity design was applied to the sharp change in vaccination rate at age 65 years that resulted from an age-based vaccination policy in the United Kingdom. In this design, comparisons were limited to individuals who were near the age-65 threshold and were thus plausibly similar along most dimensions except vaccination rate. England and Wales. Adults aged 55 to 75 years residing in the study area during 2000 to 2014. Seasonal influenza vaccine. Hospitalization and mortality rates by month of age. The data included 170 million episodes of care and 7.6 million deaths. Turning 65 was associated with a statistically and clinically significant increase in rate of seasonal influenza vaccination. However, no evidence indicated that vaccination reduced hospitalizations or mortality among elderly persons. The estimates were precise enough to rule out results from many previous studies. The study relied on observational data, and its focus was limited to individuals near age 65 years. Current vaccination strategies prioritizing elderly persons may be less effective than believed at reducing serious morbidity and mortality in this population, which suggests that supplementary strategies may be necessary. National Institute on Aging.

Seasonal influenza vaccine uptake among Chinese in Hong Kong: barriers, enablers and vaccination rates

ABSTRACT Background Low influenza vaccination rates were observed in Asian countries including China. This study investigated the updated seasonal influenza vaccination rates among Chinese in Hong Kong, and the barriers and enablers to vaccination. Methods Eight focus groups were conducted among the Chinese general public, followed by a telephone survey between March and April 2018 with 2,452 respondents (response rate 41.4%). Results Of the survey respondents, 29.1% had received influenza vaccine in the past 12 months. A majority of them agreed with ‘enhancing immunity’ (94.4%) and ‘feeling safer’ (92.3%) as their reasons for vaccination, followed by the belief on ‘quicker recovery’ if they had influenza (69.5%), and free/subsidized vaccine (53.8%). Among respondents who had not received influenza vaccine, 71.2% ‘believed in the strength of their own immunity’ and 65.6% perceived ‘low-risk of getting influenza’. Less than half were ‘worried about side-effects’ and ‘effectiveness’. The groups aged 65–74 and 75 or above had vaccination rates of 49.1% and 69.9%, respectively, in contrast to 13.9% for the group aged 18–64. A rate of 37.9% for children was reported by the 442 respondents having children. Conclusions The high uptake of vaccines among the children and elderly suggests the positive impact of the subsidy and outreach programs. However, young and middle-aged adults tend to believe in the strength of their own immunity and underestimate the infection risk. Public education should emphasize that inactivated vaccines such as influenza vaccines work by means of the viral antigens stimulating the host’s immune system toward the major types of seasonal influenza.

Seasonal Influenza Vaccination Patterns Among Pregnant Women in New Mexico.

Seasonal influenza vaccination is recommended for pregnant women, but half of the pregnant women in the United States remain unvaccinated. Vaccine coverage in U.S.-Mexico border states has not been examined in depth even though risk factors for low vaccine coverage exist in these states, especially in the counties bordering Mexico. Using 2012-2014 New Mexico (NM) Pregnancy Risk Assessment and Monitoring System data, this study examined the weighted annual seasonal influenza vaccination rates and the relationship of various factors to vaccination among NM residents with a live birth during those years. Among respondents, 53.8% were Hispanic, 15.7% were Native American, and 30.5% were non-Hispanic White. The vaccination rate in NM increased from 49.0% in 2012 to 64.8% in 2014. The adjusted odds of vaccination were higher among women whose health care provider recommended/offered vaccination during the year prior to delivery compared to women whose provider did not (AOR = 11.92, 95% confidence interval [CI: 9.86, 14.42]) and among those living in the U.S.-Mexico nonborder counties compared to those living in the border counties (AOR = 1.23, 95% CI [1.18, 1.25]). Efforts to increase the vaccination rate among pregnant women in border states should concentrate on health care providers and the highest risk women, such as those resident in the border region.

