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Datta BK, Jaremski JE, Ansa BE, Odhiambo L, Clary C, Islam KMM, Johnson JA. A Survival Analysis of Rural-Urban Disparities in COVID-19 Vaccination Uptake in the United States. Am J Health Promot 2024:8901171241300136. [PMID: 39529382 DOI: 10.1177/08901171241300136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
PURPOSE Though urban-rural disparities in COVID-19 vaccination coverage was documented at a point of time, little is known on the evolution of vaccination uptake over time. This study, using individual level time-to-event data, intend to assess the differences in monthly progression of vaccination uptake among U.S. adults by urban/rural residence. DESIGN Survival analysis. SETTING Urban and rural areas in 29 U.S. states. SUBJECTS 135,969 adults aged 18+ years. MEASURES Time (in months) to receive the first dose of COVID-19 vaccine since the U.S. Food and Drug Administration (FDA) Emergency Use Authorization of Pfizer-BioNTech- and Moderna- COVID-19 Vaccine in December 2020. ANALYSIS Kaplan-Meier survivor functions and stratified Cox proportional hazard models were estimated for the event of being vaccinated by urban/rural residence for 25 months starting from December 2020. Monthly survival probabilities for urban- and rural- adults were further assessed within certain demographic and socioeconomic groups. RESULTS We found a gradual divergence of COVID-19 vaccination uptake in favor of urban adults, which was robust across sex, age groups, race and ethnicity, education, and income levels. In April 2021, after vaccine eligibility was expanded, 42.2% adults in urban and 53.3% adults in rural areas were unvaccinated. While only 19.3% urban adults remained unvaccinated in December 2022, this rate was 32.5% among rural adults. Compared to their urban counterparts, rural adults were 0.77 (95% CI: 0.76 - 0.79) times as likely to receive the first dose of COVID-19 vaccine. CONCLUSIONS Time-to-event analysis of vaccination against COVID-19 indicated a lower uptake among rural adults, which was persistent across different demographic and socioeconomic groups.
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Affiliation(s)
- Biplab Kumar Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA
| | - Jennifer E Jaremski
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
| | - Benjamin E Ansa
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA
| | - Lorriane Odhiambo
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Biostatistics, Data Science and Epidemiology, Augusta University, Augusta, GA, USA
| | - Catherine Clary
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA
| | - K M Monirul Islam
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Biostatistics, Data Science and Epidemiology, Augusta University, Augusta, GA, USA
| | - J Aaron Johnson
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Community & Behavioral Health Sciences, Augusta University, Augusta, GA, USA
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Croft JL, Teasdale CA, Fleary S, Kelvin EA. Racial and ethnic minority status in country of birth modifies racial and ethnic disparities in influenza vaccination among New York City adults. Ann Epidemiol 2024; 95:19-25. [PMID: 38782294 DOI: 10.1016/j.annepidem.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Understanding the relationship between race/ethnicity, birthplace, and health outcomes is important for reducing health disparities. This study assessed the relationship between racial/ethnic identity and minority racial/ethnic status in country of birth on influenza vaccination among New York City (NYC) adults. METHODS Using 2015-2019 data from NYC's Community Health Surveys, we assessed the association between racial/ethnic identity and racial/ethnic minority status in birth country with past year influenza vaccination, calculating prevalence differences per 100 and assessing interaction on the additive scale using linear binomial regression, and prevalence ratios and interaction on the multiplicative scale using log-binomial regression. RESULTS Effect modification between race/ethnicity and minority racial/ethnic status in birth country was significant on the additive scale for Hispanic (p = 0.018) and Black (p = 0.025) adults and the multiplicative scale for Hispanic adults (p = 0.040). After stratifying by racial/ethnic minority or majority status in birth country, vaccination was significantly lower among Black adults compared with White adults among those in the minority (adjusted prevalence difference [aPD]=-12.98, 95%CI: -22.88-(-2.92)) and significantly higher among Hispanic adults compared with White adults among those in the majority (aPD=9.28, 95%CI: 7.35-11.21). CONCLUSIONS Racial/ethnic minority status in birth country is an important factor when examining racial/ethnic differences in vaccination status.
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Affiliation(s)
- John L Croft
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York City, NY, USA
| | - Chloe A Teasdale
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York City, NY, USA; CUNY Institute for Implementation Science in Population Health, CUNY, New York City, NY, USA
| | - Sasha Fleary
- CUNY Institute for Implementation Science in Population Health, CUNY, New York City, NY, USA; Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, CUNY, New York City, NY, USA
| | - Elizabeth A Kelvin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York City, NY, USA; CUNY Institute for Implementation Science in Population Health, CUNY, New York City, NY, USA; Department of Occupational Health, Epidemiology & Prevention, Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell Health, Hempstead, NY, USA.
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3
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Liu R, Du X, Patel A, Di Tanna GL, Zhao Y, Wang Z, Fan Y, Zhang H, Yi Y, Dong J, Anderson C, Liu H. Cluster randomized trial of influenza vaccination in patients with acute heart failure in China: A mixed-methods feasibility study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001947. [PMID: 37327192 DOI: 10.1371/journal.pgph.0001947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 05/02/2023] [Indexed: 06/18/2023]
Abstract
Uncertainties about the efficacy of influenza vaccination for populations with heart failure (HF) in preventing cardiovascular outcomes, as well as lack of effective vaccination strategies, may contribute to low vaccine coverage rate (VCR) in China and globally. We assessed the feasibility of a strategy to promote influenza vaccines in patients hospitalized with acute HF in China and to inform the design of a hybrid effectiveness-implementation cluster randomized trial to evaluate this strategy on mortality and hospital re-admission. We conducted a cluster randomized pilot trial involving 11 hospitals in Henan Province in China, with mixed-methods evaluation between December 2020 and April 2021. A process evaluation involved interviews with 51 key informants (patients, health professionals, policy makers). The intervention included education about influenza vaccination and availability of free vaccines administered prior to hospital discharge for HF patients, while usual care included attending community-based points of vaccination (PoV) for screening and vaccination. Implementation outcomes focused on reach, fidelity, adoption, and acceptability. Recruitment rates were assessed for trial feasibility. Effectiveness outcomes were influenza VCR, HF-specific rehospitalizations and mortality at 90 days. A total of 518 HF patients were recruited from 7 intervention and 4 usual care hospitals (mean of 45 participants per hospital per month). VCR was 89.9% (311/346, 86.1-92.8%) in the intervention group and 0.6% (1/172, 0.0-3.7%) in the control group. The process evaluation demonstrated reach to patients with lower socioeconomic and education status. There was good fidelity of the intervention components, with education and PoV set up processes being adapted to local hospital workflow and workforce capacity. Intervention was acceptable and adopted by patients and health professionals. However, outside of a trial setting, concerns were raised around vaccination reimbursement costs, workforce accountability and capacity. The intervention strategy appears feasible and acceptable for improving VCR in HF patients at county-level hospitals in China. Trial registration: This pilot trial is registered with the acronym PANDA II Pilot (Population Assessment of Influenza and Disease Activity) at ChiCTR.org.cn (ChiCTR2000039081).
