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Gomes de Macedo Bacurau A, Sato APS, Francisco PMSB. Reasons for nonadherence to vaccination for influenza among older people in Brazil. PLoS One 2021; 16:e0259640. [PMID: 34748598 PMCID: PMC8575254 DOI: 10.1371/journal.pone.0259640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 10/22/2021] [Indexed: 11/19/2022] Open
Abstract
This study aimed to estimate the prevalence of non-vaccination and the reasons for nonadherence to the influenza vaccine among older Brazilians according to sociodemographic characteristics. A cross-sectional study was conducted with data from older people (≥ 60 years of age; n = 23,815) who participated in the 2013 National Health Survey. Frequencies of non-vaccination and the main reasons for nonadherence were calculated with respective 95% confidence intervals. The prevalence of non-vaccination was 26.9% (approximately 7,106,730 older people). The reason rarely gets the flu was the most cited among the men (28.2%), the 60-to-69-year-old age group (29.6%), individuals with higher education (41.9%), and those with health insurance (32.3%). Fear of a reaction was the most cited reason in the northeastern region (25.4%), among women (29.3%), longer-lived individuals (≥70 years; 28.7%), and those who did not know how to read/write (26.7%). A total of 12.1% reported not believing in the vaccine's protection, and 5.5% did not know that it was necessary to take vaccine. The proportions of the main reasons for non-vaccination varied by sociodemographic characteristics. This study's findings highlight the need to increase older people's knowledge regarding influenza and influenza vaccines. Healthcare providers should be encouraged to counsel older people-especially those in subgroups with lower adherence, such as residents in the Northeast region, those aged 60-69 years, those who do not know how to read/write, those without a spouse/companion, and those without health insurance-regarding the different aspects of the vaccine and formally indicate it for groups at risk.
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Affiliation(s)
| | - Ana Paula Sayuri Sato
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
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Menezes AMB, Hallal PC, Silveira MF, Wehrmeister FC, Horta BL, Barros AJDD, Hartwig FP, Oliveira PD, Vidaletti LP, Mesenburg MA, Jacques N, Barros FC, Victora CG. Influenza vaccination in older adults during the COVID-19 pandemic: a population-based study in 133 Brazilian cities. CIENCIA & SAUDE COLETIVA 2021; 26:2937-2947. [PMID: 34378687 DOI: 10.1590/1413-81232021268.09382021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/09/2021] [Indexed: 11/21/2022] Open
Abstract
Routine immunization during pandemics can be harmed. This study estimated the influenza vaccination coverage in older adults during the COVID-19 through the EPICOVID-19, a population-based study conducted in 133 cities from the 26 Brazilian states and Federal District. We selected 25 census tracts per city, with probability proportional to the tract's size, ten households by census tract, and one random individual interviewed. A total of 8,265 older adults (≥60 years old) were interviewed and asked whether they had been vaccinated against flu in 2020. Vaccination coverage was 82.3% (95% CI: 80.1-84.2) with no difference by gender, age, and region; higher vaccination coverage was observed among the wealthiest (84.7% versus 80.1% in the poorest) and among the more educated (87.3% versus 83.2% less educated); lower coverage among indigenous (56.9% versus > 80% among other ethnic groups). A positive association was identified with the number of comorbidities among men but not among women. Most of the population was vaccinated (97.5%) in the public health system. The private network was chosen mainly in the South by the wealthiest and more educated. Vaccination coverage was seven percentage points lower than the government target (90%), and inequalities should be reversed in future campaigns.
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Affiliation(s)
- Ana Maria Baptista Menezes
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | - Pedro Curi Hallal
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | | | - Fernando César Wehrmeister
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | - Bernardo Lessa Horta
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | | | - Fernando Pires Hartwig
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | - Paula Duarte Oliveira
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | - Luís Paulo Vidaletti
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | | | - Nadege Jacques
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
| | | | - Cesar Gomes Victora
- Universidade Federal de Pelotas. Av. Marechal Deodoro 1160 3º piso, Centro. 96020-220 Pelotas RS Brasil.
