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Tatar M, Farokhi S, Araz OM, Deshpande A, Wilson FA. Association of social vulnerability and influenza vaccination rates for Annual Medicare Enrollees at the county-level in the United States. Prev Med 2023; 177:107782. [PMID: 37980957 DOI: 10.1016/j.ypmed.2023.107782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 11/21/2023]
Abstract
INTRODUCTION Influenza is a preventable acute respiratory illness with a high potential to cause serious complications and is associated with high mortality and morbidity in the US. We aimed to determine the specific community-level vulnerabilities for different race/ethnic communities that are most predictive of influenza vaccination rates. METHODS We conducted a machine learning analysis (XGBoost) to identify community-level social vulnerability features that are predictive of influenza vaccination rates among Medicare enrollees across counties in the US and by race/ethnicity. RESULTS Population density per square mile in a county is the most important feature in predicting influenza vaccination in a county, followed by unemployment rates and the percentage of mobile homes. The gain relative importance of these features are 11.6%, 9.2%, and 9%, respectively. Among whites, population density (17% gain relative importance) was followed by the percentage of mobile homes (9%) and per capita income (8.7%). For Black/African Americans, the most important features were population density (12.8%), percentage of minorities in the county (8.0%), per capita income (6.9%), and percent of over-occupied housing units (6.8%). Finally, for Hispanics, the top features were per capita income (8.4%), percentage of mobile homes (8.0%), percentage of non-institutionalized persons with a disability (7.9%), and population density (7.6%). CONCLUSIONS Our study may have implications for the success of large vaccination programs in counties with high social vulnerabilities. Further, our findings suggest that policies and interventions seeking to increase rates of vaccination in race/ethnic minority communities may need to be tailored to address their specific socioeconomic vulnerabilities.
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Affiliation(s)
- Moosa Tatar
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, United States of America.
| | - Soheila Farokhi
- Department of Computer Science, Utah State University, Logan, UT, United States of America.
| | - Ozgur M Araz
- College of Business, University of Nebraska- Lincoln, Lincoln, NE.
| | - Abhishek Deshpande
- Center for Value-Based Care Research, Cleveland Clinic, Cleveland, OH, United States of America.
| | - Fernando A Wilson
- Matheson Center for Health Care Studies, University of Utah, Salt Lake City, UT, United States of America; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States of America; Department of Economics, University of Utah, Salt Lake City, UT, United States of America.
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Characteristics of U.S. older adult medicare beneficiaries receiving the influenza vaccination at retail pharmacies. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 9:100220. [PMID: 36691454 PMCID: PMC9860398 DOI: 10.1016/j.rcsop.2023.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 11/04/2022] [Accepted: 01/01/2023] [Indexed: 01/06/2023] Open
Abstract
Background Pharmacy-provided influenza vaccination services have become more prevalent among the older adult population. However, little is known about the characteristics of older adults associated with receiving the influenza vaccination at retail pharmacies and how these associated characteristics have changed. Objective To examine characteristics of older adults associated with use of retail pharmacy-provided influenza vaccination services and how the characteristics changed between 2009 and 2015. Methods The study used a retrospective, cross-sectional design with data from the 2009 and 2015 Medicare Current Beneficiary Survey. Older adults aged 65 and older who completed a community questionnaire and received the influenza vaccination during the previous winter were identified. Andersen's Behavioral Model of Health Services Use was the conceptual framework for inclusion of the population characteristics. A multivariable log-binomial regression was performed to estimate the association between the population characteristics and use of pharmacy-provided vaccination service, and the relative change in associations between 2009 and 2015. Survey weights were applied in all analyses. Results The results showed older adults who were non-Hispanic black (compared to non-Hispanic white), who did not have secondary private insurance (compared to those who had), who did not have physician office visit (compared to those who had) and who lived in non-metro area (compared to those who lived in metro area) had become more likely to use pharmacy-provided influenza vaccination services in 2015 than in 2009. Conclusions Pharmacy-provided influenza vaccination services appear to reduce access barriers for racially and socioeconomically disadvantaged older adults. Findings could help inform not only the retail pharmacies that provide vaccination services to better outreach to potential target populations but also policy makers about the disadvantaged populations that would benefit from the vaccination services provided by retail pharmacies.