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Affiliation(s)
- Rong Liu
- Heart Health Research Center (HHRC), Beijing, China
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Xin Du
- Heart Health Research Center (HHRC), Beijing, China
- The George Institute for Global Health, UNSW, Sydney, Australia
- Beijing Anzhen Hospital, Beijing, China
| | - Anushka Patel
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Gian Luca Di Tanna
- The George Institute for Global Health, UNSW, Sydney, Australia
- Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Lugano, Switzerland
| | | | | | - Yihang Fan
- Heart Health Research Center (HHRC), Beijing, China
- The University of California, Irvine, California, United States of America
| | - Hao Zhang
- Beijing Anzhen Hospital, Beijing, China
| | - Yang Yi
- The University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jianzeng Dong
- Beijing Anzhen Hospital, Beijing, China
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Craig Anderson
- Heart Health Research Center (HHRC), Beijing, China
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Hueiming Liu
- The George Institute for Global Health, UNSW, Sydney, Australia
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, Australia
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4
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Daniels D, Imdad A, Buscemi-Kimmins T, Vitale D, Rani U, Darabaner E, Shaw A, Shaw J. Vaccine hesitancy in the refugee, immigrant, and migrant population in the United States: A systematic review and meta-analysis. Hum Vaccin Immunother 2022; 18:2131168. [PMID: 36332155 PMCID: PMC9746503 DOI: 10.1080/21645515.2022.2131168] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Refugees, immigrants, and migrants (RIM) in the United States (US) have been identified as an underimmunized population prior to the COVID-19 pandemic. Vaccine acceptance is critical to combat the public health threat incited by COVID-19 and other vaccine-preventable disease. To better understand escalating vaccine hesitancy among US RIM, a comprehensive evaluation of the problem and solutions is necessary. In this systematic review, we included 57 studies to describe vaccination rates, barriers, and interventions addressing vaccine hesitancy over the past decade. Meta-analysis was performed among 22 studies, concluding that RIM represent an underimmunized population compared to the general US population. Narrative synthesis and qualitative methods were used to identify critical barriers, including gaps in knowledge, poor access to medical care, and heightened distrust of the medical system. Our results demonstrate the need for effective, evidence-based interventions to increase vaccination rates among diverse RIM populations.
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Affiliation(s)
- Danielle Daniels
- Department of Pediatrics, Division of Infectious Diseases, Upstate Golisano Children’s Hospital, SUNY Upstate Medical University, Syracuse, NY, USA,CONTACT Danielle Daniels 750 East Adams St. Room 5400, Syracuse, NY13210, USA
| | - Aamer Imdad
- Department of Pediatrics, Karjoo Family Center for Pediatric Gastroenterology, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | - Danielle Vitale
- Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Uzma Rani
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Ellen Darabaner
- Hunter-Rice Health Sciences Library, Samaritan Medical Center, Watertown, NY, USA
| | - Andrea Shaw
- Department of Pediatrics, Department of Internal Medicine, Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jana Shaw
- Department of Pediatrics, Division of Infectious Diseases, Upstate Golisano Children’s Hospital, SUNY Upstate Medical University, Syracuse, NY, USA
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Parker SJ, DeLaroche AM, Hill AB, Arora R, Gleason-Comstock J. Influenza vaccination coverage among an urban pediatric asthma population: Implications for population health. PLoS One 2022; 17:e0269415. [PMID: 36269718 PMCID: PMC9586375 DOI: 10.1371/journal.pone.0269415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/09/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Asthma is the most common chronic disease in children. Children with asthma are at high risk for complications from influenza; however annual influenza vaccination rates for this population are suboptimal. The overall aim of this study was to describe the characteristics of a high-risk population of children with asthma presenting to an urban pediatric emergency department according to influenza vaccination status. METHODS The study was a retrospective chart review of 4355 patients aged 2 to 18 years evaluated in a Michigan pediatric emergency department (PED) between November 1, 2017 and April 30, 2018 with an ICD-10-CM code for asthma (J45.x). Eligible patient PED records were matched with influenza vaccination records for the 2017-2018 influenza season from the Michigan Care Improvement Registry. Geospatial analysis was employed to examine the distribution of influenza vaccination status. RESULTS 1049 patients (30.9%) with asthma seen in the PED had received an influenza vaccine. Influenza vaccination coverage varied by Census Tract, ranging from 10% to >99%. Most vaccines were administered in a primary care setting (84.3%) and were covered by public insurance (76.8%). The influenza vaccination rate was lowest for children aged 5-11 years (30.0%) and vaccination status was associated with race (p<0.001) and insurance type (p<0.001). CONCLUSIONS Identification of neighborhood Census Tract and demographic groups with suboptimal influenza vaccination could guide development of targeted public health interventions to improve vaccination rates in high-risk patients. Given the morbidity and mortality associated with pediatric asthma, a data-driven approach may improve outcomes and reduce healthcare-associated costs for this pediatric population.
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Affiliation(s)
- Sarah J. Parker
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States of America
| | - Amy M. DeLaroche
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI, United States of America
| | - Alex B. Hill
- Department of Urban Studies and Planning, Wayne State University, Detroit, MI, United States of America
| | - Rajan Arora
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI, United States of America
| | - Julie Gleason-Comstock
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI, United States of America
- * E-mail:
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6
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Wimberly CE, Towry L, Davis E, Johnston EE, Walsh KM. SARS-CoV-2 vaccine acceptability among caregivers of childhood cancer survivors. Pediatr Blood Cancer 2022; 69:e29443. [PMID: 34786824 PMCID: PMC8661918 DOI: 10.1002/pbc.29443] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/04/2021] [Accepted: 10/21/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To explore willingness/hesitancy to vaccinate self and children against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among caregivers of childhood cancer survivors (CCS). METHODS A 19-question survey was sent to caregivers of CCS and completed between February 25 and April 13, 2021. Logistic regression was used to investigate relationships between willingness/hesitancy to vaccinate (a) self and (b) CCS, and demographic variables, confidence in the government and medical community's responses to coronavirus disease 2019 (COVID-19), and factors specific to the CCS community (e.g., previous participation in an investigational therapeutic trial). RESULTS Caregivers (6% male) from 130 unique families completed the survey. Mean CCS age at survey was 15 years (SD 6.4). Mean CCS age at diagnosis was 4.3 years (SD 4.3). Mean time from CCS diagnosis to survey completion was 10 years (SD 6.2). Twenty-one percent of caregivers expressed hesitancy to vaccinate themselves and 29% expressed hesitancy to vaccinate their CCS. Caregivers expressing confidence in the federal government's response to COVID-19 were six-fold likelier to express willingness to self-vaccinate (p < .001) and were three-fold likelier to express willingness to vaccinate their CCS (p = .011). Qualitative analysis of free-text responses revealed three general themes, including (a) confidence in science, medicine, and vaccination as a strategy for health promotion, (b) confidence in SARS-CoV-2 vaccination and belief that CCS are at greater risk of COVID-19 complications, and (c) concerns about the swiftness of COVID-19 vaccine development and insufficient safety/efficacy data in children and CCS. CONCLUSIONS Results underscore the need for COVID-19 vaccination education and outreach, even among families highly engaged with the medical community, and emphasize the importance of updating these families as relevant data emerge from vaccine trials and registries.