Factors Associated with the 2017–2018 Seasonal Influenza Vaccination Coverage among Elementary, Middle, and High School Students

Purpose During the 2017-2018 season, influenza vaccination among elementary, middle, and high school students was not supported by the government. As vaccines that are not included in the national immunization schedule are not registered in the computerized national immunization registry, vaccination rates in these groups during this season remain unknown. Thus, the aim of this study was to estimate the vaccination rate among elementary, middle, and high school students during the 2017-2018 influenza season. Methods A total of 1,910 student’s parents (690 elementary school students; 611 middle school students; 609 high school students) participated in this survey. The survey involved a computer-assisted telephone interview (CATI). The following information related to participants’ 2017-2018 seasonal influenza vaccination status were collected: date, type, provider, and data source. Other data collected included student’s sex, grade, area of residence, and birth order, and parent’s age, educational level, and job status. Results The influenza vaccination rate for the 2017-2018 season was 70.1%, 48.9%, and 35.9% for elementary, middle, and high school students, respectively. Factors that were significantly related to the influenza vaccination rate in the 2017-2018 season were student’s sex, grade, area of residence and birth order, and parent’s age, educational level, and job status. Conclusion In the future, it will be necessary to conduct regular assessments of the rate of seasonal influenza vaccination to inform national policy development regarding seasonal influenza infectious diseases control or as an evaluation tool for vaccine programs. Key Words: Seasonal influenza, Vaccine coverage, Elementary school, Middle school, High school, Students

The mediating roles of social benefits and social influence on the relationships between collectivism, power distance, and influenza vaccination among Hong Kong nurses: A cross-sectional study

BackgroundDespite being recommended by many medical organizations, the uptake rates of seasonal influenza vaccination among healthcare workers, including nurses, are still unsatisfactory. Considering the impact of cultural values on organizational behaviors, vaccination among nurses may also be influenced by cultural values via their impacts on socially oriented motivation and the acceptance of social influence. ObjectivesThis study examined whether and in what way two individual-level cultural dimensions, collectivism and power distance, would influence vaccination via social benefits (i.e., self-and-clan protection and community protection) and social influence (i.e., authority advice, and family-and-peer advice), respectively, among nurses. DesignA cross-sectional online survey. SettingAn invitation to participate in the survey was sent to nurses using the contact list of a professional nursing organization in Hong Kong and by personal referrals. ParticipantsA total of 1386 nurses (mean age = 37.82, SD = 10.36; 89% women) completed the survey. MethodsThe survey included instruments on cultural values, perceived social benefits, and social influence, and questions regarding 2-year vaccination records. The mediation model was tested using structural equation modeling with bootstrapped samples. Subgroup analyses were conducted to examine whether the mediation paths were different across different levels of demographic factors. ResultsThe structural paths in the mediation model were different between nurses that had been vaccinated in the past and those who had not. In the adoption model (i.e., for nurses non-vaccinated in the past), the positive effects of collectivism on vaccination were mediated by self-and-clan protection and authority advice, whereas the negative effect of collectivism on vaccination was mediated by community protection. In addition, the positive effect of power distance on vaccination was mediated by authority advice. In the maintenance model (i.e., for nurses vaccinated in the past), except for the positive effect of collectivism on vaccination via authority advice, the other indirect effects were not significant. The direct effect of collectivism on vaccination was negative, whereas the direct effect of power distance on vaccination was positive. ConclusionsCollectivism and power distance may guide how nurses attend to and process social information and subsequently influence their vaccination adoption behaviors. More research is needed to examine how cultural dimensions may influence vaccination maintenance and the applicability of the current findings to other cultures.

Attitudes and barriers associated with seasonal influenza vaccination uptake among public health students; a cross-sectional study

BackgroundAlthough research has explored influenza vaccination uptake among medical and college students, there is a dearth of research in understanding influenza vaccination uptake and attitudes toward the vaccine among future public health practitioners. Undergraduate public health students represent future public health practitioners who may be a significant educational resource for health information, including the importance of vaccinations.MethodsThis cross-sectional study utilized survey data from 158 undergraduate public health students attending a large public university in Southern California. The survey assessed public health students’ attitudes and beliefs towards the seasonal influenza vaccine and seasonal vaccination rates among this population.ResultsOver 88% of respondents reported having been encouraged to receive the seasonal influenza vaccine, while only 43.0% reported receipt. Of the students who reported not receiving the vaccine, 49.4% believed it may give them the flu, 30.4% believed there may be dangerous side effects, and 28.9% believed they were not at risk for contracting the flu. Access to health care practitioners (OR: 3.947, 95% CI [1.308–11.906]) and social encouragement (OR: 3.139, 95% CI [1.447–6.811]) were significantly associated with receipt of the seasonal influenza vaccine.ConclusionAs public health program curriculum includes information about seasonal influenza vaccination and 68% of the sample were seniors soon to be exiting the program with an undergraduate degree in public health education, this low seasonal influenza vaccination rate is disturbing. This study may add to the body of data demonstrating how knowledge of the vaccine does not always guarantee vaccine uptake. Results of the current study suggest that it may be beneficial to provide additional information targeted to public health students, aimed at mediating safety concerns and increasing social pressure to assist in improving vaccine acceptance and rates in this population. Maximizing seasonal influenza vaccination uptake by addressing attitudes, barriers and misperceptions may not only improve vaccination rates among public health students, but also in communities served by these future public health practitioners.