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Azambuja HCS, Carrijo MF, Martins TCR, Luchesi BM. O impacto da vacinação contra influenza na morbimortalidade dos idosos nas regiões do Brasil entre 2010 e 2019. CAD SAUDE PUBLICA 2020; 36Suppl 2:e00040120. [DOI: 10.1590/0102-311x00040120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/11/2020] [Indexed: 11/22/2022] Open
Abstract
Resumo: Devido à importância da vacinação anual contra a gripe em idosos, objetivou-se analisar o impacto da vacinação contra gripe na morbimortalidade por influenza nos idosos no período de 2010 a 2019 nas regiões do Brasil. Trata-se de um estudo epidemiológico ecológico, com dados do Sistema de Informações do Programa Nacional de Imunizações, do Sistema de Informações Hospitalares e do Sistema de Informação sobre Mortalidade, disponíveis por intermédio do Ministério da Saúde. Os dados foram referentes ao Brasil e regiões, e contemplaram as taxas de cobertura vacinal contra gripe em idosos e de morbidade e mortalidade por causas relacionadas à influenza e pneumonia em idosos. Modelos de regressão linear simples foram utilizados para estudar a relação entre as taxas de morbidade e mortalidade e a cobertura vacinal. Houve um aumento da cobertura vacinal no período, e a meta de 80% de cobertura foi atingida em todas as regiões a partir de 2011. Identificou-se uma relação diretamente proporcional entre as variáveis estudadas, sendo que o aumento da cobertura vacinal resultou no aumento da morbimortalidade pelas causas avaliadas. Esses dados podem estar relacionados com a literatura, que mostra que o efeito da vacina é modesto em idosos. Porém, foi visto que o cálculo das taxas não leva em consideração o envelhecimento da população, utilizando dados com estimativas censitárias desatualizadas, e que os dados de internação e óbito podem incluir outros vírus e bactérias circulantes que não a influenza. A manutenção da cobertura vacinal elevada pode prevenir que o impacto da gripe seja ainda maior na morbimortalidade em idosos.
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Pinto CJM, Pereira EHR, Teodoro CM, Becari RA, Assis VGD, Ferrari JC, Hoehne EL. Vaccination against influenza in elderly people: factors associated with acceptance and refusal of the vaccine. Rev Soc Bras Med Trop 2019; 52:e20180366. [PMID: 30892550 DOI: 10.1590/0037-8682-0366-2018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/28/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Immunization is the primary method of preventing influenza. The objective of this study was to describe reasons and determine causes of acceptance or refusal of the influenza vaccine by elderly people. METHODS This cross-sectional and descriptive study included elderly patients (aged >60 years) from the City of Jundiai, São Paulo, Brazil. RESULTS The sample comprised 185 people; 71.9% reported receiving the vaccine and 21% claimed to have experienced complications. CONCLUSIONS The vaccination coverage was below the national goal; the reasons for not being vaccinated was "did not want to receive the vaccine", in addition to "forgot".
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Affiliation(s)
| | | | | | | | | | | | - Eduardo Luiz Hoehne
- Centro Universitário Padre Anchieta, Curso de Enfermagem, Jundiaí, SP, Brasil
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Fernandez-Sierra MA, Rueda-Domingo MT, Rodriguez-del-Aguila MM, Perez-Lozano MJ, Force L, Fernandez-Villa T, Astray J, Egurrola M, Castilla J, Sanz F, Toledo D, Dominguez A. Adaptation of antibiotic treatment to clinical practice guidelines in patients aged ⩾65 years hospitalised due to community-acquired pneumonia. Epidemiol Infect 2018; 146:1870-1877. [PMID: 30070190 PMCID: PMC9506693 DOI: 10.1017/s0950268818002121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 06/21/2018] [Accepted: 07/09/2018] [Indexed: 11/06/2022] Open
Abstract
Early, conforming antibiotic treatment in elderly patients hospitalised for community-acquired pneumonia (CAP) is a key factor in the prognosis and mortality. The objective was to examine whether empirical antibiotic treatment was conforming according to the Spanish Society of Pulmonology and Thoracic Surgery guidelines in these patients. Multicentre study in patients aged ⩾65 years hospitalised due to CAP in the 2013-14 and 2014-15 influenza seasons. We collected socio-demographic information, comorbidities, influenza/pneumococcal vaccination history and antibiotics administered using a questionnaire and medical records. Bivariate analyses and multilevel logistic regression were made. In total, 1857 hospitalised patients were included, 82 of whom required intensive care unit (ICU) admission. Treatment was conforming in 51.4% (95% confidence interval (CI) 49.1-53.8%) of patients without ICU admission and was associated with absence of renal failure without haemodialysis (odds ratio (OR) 1.49, 95% CI 1.15-1.95) and no cognitive dysfunction (OR 1.71, 95% CI 1.25-2.35), when the effect of the autonomous community was controlled for. In patients with ICU admission, treatment was conforming in 45.1% (95% CI 34.1-56.1%) of patients and was associated with the hospital visits in the last year (<3 vs. ⩾3, OR 2.70, 95% CI 1.03-7.12) and there was some evidence that this was associated with season. Although the reference guidelines are national, wide variability between autonomous communities was found. In patients hospitalised due to CAP, health services should guarantee the administration of antibiotics in a consensual manner that is conforming according to clinical practice guidelines.