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Affiliation(s)
- Courtney E. Wimberly
- Division of Neuro‐Epidemiology, Department of NeurosurgeryDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Lisa Towry
- Alex's Lemonade Stand FoundationBala CynwydPennsylvaniaUSA
| | - Elizabeth Davis
- Institute for Cancer Survivorship and OutcomesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Emily E. Johnston
- Institute for Cancer Survivorship and OutcomesUniversity of Alabama at BirminghamBirminghamAlabamaUSA,Division of Pediatric Hematology/Oncology, Department of PediatricsUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Kyle M. Walsh
- Division of Neuro‐Epidemiology, Department of NeurosurgeryDuke University School of MedicineDurhamNorth CarolinaUSA,Children's Health and Discovery Institute, Department of PediatricsDuke University School of MedicineDurhamNorth CarolinaUSA,Duke Cancer InstituteDuke University School of MedicineDurhamNorth CarolinaUSA
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7
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Tankwanchi ABS, Jaca A, Ndlambe AM, Zantsi ZP, Bowman B, Garrison MM, Larson HJ, Vermund SH, Wiysonge CS. Non-COVID-19 vaccine hesitancy among migrant populations worldwide: a scoping review of the literature, 2000-2020. Expert Rev Vaccines 2022; 21:1269-1287. [DOI: 10.1080/14760584.2022.2084075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Anelisa Jaca
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
| | - Asiphe M Ndlambe
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
| | - Zukiswa P Zantsi
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
| | - Brett Bowman
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, SA
| | - Michelle M Garrison
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Sten H Vermund
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
- Department of Global Health, Stellenbosch University, Cape Town, SA
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, SA
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8
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Granade CJ, Lindley MC, Jatlaoui T, Asif AF, Jones-Jack N. Racial and Ethnic Disparities in Adult Vaccination: A Review of the State of Evidence. Health Equity 2022; 6:206-223. [PMID: 35402775 PMCID: PMC8985539 DOI: 10.1089/heq.2021.0177] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Adult vaccination coverage remains low in the United States, particularly among racial and ethnic minority populations. Objective To conduct a comprehensive literature review of research studies assessing racial and ethnic disparities in adult vaccination. Search Methods We conducted a search of PubMed, Cochrane Library, ClinicalTrials.gov, and reference lists of relevant articles. Selection Criteria Research studies were eligible for inclusion if they met the following criteria: (1) study based in the United States, (2) evaluated receipt of routine immunizations in adult populations, (3) used within-study comparison of race/ethnic groups, and (4) eligible for at least one author-defined PICO (patient, intervention, comparison, and outcome) question. Data Collection and Analysis Preliminary abstract review was conducted by two authors. Following complete abstraction of articles using a standardized template, abstraction notes and determinations were reviewed by all authors; disagreements regarding article inclusion/exclusion were resolved by majority rule. The Social Ecological Model framework was used to complete a narrative review of observational studies to summarize factors associated with disparities; a systematic review was used to evaluate eligible intervention studies. Results Ninety-five studies were included in the final analysis and summarized qualitatively within two main topic areas: (1) factors associated with documented racial-ethnic disparities in adult vaccination and (2) interventions aimed to reduce disparities or to improve vaccination coverage among racial-ethnic minority groups. Of the 12 included intervention studies, only 3 studies provided direct evidence and were of Level II, fair quality; the remaining 9 studies met the criteria for indirect evidence (Level I or II, fair or poor quality). Conclusions A considerable amount of observational research evaluating factors associated with racial and ethnic disparities in adult vaccination is available. However, intervention studies aimed at reducing these disparities are limited, are of poor quality, and insufficiently address known reasons for low vaccination uptake among racial and ethnic minority adults.
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Affiliation(s)
- Charleigh J. Granade
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Megan C. Lindley
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Tara Jatlaoui
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Amimah F. Asif
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, U.S. Department of Energy, Atlanta, Georgia, USA
| | - Nkenge Jones-Jack
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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9
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Paramanathan P, Abbas M, Huda SA, Huda S, Mortazavi M, Taravati P. Comparing racial health disparities in pandemics a decade apart: H1N1 and COVID-19. Future Healthc J 2021. [PMID: 34888475 DOI: 10.7861/fhj.2021-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background and aims The Centers for Disease Control and Prevention has reported disproportionate health disparities with respect to disease for Blacks/African Americans (AAs) compared to Whites in the USA. In this paper, we identify and compare the factors involved in creating these disparities among these populations during the 2009 H1N1 and current COVID-19 pandemics. Methods We included studies describing health disparities towards Blacks/AAs in the USA during the H1N1 and COVID-19 pandemics. Only observational empirical studies with free full-text availability in English from PubMed, PubMed Central and Google Scholar were included. Results A total of 31 papers were included: 19 pertaining to the H1N1 pandemic and 12 to the COVID-19 pandemic. Qualitative analysis for health disparities resulted in 43 different factors, which were subdivided into nine overarching themes. Discussion The similarities that exist between the two pandemics indicate that there are many neglected issues in American healthcare that need to be addressed. The listed factors have led to disparities in screening and treating for disease resulting in disparities in infection rates, severity of illness and mortality. This calls for a change in healthcare dynamics to improve access to healthcare, remove any form of possible discrimination, and regain the lost trust with the Black/AA communities, repairing historical damage. Conclusions Effective utilisation of social media and faith-based centres to educate patients, implementation of new policies improving access to healthcare, and culture-sensitive education for healthcare providers are suggested to decrease health disparities and improve health outcomes across the USA.
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Affiliation(s)
- Prathayini Paramanathan
- All Saints University College of Medicine, Saint Vincent and the Grenadines, and clinical research coordinator, McMaster University, Canada
| | | | - Sajjad Ali Huda
- Avalon University School of Medicine, Curacao, and Canadian pharmacist, Kingston University, London, UK
| | | | | | - Parastoo Taravati
- Saint James School of Medicine, Saint Vincent and the Grenadines, and public health extern, Illinois Academy of Family Physicians, Chicago, USA
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10
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Paramanathan P, Abbas M, Huda SA, Huda S, Mortazavi M, Taravati P. Comparing racial health disparities in pandemics a decade apart: H1N1 and COVID-19. Future Healthc J 2021; 8:e722-e728. [PMID: 34888475 PMCID: PMC8651308 DOI: 10.7861/fhj.2021.0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS The Centers for Disease Control and Prevention has reported disproportionate health disparities with respect to disease for Blacks/African Americans (AAs) compared to Whites in the USA. In this paper, we identify and compare the factors involved in creating these disparities among these populations during the 2009 H1N1 and current COVID-19 pandemics. METHODS We included studies describing health disparities towards Blacks/AAs in the USA during the H1N1 and COVID-19 pandemics. Only observational empirical studies with free full-text availability in English from PubMed, PubMed Central and Google Scholar were included. RESULTS A total of 31 papers were included: 19 pertaining to the H1N1 pandemic and 12 to the COVID-19 pandemic. Qualitative analysis for health disparities resulted in 43 different factors, which were subdivided into nine overarching themes. DISCUSSION The similarities that exist between the two pandemics indicate that there are many neglected issues in American healthcare that need to be addressed. The listed factors have led to disparities in screening and treating for disease resulting in disparities in infection rates, severity of illness and mortality. This calls for a change in healthcare dynamics to improve access to healthcare, remove any form of possible discrimination, and regain the lost trust with the Black/AA communities, repairing historical damage. CONCLUSIONS Effective utilisation of social media and faith-based centres to educate patients, implementation of new policies improving access to healthcare, and culture-sensitive education for healthcare providers are suggested to decrease health disparities and improve health outcomes across the USA.
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Affiliation(s)
- Prathayini Paramanathan
- All Saints University College of Medicine, Saint Vincent and the Grenadines, and clinical research coordinator, McMaster University, Canada
| | | | - Sajjad Ali Huda
- Avalon University School of Medicine, Curacao, and Canadian pharmacist, Kingston University, London, UK
| | | | | | - Parastoo Taravati
- Saint James School of Medicine, Saint Vincent and the Grenadines, and public health extern, Illinois Academy of Family Physicians, Chicago, USA
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Hofstetter AM, Opel DJ, Stockwell MS, Hsu C, Zhou C, Mangione-Smith RM, Englund JA. Associations Between Health Care Professional Communication Practices and Influenza Vaccination of Hospitalized Children. Acad Pediatr 2021; 21:1142-1150. [PMID: 34217901 DOI: 10.1016/j.acap.2021.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/15/2021] [Accepted: 06/27/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Health care professionals (HCPs) (eg, nurses, doctors) play a key role in vaccine uptake. Few studies describe HCP influenza vaccine communication with parents of hospitalized children. METHODS This study included English- and Spanish-speaking parents of influenza vaccine-eligible children hospitalized at a tertiary care pediatric hospital between October 2018 and May 2019. A survey was completed online or via telephone 2 to 15 weeks (median 4 weeks) after discharge. It examined parental intent to vaccinate their child during hospitalization and parent-reported inpatient HCP communication practices (eg, vaccine recommendation strength, format for initiating the recommendation). Multivariable logistic regression examined the associations between HCP communication practices and influenza vaccination during hospitalization, adjusting for demographic, clinical, and visit characteristics. RESULTS Parents (n = 194; 63.0% response rate) were mostly white (66.8%) and English-speaking (97.4%). Their children were primarily 5 through 17 years (67.0%) with chronic disease (68.6%); 24.7% were vaccinated before discharge. Most parents initially had no plan (55.6%) or planned to decline (31.1%) influenza vaccine for their child during hospitalization. Of these parents, 22.2% decided to accept the vaccine, 66.7% citing a HCP conversation as the main reason for changing their mind. Overall, 75.3% recalled a HCP conversation about influenza vaccination. Of these parents, 61.0% reported a HCP recommendation (53.8% described it as "very strong"; 11.1% noted a presumptive initiation format). A parent-reported HCP conversation (adjusted odds ratio [AOR] 5.23, 95% confidence interval [CI] 1.64-16.68) and recommendation (AOR 5.59, 95% CI 2.01-15.51) were associated with influenza vaccination during hospitalization. CONCLUSION This study highlights the importance of discussing and recommending influenza vaccination with parents of hospitalized children.