Beneficiary characteristics and vaccinations in the end-stage renal disease Medicare beneficiary population, an analysis of claims data 2006-2015.

The Advisory Committee on Immunization Practices (ACIP) routinely recommends three vaccines - influenza, hepatitis B, and pneumococcal vaccines - for End-Stage Renal Disease (ESRD) dialysis patients. We sought to assess vaccination coverage among fee-for-service (FFS) Medicare beneficiaries with ESRD who received Part B dialysis services at any point from January 1, 2006 through December 31, 2015 (through June 30, 2016 for influenza). To assess influenza vaccination rates in a given influenza season, we restricted the population to beneficiaries who were continuously enrolled in Medicare Parts A and B throughout all twelve months of that season. To assess hepatitis B and pneumococcal vaccine coverage following dialysis initiation, we developed a Kaplan-Meier curve for all patients who began dialysis between 2006 and 2015. For influenza vaccination, we identified an average of approximately 325,000 ESRD dialysis beneficiaries enrolled through each influenza season from 2006-2015. Seasonal influenza vaccination rates steadily increased during the 10-year period, from 52% in 2006-2007 to 71% in 2015-2016. The greatest increases in influenza vaccination appear in non-white beneficiaries with overall utilization in non-whites higher than in whites (p < .001). For the hepatitis B and pneumococcal vaccinations, we identified over 350,000 ESRD dialysis beneficiaries who began dialysis over the 10-year study window. The probability of receiving a hepatitis B vaccine within the first three years of entering into the ESRD program was higher (77%) than the probability of receiving any pneumococcal vaccine (53%). 45% of ESRD patients completed at least one dose of the two hepatitis B series (three-dose or four-dose) at any time during the study period. Opportunities exist at regional and facility levels to improve vaccination coverage. Compliance to ACIP recommendations may directly affect risk for ESRD dialysis patients for complications from diseases that can be mitigated by vaccination.

Driving immunization through the Medicare Annual Wellness Visit: A growing opportunity.

The Annual Wellness Visit (AWV) is a Medicare benefit designed to help prevent disease and disability based on individualized health and risk factors. This study analyzes Medicare Part B fee-for-service claims from 2011 to 2016 to assess AWV and seasonal influenza and pneumococcal conjugate vaccinations utilization over time. Utilization of the AWV has increased from 8% of Medicare beneficiaries in 2011 to 19% in 2015. In each year, influenza and PCV13 vaccination rates are higher among those who utilize the benefit. More than one-third (33%) of patients who had an AWV in 2015 received a PCV13 vaccination in that same year, compared to 14% of those who did not. Similarly, the seasonal influenza vaccination rate was 64% among those with an AWV and 44% among those without. The AWV demonstrates promise for improving immunization rates among Medicare beneficiaries particularly at the point of care.

Patterns of influenza vaccination coverage in the United States from 2009 to 2015

BackgroundGlobally, influenza is a major cause of morbidity, hospitalization and mortality. Influenza vaccination has shown substantial protective effectiveness in the United States. MethodsWe investigated state-level patterns of coverage rates of seasonal and pandemic influenza vaccination, among the overall population (six months or older) in the U.S. and specifically among children (aged between 6 months and 17 years) and the elderly (aged 65 years or older), from 2009/10 to 2014/15, and associations with ecological factors. We obtained state-level influenza vaccination rates from national surveys, and state-level socio-demographic and health data from a variety of sources. We employed a retrospective ecological study design, and used both linear models and linear mixed-effect models to determine the levels of ecological association of the state-level vaccinations rates with these factors, both with and without region as a factor for the three populations. Results and ConclusionsHealth-care access has a robust, positive association with state-level vaccination rates across all populations and models. This highlights a potential population-level advantage of expanding health-care access. We also found that prevalence of asthma in adults is negatively associated with mean influenza vaccination rates in the elderly populations.