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Fishman J, Mandell DS, Salmon MK, Candon M. Large and small financial incentives may motivate COVID-19 vaccination: A randomized, controlled survey experiment. PLoS One 2023; 18:e0282518. [PMID: 36930588 PMCID: PMC10022800 DOI: 10.1371/journal.pone.0282518] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/16/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Experts continue to debate how to increase COVID-19 vaccination rates. Some experts advocate for financial incentives. Others argue that financial incentives, especially large ones, will have counterproductive psychological effects, reducing the percent of people who want to vaccinate. Among a racially and ethnically diverse U.S. sample of lower income adults, for whom vaccine uptake has lagged compared with higher income adults, we empirically examine such claims about relatively large and small guaranteed cash payments. METHODS In 2021, we conducted a randomized, controlled experiment among U.S. residents with incomes below $80,000 who reported being unvaccinated against COVID-19. Study participants were randomized to one of four study arms. In two arms, respondents first learned about a policy proposal to pay $1,000 or $200 to those who received COVID-19 vaccination and were then asked if, given that policy, they would want to vaccinate. In the two other arms, respondents received either an educational message about this vaccine or received no vaccine information and were then asked if they wanted to vaccinate for COVID-19. The primary analyses estimated and compared the overall percentage in each study arm that reported wanting to vaccinate for COVID-19. In other analyses, we estimated and compared these percentages for subgroups of interest, including gender, race/ethnicity, and education. MAIN RESULTS Among 2,290 unvaccinated adults, 79.7% (95%CI, 76.4-83.0%) of those who learned about the proposed $1,000 payment wanted to get vaccinated, compared with 58.9% (95%CI, 54.8-63.0%) in the control condition without vaccine information, a difference of 20 percentage points. Among those who learned of the proposed $200 payment, 74.8% (95% CI, 71.3-78.4%) wanted to vaccinate. Among those who learned only about the safety and efficacy of COVID-19 vaccines, 68.9% (95% CI, 65.1-72.7%) wanted to vaccinate. Findings were consistent across various subgroups. DISCUSSION Despite several study limitations, the results do not support concerns that the financial incentive policies aimed to increase COVID-19 vaccination would have counterproductive effects. Instead, those who learned about a policy with a large or small financial incentive were more likely than those in the control condition to report that they would want to vaccinate. The positive effects extended to subgroups that have been less likely to vaccinate, including younger adults, those with less education, and racial and ethnic minorities. Financial incentives of $1,000 performed similarly to those offering only $200.
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Affiliation(s)
- Jessica Fishman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Message Effects Lab, Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| | - David S. Mandell
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Mandy K. Salmon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Molly Candon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Fishman J, Salmon MK, Scheitrum D, Aleks Schaefer K, Robertson CT. Comparative effectiveness of mandates and financial policies targeting COVID-19 vaccine hesitancy: A randomized, controlled survey experiment. Vaccine 2022; 40:7451-7459. [PMID: 35914961 PMCID: PMC9148933 DOI: 10.1016/j.vaccine.2022.05.073] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/21/2022] [Accepted: 05/23/2022] [Indexed: 01/28/2023]
Abstract
Experts debate whether COVID-19 vaccine mandates or financial incentives will reduce, rather than increase, interest in vaccination. Among 3,698 unvaccinated U.S. residents, we conducted a randomized, controlled survey-embedded experiment to estimate the absolute and relative psychological effects of vaccine policies specifying: mandates by employers or airlines, bars, and restaurants; lotteries for $1 million, $200,000, or $100,000; guaranteed cash for $1000, $200, or $100; and $1,000 as either a tax credit or penalty. Vaccine intention -the study outcome- predicts uptake and provides insight into the psychological mechanism that is most proximal to behavior (i.e., vaccination). Compared to controls, those who learned about the $1,000 cash reward policy were 17.1 (±5.3)% more likely to want vaccination. Employer mandates are more promising than other mandate policies (8.6 [+/- 7.4]% vs. 1.4 [+/- 6.0]%). The full results suggest that neither mandates nor financial incentives are likely to have counterproductive psychological effects. These policies are not mutually exclusive and, if implemented well, they may increase vaccine uptake.