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Affiliation(s)
- Annika M Hofstetter
- Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash.
| | - Douglas J Opel
- Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
| | - Melissa S Stockwell
- Department of Pediatrics, Columbia University (MS Stockwell), New York, NY; Department of Population and Family Health, Mailman School of Public Health, Columbia University (MS Stockwell), New York, NY
| | - Clarissa Hsu
- Kaiser Permanente Washington Health Research Institute (C Hsu and RM Mangione-Smith), Seattle, Wash
| | - Chuan Zhou
- Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
| | - Rita M Mangione-Smith
- Kaiser Permanente Washington Health Research Institute (C Hsu and RM Mangione-Smith), Seattle, Wash
| | - Janet A Englund
- Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash; Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
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12
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Peterson EB, Chou WYS, Kelley DE, Hesse B. Trust in national health information sources in the United States: comparing predictors and levels of trust across three health domains. Transl Behav Med 2021; 10:978-988. [PMID: 31116400 DOI: 10.1093/tbm/ibz066] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Public trust in traditional sources of health information is essential for public health agencies and organizations to perform necessary public health functions. Little research has examined levels and predictors of trust in government health agencies and national health organizations. Additionally, few studies have simultaneously analyzed trust in multiple health topics. The major aim of this study was to compare levels and factors associated with trust in national health sources across three health topics: information about tobacco, electronic cigarettes, and general health. Data from two cycles of the National Cancer Institute's Health Information National Trends Survey collected in 2015 and 2017 were merged and analyzed for this study (n = 5,474). A series of weighted multivariable logistic regression models calculated odds of high trust in government health agencies and health organizations for each health topic. More respondents reported high trust in health organizations than for government health agencies across all topics. More participants reported high trust in these sources tobacco information, as compared to general health or e-cigarette information. Logistic models found that those higher in information seeking confidence were more likely to report high trust across all models. Other demographic variables were inconsistent predictors of trust across topics. This study highlights inconsistent sociodemographic predictors of trust across multiple health topics and national health sources. Researchers, practitioners, and policymakers should consider the unique context of specific health topics in health promotion campaigns, partner with existing community-based organizations, and encourage and enable health information seeking.
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Affiliation(s)
- Emily B Peterson
- Behavioral Research Program, National Cancer Institute, Rockville, MD, USA
| | | | - Dannielle E Kelley
- Behavioral Research Program, National Cancer Institute, Rockville, MD, USA
| | - Brad Hesse
- Behavioral Research Program, National Cancer Institute, Rockville, MD, USA
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13
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Bhugra P, Grandhi GR, Mszar R, Satish P, Singh R, Blaha M, Blankstein R, Virani SS, Cainzos-Achirica M, Nasir K. Determinants of Influenza Vaccine Uptake in Patients With Cardiovascular Disease and Strategies for Improvement. J Am Heart Assoc 2021; 10:e019671. [PMID: 34315229 PMCID: PMC8475658 DOI: 10.1161/jaha.120.019671] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Influenza infection is associated with an increased risk of cardiovascular events (myocardial infarction, stroke, and heart failure exacerbation) and mortality, and all‐cause mortality in patients with CVD. Infection with influenza leads to a systemic inflammatory and thrombogenic response in the host body, which further causes destabilization of atherosclerotic plaques. Influenza vaccination has been shown to be protective against cardiovascular and cerebrovascular events in several observational and prospective studies of at‐risk populations. Hence, many international guidelines recommend influenza vaccination for adults of all ages, especially for individuals with high‐risk conditions such as CVD. Despite these long‐standing recommendations, influenza vaccine uptake among US adults with CVD remains suboptimal. Specifically, vaccination uptake is strikingly low among patients aged <65 years, non‐Hispanic Black individuals, those without health insurance, and those with diminished access to healthcare services. Behavioral factors such as perceived vaccine efficacy, vaccine safety, and attitudes towards vaccination play an important role in vaccine acceptance at the individual and community levels. With the ongoing COVID‐19 pandemic, there is a potential threat of a concurrent epidemic with influenza. This would be devastating for vulnerable populations such as adults with CVD, further stressing the need for ensuring adequate influenza vaccination coverage. In this review, we describe a variety of strategies to improve the uptake of influenza vaccination in patients with CVD through improved understanding of key sociodemographic determinants and behaviors that are associated with vaccination, or the lack thereof. We further discuss the potential use of relevant strategies for COVID‐19 vaccine uptake among those with CVD.
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Affiliation(s)
| | | | - Reed Mszar
- Center for Outcomes Research and EvaluationYale New Haven Health New Haven CT
| | - Priyanka Satish
- Department of CardiologyHouston Methodist Hospital Houston TX
| | - Rahul Singh
- Department of Internal Medicine Houston Methodist Hospital Houston TX
| | - Michael Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease Baltimore MD
| | - Ron Blankstein
- Cardiovascular Imaging Program, Cardiovascular Division and Department of Radiology Brigham and Women's Hospital Boston MA
| | - Salim S Virani
- Michael E. DeBakey Veterans Affairs Medical Center Houston TX.,Baylor College of Medicine Houston TX
| | - Miguel Cainzos-Achirica
- Division of Cardiovascular Prevention and Wellness Department of CardiologyHouston Methodist DeBakey Heart & Vascular Center Houston TX.,Center for Outcomes Research Yale University New Haven CT
| | - Khurram Nasir
- Division Health Equity & Disparities Research Center for Outcomes Research Houston Methodist Hospital Houston TX.,Division of Cardiovascular Prevention and Wellness Department of Cardiovascular MedicineHouston Methodist DeBakey Heart & Vascular Center Houston TX.,Center for Cardiovascular Computational & Precision Health (C3-PH) Department of Cardiovascular Medicine Houston Methodist DeBakey Heart & Vascular Center Houston TX.,Division of Cardiology Yale University New Haven CT
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14
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Chen G, Kazmi M, Chen D, Phillips J. Identifying Associations Between Influenza Vaccination Status and Access, Beliefs, and Sociodemographic Factors Among the Uninsured Population in Suffolk County, NY. J Community Health 2021; 45:1236-1241. [PMID: 32607750 DOI: 10.1007/s10900-020-00873-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Seasonal influenza continues to impose a substantial healthcare and economic burden in the United States each year. This study assessed influenza vaccination rates among the uninsured population, determined the need for free flu vaccines, and analyzed associations of vaccination status with access, beliefs, and sociodemographic factors. Stony Brook Outreach and Medical Education (SB HOME) free clinic offers free flu vaccinations to uninsured patients over the age of 18 living in Suffolk County, New York. All patients visiting SB HOME between October 2018 and February 2019 were offered a 10-min anonymous survey assessing demographic characteristics, self-evaluation of health status, vaccination status during the 2017-2018 and 2018-2019 flu seasons, willingness to obtain a free flu vaccine, and beliefs and barriers surrounding flu vaccines. Analysis consisted of descriptive statistics, paired t tests, and χ2 tests using a significance threshold of p < 0.05. A total of 102 participants were surveyed, 80% of whom identified as Hispanic/Latino. The majority of participants expressed positive attitudes towards the influenza vaccine. Despite these positive attitudes, 72% reported not receiving the influenza vaccination during the 2017-2018 flu season, the commonly cited reasons being fear of getting sick from the flu vaccine, high cost, and not knowing where to get the vaccine. During the 2018-2019 flu season 60% of participants elected to receive a free flu shot at SB HOME, and participants with positive attitudes towards flu vaccines were more likely to accept the vaccine when offered at no cost. Fear of getting sick from the flu vaccine remained the most common reason for participants declining a free flu vaccine. Only 17% of participants would seek vaccination at the market price of $30, compared to the 76% who would if the vaccine was offered for free. Our study highlights the need for convenient and affordable access to the flu vaccine among uninsured populations, who despite recognizing the benefits of receiving the flu vaccine are unable to overcome certain barriers. Elucidating and targeting barriers specific to uninsured populations at the local community level may improve public health strategies centered on increasing vaccination rates.