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Affiliation(s)
- M. A. Fernandez-Sierra
- UGC Prevención Promoción y Vigilancia Salud. Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - M. T. Rueda-Domingo
- UGC Prevención Promoción y Vigilancia Salud. Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - M. M. Rodriguez-del-Aguila
- UGC Prevención Promoción y Vigilancia Salud. Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - M. J. Perez-Lozano
- UGC Prevención, Promoción y Vigilancia Salud. Hospital de Valme, Sevilla, Spain
| | - L. Force
- Hospital de Mataró, Barcelona, Spain
| | - T. Fernandez-Villa
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS). Instituto de Biomedicina (IBIOMED). Universidad de León, León, Spain
| | - J. Astray
- Consejería de Sanidad de Madrid, Madrid, Spain
| | - M. Egurrola
- Hospital de Galdakao, Usansolo, Vizcaya, Spain
| | - J. Castilla
- Instituto de Salud Pública de Navarra, IdiSNA, Pamplona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - F. Sanz
- Consorci Hospital General Universitari de Valencia, Valencia, Spain
| | - D. Toledo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - A. Dominguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
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Spruijt IT, de Lange MMA, Dijkstra F, Donker GA, van der Hoek W. Long-Term Correlation between Influenza Vaccination Coverage and Incidence of Influenza-Like Illness in 14 European Countries. PLoS One 2016; 11:e0163508. [PMID: 27684558 PMCID: PMC5042488 DOI: 10.1371/journal.pone.0163508] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 09/09/2016] [Indexed: 01/26/2023] Open
Abstract
We aimed to examine the long-term correlation between influenza vaccination coverage and the incidence of influenza-like illness (ILI) in the total and elderly populations of European countries for which data was available on at least six consecutive influenza seasons. We graphically visualised vaccination coverage and ILI incidence trends and calculated Spearman rank correlation coefficients. Additionally, we fitted a negative binomial regression model to estimate the change in ILI incidence per percentage point change in vaccination coverage. We found significant negative correlations for the total population of the Netherlands (ρ = -0.60, p-value = 0.003) and for the elderly populations of England (ρ = -0.80, p-value < 0.001) and Germany (ρ = -0.57, p-value = 0.04). However, results were not consistent, and for some countries we observed significant positive correlations. Only for the elderly in England was there a significant decline in incidence rate per percentage point increase in vaccination coverage (incidence rate ratio = 0.93; 95% confidence interval 0.88–0.99). Based on this ecological study it is not possible to provide evidence for a negative correlation between influenza vaccination coverage and ILI incidence. For future, aetiological studies to assess impact of influenza vaccinations on the population, there is a need for high quality data over long periods of time, on proportion of ILI caused by influenza virus infection, on severe outcome measures such as hospitalisation for influenza, and on other factors that potentially affect influenza transmission.
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Affiliation(s)
- Ineke T. Spruijt
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Marit M. A. de Lange
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- * E-mail:
| | - Frederika Dijkstra
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Gé A. Donker
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Domínguez À, Soldevila N, Toledo D, Godoy P, Castilla J, Force L, Morales M, Mayoral JM, Egurrola M, Tamames S, Martín V, Astray J. Factors Associated with Influenza Vaccination of Hospitalized Elderly Patients in Spain. PLoS One 2016; 11:e0147931. [PMID: 26824383 PMCID: PMC4732680 DOI: 10.1371/journal.pone.0147931] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 01/11/2016] [Indexed: 11/19/2022] Open
Abstract
Vaccination of the elderly is an important factor in limiting the impact of influenza in the community. The aim of this study was to investigate the factors associated with influenza vaccination coverage in hospitalized patients aged ≥ 65 years hospitalized due to causes unrelated to influenza in Spain. We carried out a cross-sectional study. Bivariate analysis was performed comparing vaccinated and unvaccinated patients, taking in to account sociodemographic variables and medical risk conditions. Multivariate analysis was performed using multilevel regression models. We included 1038 patients: 602 (58%) had received the influenza vaccine in the 2013-14 season. Three or more general practitioner visits (OR = 1.61; 95% CI 1.19-2.18); influenza vaccination in any of the 3 previous seasons (OR = 13.57; 95% CI 9.45-19.48); and 23-valent pneumococcal polysaccharide vaccination (OR = 1.97; 95% CI 1.38-2.80) were associated with receiving the influenza vaccine. Vaccination coverage of hospitalized elderly people is low in Spain and some predisposing characteristics influence vaccination coverage. Healthcare workers should take these characteristics into account and be encouraged to proactively propose influenza vaccination to all patients aged ≥ 65 years.
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Affiliation(s)
- Àngela Domínguez
- Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Núria Soldevila
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Diana Toledo
- Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
| | - Pere Godoy
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Catalunya, Barcelona, Spain
- Institut de Recerca Biomèdica de Lleida, Universitat de Lleida, Lleida, Spain
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Salud Pública, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | | | - María Morales
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Universitat de Valencia, Valencia, Spain
| | | | | | - Sonia Tamames
- Dirección General de Salud Pública, Investigación, Desarrollo e Innovación, Junta de Castilla y León, León, Spain
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