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Affiliation(s)
- Jessica Fishman
- Message Effects Lab, Perelman School of Medicine & Annenberg School, University of Pennsylvania, Philadelphia, PA, United States,Corresponding author at: Director, Message Effects Lab, University of Pennsylvania, United States
| | - Mandy K. Salmon
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Daniel Scheitrum
- Department of Agricultural and Resource Economics, University of Arizona, Tucson, AZ, United States
| | - K. Aleks Schaefer
- Department of Agricultural Economics, Oklahoma State University, Stillwater, OK, United States
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Ruf AK, Völkl-Kernstock S, Eitenberger M, Gabriel M, Klager E, Kletecka-Pulker M, Klomfar S, Teufel A, Wochele-Thoma T. Employer impact on COVID-19 vaccine uptake among nursing and social care employees in Austria. Front Public Health 2022; 10:1023914. [PMID: 36438259 PMCID: PMC9686277 DOI: 10.3389/fpubh.2022.1023914] [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: 08/20/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction Since becoming available, vaccines against COVID-19 have been a focus of public debate. This is particularly relevant among healthcare and social workers, who interact with vulnerable patients and clients on a daily basis. With employers implementing educational programs and offering incentives to raise vaccine willingness among their staff, it is crucial to understand drivers of vaccine acceptance and hesitancy as well as the impact employers can play on vaccine decision-making. Methods We conducted a cross-sectional study via computer-assisted telephone and web interviews. We recruited from a pool of employees from nursing and social care institutions in Vienna and Lower Austria operated by one healthcare NGO. Variables included in the analysis were socio-demographic attributes, reasons for or against the vaccine, sources of information, opinions of mandatory vaccination, and whether respondents had previously been infected with COVID-19 or knew someone who had. Results 86.2% of respondents had received at least one dose of the COVID-19 vaccine. 13.8% were unvaccinated. Vaccinated respondents' main reason for getting the vaccine was to protect themselves (79.6%) as well as others (74.1%), while non-vaccinated respondents cited a fear of short or long-term side effects (58.8 and 42.4%, respectively) as their primary reason for not getting vaccinated. 72.8% of the unvaccinated said no incentive would make them change their mind, while 17.4% specified abstract concepts or systemic change as effective incentives. Monetary incentives were not seen as a motivator. Unvaccinated respondents were significantly more worried about the future than vaccinated respondents (78.8 vs. 26.3%, p < 0.001). They were also significantly more likely to view their employers' vaccine recommendations as "manipulative" (50.6 vs. 12.4%, p < 0.001), while vaccinated respondents were significantly more likely to view them as "supportive" (68.0 vs. 25.9%, p < 0.001). Conclusion While employers have the means to mediate public health decision-making by providing information, deciding to become vaccinated is a more complex process including public debate, world views, political influences, and the uptake of information. Employers can act as mediators for public health decision-making, moving policy measures beyond an individualized view of health choices and health literacy toward more structural, systemic, and community-based efforts.
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Affiliation(s)
- Ann-Kathrin Ruf
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
| | - Sabine Völkl-Kernstock
- Medical University of Vienna, Department of Child and Adolescent Psychiatry, Vienna, Austria
| | | | - Marcus Gabriel
- Institute for Ethics and Law in Medicine, University of Vienna, Vienna, Austria
| | - Elisabeth Klager
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
| | - Maria Kletecka-Pulker
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
- Institute for Ethics and Law in Medicine, University of Vienna, Vienna, Austria
| | - Sophie Klomfar
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
| | - Anna Teufel
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
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Xu Z, Jiang B. Effects of Social Vulnerability and Spatial Accessibility on COVID-19 Vaccination Coverage: A Census-Tract Level Study in Milwaukee County, USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912304. [PMID: 36231608 PMCID: PMC9565019 DOI: 10.3390/ijerph191912304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/19/2022] [Accepted: 09/24/2022] [Indexed: 06/01/2023]
Abstract
COVID-19 vaccination coverage was studied by race/ethnicity, up-to-date doses, and by how it was affected by social vulnerability and spatial accessibility at the census-tract level in Milwaukee County, WI, USA. Social vulnerability was quantified at the census-tract level by an aggregate index and its sub-components calculated using the principal components analysis method. The spatial accessibility was assessed by clinic-to-population ratio and travel impedance. Ordinary least squares (OLS) and spatial regression models were employed to examine how social vulnerability and spatial accessibility relate to the vaccination rates of different doses. We found great disparities in vaccination rates by race and between areas of low and high social vulnerability. Comparing to non-Hispanic Blacks, the vaccination rate of non-Hispanic Whites in the county is 23% higher (60% vs. 37%) in overall rate (one or more doses), and 20% higher (29% vs. 9%) in booster rate (three or more doses). We also found that the overall social-vulnerability index does not show a statistically significant relationship with the overall vaccination rate when it is defined as the rate of people who have received one or more doses of vaccines. However, after the vaccination rate is stratified by up-to-date doses, social vulnerability has positive effects on one-dose and two-dose rates, but negative effects on booster rate, and the effects of social vulnerability become increasingly stronger and turn to negative for multi-dose vaccination rates, indicating the increasing challenges of high social vulnerability areas to multi-dose vaccination. The large negative effects of socio-economic status on the booster rate suggests the importance of improving general socio-economic conditions to promote multi-dose vaccination rates.