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Affiliation(s)
- George Chen
- Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY, 11794-8434, USA.
| | - Masooma Kazmi
- Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY, 11794-8434, USA
| | - Danling Chen
- Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY, 11794-8434, USA
| | - Jedan Phillips
- Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY, 11794-8434, USA
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15
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Jungquist RM, Abuelezam NN. Disparities in influenza vaccination: Arab Americans in California. BMC Public Health 2021; 21:443. [PMID: 33663444 PMCID: PMC7932900 DOI: 10.1186/s12889-021-10476-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/18/2021] [Indexed: 01/24/2023] Open
Abstract
Background Influenza vaccination among minoritized groups remains below federal benchmarks in the United States (US). We used data from the 2004–2016 California Health Interview Surveys (CHIS) to characterize influenza vaccination patterns among Arab Americans in California. Methods Influenza vaccination was self-reported by Arab American adults (N = 1163) and non-Hispanic Whites (NHW, N = 166,955). Differences in influenza vaccination prevalence and odds were compared using chi-squared tests and survey-weighted logistic regression, respectively. Results Across all years, 30.3% of Arab Americans self-reported receiving an influenza vaccine (vs. 40.5% for NHW, p < 0.05). After sequential adjustment by sociodemographic, health behavior, and acculturation variables no differences in odds of self-reported influenza vaccination were observed between Arab Americans and NHW (odds ratio: 1.02, 95% confidence interval: 0.76–1.38). Male and unemployed Arab Americans had higher odds of reporting influenza vaccination than female and employed Arab Americans. Conclusions Future work should consider specific barriers to influenza vaccination in Arab American communities.
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Affiliation(s)
| | - Nadia N Abuelezam
- William F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
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16
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Burger AE, Reither EN, Mamelund SE, Lim S. Black-white disparities in 2009 H1N1 vaccination among adults in the United States: A cautionary tale for the COVID-19 pandemic. Vaccine 2021; 39:943-951. [PMID: 33454136 PMCID: PMC7800135 DOI: 10.1016/j.vaccine.2020.12.069] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/18/2020] [Accepted: 12/23/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Prior research has highlighted racial and ethnic disparities in H1N1 vaccination in the United States. Our study adds to this literature by utilizing an intersectionality framework to examine the joint influence of race and sex on H1N1 vaccination beliefs and behaviors among non-Hispanic blacks and non-Hispanic whites (hereafter blacks and whites). METHODS Using data from the National H1N1 Flu Survey of U.S. adults, we measured differences in beliefs about the safety and efficacy of the H1N1 vaccine among black women, black men, white women, and white men. We then estimated a series of nested logistic regression models to examine how race/sex vaccination disparities were influenced by health beliefs, socioeconomic status (SES), pre-existing conditions, and healthcare. RESULTS Black respondents were more likely than white respondents to express reservations about the safety and efficacy of the H1N1 vaccine. Consistent with those beliefs, white females reported the highest rate of H1N1 vaccination (28.4%), followed by white males (26.3%), black males (21.6%), and black females (17.5%). Differences in health beliefs, SES, pre-existing conditions, and healthcare explained lower odds of H1N1 vaccination among white men and black men, relative to white women. However, black women experienced 35-45% lower odds of vaccination than white women across all models, highlighting the intersectional nature of these associations. DISCUSSION The 2009 H1N1 influenza pandemic provides a cautionary tale about the distribution of new vaccines across large populations with diverse racial, sex, and socioeconomic characteristics. Despite differences between the H1N1 and COVID-19 pandemics, our study warns that many black Americans will forego COVID-19 vaccines unless swift action is taken to address black-white disparities in access to vital resources. Public health stakeholders can also encourage widespread adoption of COVID-19 vaccines by tailoring health promotion messages for different groups of racial minorities, especially groups like black women who face intersecting disadvantages.
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Affiliation(s)
- Andrew E Burger
- Brigham Young University-Idaho, 525 S 2nd E, Rexburg, ID 83420, United States.
| | - Eric N Reither
- Utah State University, 0730 Old Main Hill, Logan, UT 84322, United States
| | - Svenn-Erik Mamelund
- OsloMet, Centre for Welfare and Labor Research, Stensberggata 26, 0170 Oslo, Norway
| | - Sojung Lim
- Utah State University, 0730 Old Main Hill, Logan, UT 84322, United States
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17
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Yeung MPS, Lam FLY, Coker R. Factors associated with the uptake of seasonal influenza vaccination in adults: a systematic review. J Public Health (Oxf) 2018; 38:746-753. [PMID: 28158550 DOI: 10.1093/pubmed/fdv194] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Frank L Y Lam
- Department of Chemical and Biomolecular Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Richard Coker
- Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
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18
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Kahn KE, Santibanez TA, Zhai Y, Bridges CB. Association between provider recommendation and influenza vaccination status among children. Vaccine 2018; 36:3486-3497. [PMID: 29764679 PMCID: PMC6432907 DOI: 10.1016/j.vaccine.2018.04.077] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/19/2018] [Accepted: 04/25/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Provider recommendation is associated with influenza vaccination receipt. The objectives of this study were to estimate the percentage of children 6 months-17 years for whom a provider recommendation for influenza vaccination was received, identify factors associated with receipt of provider recommendation, and evaluate the association between provider recommendation and influenza vaccination status among children. METHODS National Immunization Survey-Flu (NIS-Flu) parentally reported data for the 2013-14, 2014-15, and 2015-16 seasons were analyzed. Tests of association between provider recommendation and demographic characteristics were conducted using Wald chi-square tests and pairwise comparison t-tests. Multivariable logistic regression was used to determine variables independently associated with receiving provider recommendation and the association between provider recommendation and influenza vaccination status. RESULTS Approximately 70% of children had a parent report receiving a provider recommendation for influenza vaccination for their child. The strongest association between receipt of provider recommendation and demographic characteristics was with child's age, with younger children (6-23 months, 2-4 years, and 5-12 years) being more likely to have a provider recommendation than older children (13-17 years). In addition, children living in a household above poverty with household income >$75,000 were more likely to have a parent report receipt of a provider recommendation than children living below poverty. Children with a provider recommendation were twice as likely to be vaccinated than those without. CONCLUSIONS This study affirms the importance of provider recommendation for influenza vaccination among children. Ensuring that parents of all children receive a provider recommendation may improve vaccination coverage.
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Affiliation(s)
- Katherine E Kahn
- Leidos, Inc., Atlanta, Georgia, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
| | | | - Yusheng Zhai
- Leidos, Inc., Atlanta, Georgia, USA; Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carolyn B Bridges
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA; Berry Technology Solutions, Peachtree City, GA, USA
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19
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Quinn SC, Jamison A, An J, Freimuth VS, Hancock GR, Musa D. Breaking down the monolith: Understanding flu vaccine uptake among African Americans. SSM Popul Health 2017; 4:25-36. [PMID: 29349270 PMCID: PMC5769118 DOI: 10.1016/j.ssmph.2017.11.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 11/10/2017] [Accepted: 11/11/2017] [Indexed: 11/30/2022] Open
Abstract
Black adults are significantly less likely to be immunized for seasonal influenza when compared to Whites. This persistent disparity contributes to increased influenza-related morbidity and mortality in the African American population. Most scholarship on vaccine disparities has compared Whites and Blacks. Employing Public Health Critical Race Praxis, this study seeks to shift the focus to explore differences within the Black population. Utilizing a nationally-representative 2015 survey of US Black adults (n = 806), we explore differences by gender, age, income, and education across vaccine-related measures (e.g., perceived risk, knowledge, attitudes) and racial factors (e.g. racial salience, racial fairness, perceived discrimination). We also explore differences by vaccine behavior in the past five years among those who vaccinate every year, most years but not all, once or twice, and never. Greater frequency of flu vaccine uptake was associated with better self-reported vaccine knowledge, more positive vaccine attitudes, more trust in the flu vaccine and the vaccine process, higher perceived disease risk, lower perceived risk of vaccine side effects, stronger subjective and moral norms, lower general vaccine hesitancy, higher confidence in the flu vaccine, and lower perceived barriers. Logistic regression results highlighted other significant differences among the groups, emphasizing areas to target for improved vaccination rates. We find great diversity within the Black community related to influenza immunization decisions, highlighting the need to “break down the monolith” in future research. Empirically tested differences within the Black population for flu vaccine behavior. Detected significant differences in past vaccine behavior by age, gender, income, and education. Focus on past behavior to move adults along the continuum to increase vaccination. Highlights diversity within the Black population, often missing from comparative studies.
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Affiliation(s)
- Sandra Crouse Quinn
- Department of Family Science, School of Public Health, University of Maryland, 4200 Valley Drive, Suite 1142, College Park, MD 20742, USA.,Maryland Center for Health Equity, School of Public Health, University of Maryland, 4200 Valley Drive, Suite 1304, College Park, MD 20742, USA
| | - Amelia Jamison
- Maryland Center for Health Equity, School of Public Health, University of Maryland, 4200 Valley Drive, Suite 1304, College Park, MD 20742, USA
| | - Ji An
- Department of Human Development and Quantitative Methods, University of Maryland,1230 Benjamin Building, College Park, MD 20742, USA
| | - Vicki S Freimuth
- Department of Health Promotion and Behavior, University of Georgia, 100 Foster Road, Athens, GA 30602, USA
| | - Gregory R Hancock
- Department of Human Development and Quantitative Methods, University of Maryland,1230 Benjamin Building, College Park, MD 20742, USA
| | - Donald Musa
- University Center for Social and Urban Research, University of Pittsburgh, 3343 Forbes Avenue, Pittsburgh, PA 15260, USA
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20
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Mulinari S, Wemrell M, Rönnerstrand B, Subramanian SV, Merlo J. Categorical and anti-categorical approaches to US racial/ethnic groupings: revisiting the National 2009 H1N1 Flu Survey (NHFS). CRITICAL PUBLIC HEALTH 2017. [DOI: 10.1080/09581596.2017.1316831] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Shai Mulinari
- Faculty of Social Sciences, Department of Sociology, Lund University, Lund, Sweden
- Faculty of Medicine, Department of Clinical Sciences, Unit of Social Epidemiology, Lund University, Malmö, Sweden
| | - Maria Wemrell
- Faculty of Medicine, Department of Clinical Sciences, Unit of Social Epidemiology, Lund University, Malmö, Sweden
| | - Björn Rönnerstrand
- Department of Political Science, University of Gothenburg, Göteborg, Sweden
| | - S. V. Subramanian
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Juan Merlo
- Faculty of Medicine, Department of Clinical Sciences, Unit of Social Epidemiology, Lund University, Malmö, Sweden
- Center for Primary Health Care Research, Region Skåne, Malmö, Sweden
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21
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Sevin AM, Romeo C, Gagne B, Brown NV, Rodis JL. Factors influencing adults' immunization practices: a pilot survey study of a diverse, urban community in central Ohio. BMC Public Health 2016; 16:424. [PMID: 27216805 PMCID: PMC4877755 DOI: 10.1186/s12889-016-3107-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 05/14/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Adult vaccination rates in the United States are well below recommendations with disparities in race, ethnicity, and education level resulting in even lower rates for these populations. This study aimed to identify the barriers to and perceptions of immunizations in adults in an urban, underserved, multicultural community. Understanding the factors that influence adults' decisions to receive routinely recommended vaccines will aid health care providers and public health officials to design programs to improve vaccination rates. METHODS This cross-sectional, survey-based study was conducted in January 2014 in Columbus, Ohio. Participants were recruited from four urban federally-qualified health centers and four grocery stores affiliated with those clinics. The survey gathered self-reported receipt of immunizations, knowledge about indications for immunizations, and factors influencing decisions to receive an immunization. Data was analyzed in 2014. Descriptive statistics were generated for all survey items and Chi-Square or Fisher's Exact tests were used as appropriate to test for associations between demographic characteristics and factors influencing immunization decisions. RESULTS The top five factors likely to affect the decision to receive an immunization among the 304 respondents were: "doctor's recommendation" (80.6 %), "knowing why I should get a vaccine" (78.2 %), "knowing which vaccines I need" (75.5 %), cost (54.2 %), and "concern about getting sick if I get a vaccine" (54.0 %). Significant differences in factors influencing the immunization decision exist among respondents based on ethnicity and education level. For those participants with self-identified diabetes, heart disease, or asthma, less than half were aware that certain immunizations could reduce the risk of complications associated with their disease(s). CONCLUSIONS Data from this study may inform and shape patient education programs conducted in clinics, retailers, and communities, as well as advocacy efforts for adult immunizations. Results from this study suggest that patients would respond to programs for promoting vaccine uptake if they focused on benefits and indications for vaccines. The results also highlighted the need for education regarding immunizations for patients with chronic diseases and special indications. The differences in perceptions found between groups can be used to create targeted interventions based on the needs of those patient populations.
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Affiliation(s)
- Alexa M Sevin
- Pharmacy Practice and Science, The Ohio State University College of Pharmacy, 129C Parks Hall, 500W. 12th Avenue, Columbus, OH, 43210, USA
| | | | | | - Nicole V Brown
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Jennifer L Rodis
- Pharmacy Practice and Science, The Ohio State University College of Pharmacy, 129C Parks Hall, 500W. 12th Avenue, Columbus, OH, 43210, USA.
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22
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Suryadevara M, Bonville CA, Rosenbaum PF, Domachowske JB. Influenza vaccine hesitancy in a low-income community in central New York State. Hum Vaccin Immunother 2016; 10:2098-103. [PMID: 25424822 DOI: 10.4161/hv.28803] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Influenza vaccine (IV) coverage rates remain suboptimal among US adults. Socioeconomic disparities exist in IV coverage. We describe influenza vaccine attitudes among a low-income community in central New York. METHODS Adults attending a Salvation Army function during December 2012 were surveyed regarding IV including their intention to be immunized. On-site IV was offered to eligible participants. RESULTS The 1041 participants included Whites (non-Hispanics), African Americans, Hispanics, Native Americans, and multi-racial ethnicities. At time of enrollment, 386 (37%) participants had already received 2012-13 IV. Of the 655 unimmunized participants, 299 (46%) stated intent to receive IV, evenly distributed by age, gender, and ethnicity. Of the 312 participants who declined IV, 46% did so because of IV misperceptions. Of the 299 participants who intended to receive vaccine but had not yet done so, 284 (95%) stated the reason for delay was difficult access to vaccine. Intent to receive vaccine was strongly associated with the belief that IV is safe and/or effective (P < 0.05). CONCLUSION IV misperceptions regarding IV efficacy and safety result in suboptimal vaccine uptake in this low-income community, regardless of age, gender, or ethnicity.