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Affiliation(s)
- Zengwang Xu
- Department of Geography, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA
| | - Bin Jiang
- Faculty of Engineering and Sustainable Development, Division of GIScience, University of Gävle, 801 76 Gävle, Sweden
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Çakır E, Taş MA, Ulukan Z. Spherical bipolar fuzzy weighted multi-facility location modeling for mobile COVID-19 vaccination clinics. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2021. [DOI: 10.3233/jifs-219189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A pandemic was declared in 2020 due to COVID-19. The most important way to deal with the virus is mass vaccination which is a complex task in terms of fast transportation and process management. Hospitals and other health centers are appropriate for vaccination process. In addition, in order to protect other patients from COVID-19 and provide rapid access to vaccines, mobile vaccination clinics can also be considered. In this study, the location assignments of mobile vaccination clinics that can serve some regions of three cities in Turkey are examined. The linear formulation of the problem is given, and the multi-facility location problem for COVID-19 vaccination is investigated with Lagrange relaxation and modified saving heuristic algorithm. For the proposed fuzzy MCDM integrated saving heuristic, the importance of candidate locations is calculated with the aid of decision makers who give their views in spherical bipolar fuzzy information. The results of different approaches are compared, and it is intended to guide future studies.
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Affiliation(s)
- Esra Çakır
- Industrial Engineering Department, GalatasarayUniversity, Ortakoy/Istanbul, Turkey
| | - Mehmet Ali Taş
- IndustrialEngineering Department, Turkish-German University, Beykoz/Istanbul, Turkey
| | - Ziya Ulukan
- Industrial Engineering Department, GalatasarayUniversity, Ortakoy/Istanbul, Turkey
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Fonzi V, Thapa K, Luitel K, Padilla H, Harris C, Khan MM, Nowak G, Rajbhandari-Thapa J. Using Influenza Vaccination Location Data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) to Expand COVID-19 Vaccination Coverage. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157753. [PMID: 34360048 PMCID: PMC8345551 DOI: 10.3390/ijerph18157753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 11/29/2022]
Abstract
Effective COVID-19 vaccine distribution requires prioritizing locations that are accessible to high-risk target populations. However, little is known about the vaccination location preferences of individuals with underlying chronic conditions. Using data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we grouped 162,744 respondents into high-risk and low-risk groups for COVID-19 and analyzed the odds of previous influenza vaccination at doctor’s offices, health departments, community settings, stores, or hospitals. Individuals at high risk for severe COVID-19 were more likely to be vaccinated in doctor’s offices and stores and less likely to be vaccinated in community settings.
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Affiliation(s)
- Victoria Fonzi
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA 30602, USA; (V.F.); (M.M.K.)
| | - Kiran Thapa
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA 30602, USA;
| | - Kishor Luitel
- School of Agriculture, Middle Tennessee State University, Murfreesboro, TN 37132, USA;
| | - Heather Padilla
- Department of Health Promotion & Behavior, College of Public Health, University of Georgia, Athens, GA 30602, USA;
| | - Curt Harris
- Institute for Disaster Management, College of Public Health, University of Georgia, Athens, GA 30602, USA;
| | - M. Mahmud Khan
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA 30602, USA; (V.F.); (M.M.K.)
| | - Glen Nowak
- Grady College Center for Health and Risk Communication, Grady College of Journalism and Mass Communication, University of Georgia, Athens, GA 30602, USA;
| | - Janani Rajbhandari-Thapa
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA 30602, USA; (V.F.); (M.M.K.)