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Affiliation(s)
- Manika Suryadevara
- a Department of Pediatrics; State University of New York; Upstate Medical University; Syracuse, NY USA
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23
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Gilstad-Hayden K, Durante A, Earnshaw VA, Rosenthal L, Ickovics JR. Association of influenza vaccine uptake with health, access to health care, and medical mistreatment among adults from low-income neighborhoods in New Haven, CT: a classification tree analysis. Prev Med 2015; 74:97-102. [PMID: 25724105 PMCID: PMC4390513 DOI: 10.1016/j.ypmed.2015.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 02/11/2015] [Accepted: 02/16/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study is to identify population subgroups under-vaccinated for influenza through classification tree analysis to inform interventions aimed at improving future vaccine uptake. METHOD A cross-sectional community health needs assessment was conducted from 09/2012 through 11/2012 among randomly selected households in six low-income neighborhoods in New Haven, CT (N=1300 adults, aged 18-65). Known correlates of influenza vaccine uptake plus experience of medical mistreatment were used to develop a classification tree to identify under-vaccinated population subgroups RESULTS Forty-five percent of respondents reported receiving the influenza vaccine. The classification tree identified healthy adults and uninsured adults at increased risk of influenza complications as subgroups with low vaccine uptake (40% and 30%, respectively). The subgroup representing insured, high-risk adults who reported experience of medical mistreatment had moderate vaccine uptake (45%). Sensitivity of the classification tree was high (83%, 95% CI=80% to 86%), indicating a strong true positive rate using these subgroups. CONCLUSION Results highlight the need for renewed attention to promoting the influenza vaccination recommendation for all adults, particularly among healthy adults, uninsured, high-risk adults and insured, high-risk adults who have experienced medical mistreatment. Further research is needed to better understand how to reach these population subgroups.
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Affiliation(s)
- Kathryn Gilstad-Hayden
- Community Alliance for Research and Engagement, Yale School of Public Health, 135 College Street, Suite 200, New Haven, CT 06510, USA.
| | - Amanda Durante
- New Haven Health Department, 54 Meadow Street, New Haven, CT 06519, USA; Yale School of Public Health, Department of Epidemiology of Microbial Diseases, 60 College Street, New Haven, CT 06520, USA.
| | - Valerie A Earnshaw
- Boston Children's Hospital, Department of Medicine, Division of General Pediatrics, BCH3201, Attn: Valerie Earnshaw, Boston, MA 02115, USA; Harvard Medical School, Department of Pediatrics, USA.
| | - Lisa Rosenthal
- Pace University, Psychology Department, 41 Park Row, 13th Floor, Room 1317, New York, NY 10038, USA.
| | - Jeannette R Ickovics
- Community Alliance for Research and Engagement, Yale School of Public Health, 135 College Street, Suite 200, New Haven, CT 06510, USA.
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Pierson RC, Malone AM, Haas DM. Increasing Influenza Vaccination Rates in a Busy Urban Clinic. JOURNAL OF NATURE AND SCIENCE 2015; 1:e57. [PMID: 25750936 PMCID: PMC4347981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Influenza infection is the cause of thousands of hospitalizations and deaths each year; infection during pregnancy results in increased morbidity and mortality. Underserved women are particularly susceptible to not receiving recommended vaccinations. This project explored the effect of a simple paper based prompt on the influenza vaccination rate in a resident continuity clinic for the underserved. Using this reminder to providers to discuss the influenza vaccination with their patients, we were able to increase vaccination rates in our clinic from 2.2% to 14.2%. This implementation of a simple, low cost, low tech prompt to providers increased the rate of influenza vaccination in our clinic and we present this approach as an easy to implement method of improving vaccination rates. We also suggest this method as an alternative to an alert in the electronic medical record in situations where the electronic medical record may not be accessed during every patient encounter.
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Affiliation(s)
- Rebecca C. Pierson
- Department of Medicine, Division of Clinical Pharmacology, Indiana University, Indianapolis, Indiana,
| | - Anita M. Malone
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan,
| | - David M. Haas
- Department of Obstetrics and Gynecology, Department of Medicine, Division of Clinical Pharmacology, Indiana University, Indianapolis, Indiana
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Dallo FJ, Kindratt TB. Disparities in vaccinations and cancer screening among U.S.- and foreign-born Arab and European American non-Hispanic White women. Womens Health Issues 2014; 25:56-62. [PMID: 25498764 DOI: 10.1016/j.whi.2014.10.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/27/2014] [Accepted: 10/08/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Disparities in vaccinations and cancer screening exist when comparing foreign-born and U.S.-born women collectively and disaggregated by race and ethnicity. The purpose of this study was to estimate and compare the age-adjusted prevalence of not receiving a flu or pneumonia vaccine, clinical breast examination, mammogram or Pap smear among U.S.- and foreign-born White women by region of birth and examine associations while controlling for potential confounders. METHODS We pooled 12 years of National Health Interview Survey data (n = 117,893). To approximate an "Arab-American" ethnicity, we identified 15 "Arab" countries from the Middle East region that comprise the Arab Nations. Data was requested from the National Center for Health Statistics Research Data Center. We used the χ(2) statistic to compare descriptive statistics and odds ratios (ORs) with 95% CIs were used for inferential statistics. FINDINGS Compared to U.S.-born, foreign-born Whites from the Arab Nations had higher estimates of not receiving recommended vaccinations and cancer screenings. In crude and adjusted analyses, foreign-born Arab-American women were less likely to report receiving a flu vaccine (OR, 0.34; 95% CI, 0.21-0.58), pneumonia vaccine (OR, 0.14; 95% CI, 0.06-0.32), Pap smear (OR, 0.13; 95% CI, 0.05-0.31), or clinical breast examination (OR, 0.16; 95% CI, 0.07-0.37) compared with U.S.-born White women. There were no differences for mammography. CONCLUSIONS This national study examining uptake of flu and pneumonia vaccines and preventive cancer screenings suggests that estimates are lower for foreign-born Arab-American women compared with U.S.-born White women. Future studies should collect qualitative data that assess the cultural context surrounding prevention and screening behaviors among Arab-American women.
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Affiliation(s)
- Florence J Dallo
- Wellness, Health Promotion and Injury Prevention, School of Health Sciences, Oakland University, Rochester, Michigan.
| | - Tiffany B Kindratt
- Department of Physician Assistant Studies, University of Texas Southwestern Medical Center, Dallas, Texas
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26
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Lu PJ, Rodriguez-Lainz A, O'Halloran A, Greby S, Williams WW. Adult vaccination disparities among foreign-born populations in the U.S., 2012. Am J Prev Med 2014; 47:722-33. [PMID: 25300733 PMCID: PMC5822444 DOI: 10.1016/j.amepre.2014.08.009] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 07/08/2014] [Accepted: 08/01/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Foreign-born persons are considered at higher risk of undervaccination and exposure to many vaccine-preventable diseases. Information on vaccination coverage among foreign-born populations is limited. PURPOSE To assess adult vaccination coverage disparities among foreign-born populations in the U.S. METHODS Data from the 2012 National Health Interview Survey were analyzed in 2013. For non-influenza vaccines, the weighted proportion vaccinated was calculated. For influenza vaccination, Kaplan-Meier survival analysis was used to assess coverage among individuals interviewed during September 2011-June 2012 and vaccinated in August 2011-May 2012. RESULTS Overall, unadjusted vaccination coverage among U.S.-born respondents was significantly higher than that of foreign-born respondents: influenza, age ≥18 years (40.4% vs 33.8%); pneumococcal polysaccharide vaccine (PPV), 18-64 years with high-risk conditions (20.8% vs 13.7%); PPV, ≥65 years (62.6% vs 40.5%); tetanus vaccination, ≥18 years (65.0% vs 50.6%); tetanus, diphtheria, and acellular pertussis (Tdap), ≥18 years (15.5% vs 9.3%); hepatitis B, 18-49 years (37.2% vs 28.4%); shingles, ≥60 years (21.3% vs 12.0%); and human papilloma virus (HPV), women 18-26 years (38.7% vs 14.7%). Among the foreign born, vaccination coverage was generally lower for non-U.S. citizens, recent immigrants, and those interviewed in a language other than English. Foreign-born individuals were less likely than U.S.-born people to be vaccinated for pneumococcal (≥65 years), tetanus, Tdap, and HPV (women) after adjusting for confounders. CONCLUSIONS Vaccination coverage is lower among foreign-born adults than those born in the U.S. It is important to consider foreign birth and immigration status when assessing vaccination disparities and planning interventions.
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Affiliation(s)
- Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia.
| | - Alfonso Rodriguez-Lainz
- Division of Global Migration and Quarantine, National Center for Emerging & Zoonotic Infectious Diseases, CDC, Atlanta, Georgia
| | - Alissa O'Halloran
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia
| | - Stacie Greby
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia
| | - Walter W Williams
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia
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Resources and interest among faith based organizations for influenza vaccination programs. J Immigr Minor Health 2014; 15:758-63. [PMID: 22623183 DOI: 10.1007/s10903-012-9645-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In the United States, annual influenza vaccination rates are suboptimal and are well below the national health objectives. Project VIVA mobilized community members and organizations to implement an influenza vaccination program in Harlem by administering vaccines in "non-traditional" venues, such as community-based organizations, pharmacies, and faith-based organizations (FBOs). FBOs have been recognized as important venues for health promotion initiatives within medically underserved communities. However, data regarding the extent of resources and interest in health promotion programs among FBOs are sparse. We conducted a telephone survey among 115 FBOs in three New York City neighborhoods with histories of low influenza immunization rates to identify the congregation's health concerns, interest in serving as a community-based venue for influenza vaccinations, and existing resources for health programming. Twenty-six percent of the FBOs had an established health ministry, while 45 % expressed interest in developing one. Seven percent included nurses among their health activities and 16.5 % had contact with the local health department. Most FBOs expressed interest in common health promotions programs; 60 % expressed interest in providing on-site influenza vaccination programs within their organization. Health programs within FBOs can be a point of access that may improve the health of their congregants as well as the larger community.
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Dallo FJ, Kindratt TB. Disparities in preventive health behaviors among non-Hispanic White men: heterogeneity among foreign-born Arab and European Americans. Am J Mens Health 2014; 9:124-31. [PMID: 24780937 DOI: 10.1177/1557988314532285] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The objectives of this study were to estimate and compare the age-adjusted prevalence of not receiving a flu vaccine, pneumonia vaccine, or prostate cancer screening among U.S.- and foreign-born White men by region of birth (Europe/Russia and the Arab Nations) and examine these associations while controlling for potential confounders. Twelve years of restricted data from the National Health Interview Survey (NHIS) including 91,636 U.S.- and foreign-born men were used. Chi-squares were used to compare descriptive statistics, and odds ratios (ORs; 95% confidence intervals [CIs]) were used for inferential statistics. In crude and adjusted analyses, foreign-born Arab American men were less likely to report receiving a flu (OR = 0.38; 95% CI = 0.21, 0.67) and pneumonia (OR = 0.33; 95% CI = 0.16, 0.70) vaccine compared with U.S.-born White men. There were no statistically significant differences for PSA testing between Arab American and White men. This national study examining uptake of flu and pneumonia vaccines suggests estimates are lower for foreign-born Arab American men compared with U.S.-born White men. Future studies should collect qualitative data that assesses the cultural context surrounding prevention and screening behaviors among Arab Americans.
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29
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Provider Education about Glaucoma and Glaucoma Medications during Videotaped Medical Visits. J Ophthalmol 2014; 2014:238939. [PMID: 24868450 PMCID: PMC4020294 DOI: 10.1155/2014/238939] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 03/04/2014] [Accepted: 04/06/2014] [Indexed: 11/17/2022] Open
Abstract
Objective. The purpose of this study was to examine how patient, physician, and situational factors are associated with the extent to which providers educate patients about glaucoma and glaucoma medications, and which patient and provider characteristics are associated with whether providers educate patients about glaucoma and glaucoma medications. Methods. Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited and a cross-sectional study was conducted at six ophthalmology clinics. Patients' visits were videotape recorded and patients were interviewed after visits. Generalized estimating equations were used to analyze the data. Results. Two hundred and seventy-nine patients participated. Providers were significantly more likely to educate patients about glaucoma and glaucoma medications if they were newly prescribed glaucoma medications. Providers were significantly less likely to educate African American patients about glaucoma. Providers were significantly less likely to educate patients of lower health literacy about glaucoma medications. Conclusion. Eye care providers did not always educate patients about glaucoma or glaucoma medications. Practice Implications. Providers should consider educating more patients about what glaucoma is and how it is treated so that glaucoma patients can better understand their disease. Even if a patient has already been educated once, it is important to reinforce what has been taught before.
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Tung WC. Influenza and Pneumococcal Vaccination Among Hispanic Americans. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2013. [DOI: 10.1177/1084822313494087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lavela SL, Goldstein B, Etingen B, Miskevics S, Weaver FM. Factors Associated With H1N1 Influenza Vaccine Receipt in a High-Risk Population During the 2009-2010 H1N1 Influenza Pandemic. Top Spinal Cord Inj Rehabil 2013; 18:306-14. [PMID: 23459437 DOI: 10.1310/sci1804-306] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Persons with spinal cord injuries and disorders (SCI/D) are at high risk for respiratory complications from influenza. During pandemic situations, where resources may be scarce, uncertainties may arise in veterans with SCI/D. OBJECTIVE To describe concerns, knowledge, and perceptions of information received during the 2009-2010 H1N1 influenza pandemic and to examine variables associated with H1N1 vaccine receipt. METHODS In August 2010, a cross-sectional survey was mailed to a national sample of veterans with traumatic and nontraumatic SCI/D. RESULTS During the pandemic, 58% of veterans with SCI/D received the H1N1 vaccine. Less than two-thirds of non-H1N1 vaccine recipients indicated intentions to get the next season's influenza vaccine. Being ≥50 years of age and depressed were significantly associated with higher odds of H1N1 vaccination. Being worried about vaccine side effects was associated with lower odds of H1N1 receipt. Compared to individuals who reported receiving an adequate amount of information about the pandemic, those who received too little information had significantly lower odds of receiving the H1N1 vaccine. Those who received accurate/clear information (vs confusing/conflicting) had 2 times greater odds of H1N1 vaccine receipt. CONCLUSIONS H1N1 influenza vaccination was low in veterans with SCI/D. Of H1N1 vaccine nonrecipients, only 63% intend to get a seasonal vaccine next season. Providing an adequate amount of accurate and clear information is vital during uncertain times, as was demonstrated by the positive associations with H1N1 vaccination. Information-sharing efforts are needed, so that carry-over effects from the pandemic do not avert future healthy infection prevention behaviors.
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Affiliation(s)
- Sherri L Lavela
- Center for Management of Complex Chronic Care, Hines VA Hospital, Hines, Illinois ; Spinal Cord Injury Quality Enhancement Research Initiative, Department of Veterans Affairs , Hines, Illinois ; Institute for Healthcare Studies , Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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