- Correspondence:
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BOCCALINI SARA, PARIANI ELENA, CALABRÒ GIOVANNAELISA, DE WAURE CHIARA, PANATTO DONATELLA, AMICIZIA DANIELA, LAI PIEROLUIGI, RIZZO CATERINA, AMODIO EMANUELE, VITALE FRANCESCO, CASUCCIO ALESSANDRA, DI PIETRO MARIALUISA, GALLI CRISTINA, BUBBA LAURA, PELLEGRINELLI LAURA, VILLANI LEONARDO, D’AMBROSIO FLORIANA, CAMINITI MARTA, LORENZINI ELISA, FIORETTI PAOLA, MICALE ROSANNATINDARA, FRUMENTO DAVIDE, CANTOVA ELISA, PARENTE FLAVIO, TRENTO GIACOMO, SOTTILE SARA, PUGLIESE ANDREA, BIAMONTE MASSIMILIANOALBERTO, GIORGETTI DUCCIO, MENICACCI MARCO, D’ANNA ANTONIO, AMMOSCATO CLAUDIA, LA GATTA EMANUELE, BECHINI ANGELA, BONANNI PAOLO. [Health Technology Assessment (HTA) of the introduction of influenza vaccination for Italian children with Fluenz Tetra ®]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E1-E118. [PMID: 34909481 PMCID: PMC8639053 DOI: 10.15167/2421-4248/jpmh2021.62.2s1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- SARA BOCCALINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
- Autore corrispondente: Sara Boccalini, Dipartimento di Scienze della Salute, Università degli Studi di Firenze, 50134 Firenze, Italia - Tel.: 055-2751084 - E-mail:
| | - ELENA PARIANI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
| | - GIOVANNA ELISA CALABRÒ
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- VIHTALI (Value In Health Technology and Academy for Leadership & Innovation), spin off dell’Università Cattolica del Sacro Cuore, Roma, Italia
| | - CHIARA DE WAURE
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - DONATELLA PANATTO
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - DANIELA AMICIZIA
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - PIERO LUIGI LAI
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - CATERINA RIZZO
- Area Funzionale Percorsi Clinici ed Epidemiologia, Ospedale Pediatrico Bambino Gesù, IRCCS, Roma, Italia
| | - EMANUELE AMODIO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - FRANCESCO VITALE
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - ALESSANDRA CASUCCIO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - MARIA LUISA DI PIETRO
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - CRISTINA GALLI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LAURA BUBBA
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LAURA PELLEGRINELLI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LEONARDO VILLANI
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - FLORIANA D’AMBROSIO
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - MARTA CAMINITI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - ELISA LORENZINI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - PAOLA FIORETTI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | | | - DAVIDE FRUMENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - ELISA CANTOVA
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - FLAVIO PARENTE
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - GIACOMO TRENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - SARA SOTTILE
- Università degli Studi di Trento, Trento, Italia
| | | | | | - DUCCIO GIORGETTI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - MARCO MENICACCI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - ANTONIO D’ANNA
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - CLAUDIA AMMOSCATO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - EMANUELE LA GATTA
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - ANGELA BECHINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - PAOLO BONANNI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
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Olatunji EA, Ogunsola AS, Khodakarami N, Callaghan T. Who receives influenza vaccinations at the Pharmacy? An analysis of the Texas Behavioral Risk Factor Surveillance System. Vaccine 2021; 39:2857-2866. [PMID: 33896664 DOI: 10.1016/j.vaccine.2021.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Vaccination helps to prevent influenza infection and reduce associated costs but the influenza vaccination rate in Texas for adults between the ages of 18 to 64 years old is the lowest in the US. Pharmacies and alternative locations have been shown to help increase vaccination rates but many adults still go unvaccinated. OBJECTIVE This research aims to determine the factors associated with obtaining influenza vaccination at the pharmacy compared to non-pharmacy locations in Texas. METHOD This study used pooled Texas Behavior Risk Factor Surveillance System datasets (2014 to 2018) for this assessment. The main outcome variable was categorized into pharmacy and non-pharmacy vaccination locations and analyzed using a logistic regression analysis. Further statistical analysis was done using a multinomial logistic regression after re-categorizing the outcome variable into pharmacy, doctor office, and other locations. RESULT Blacks were 63% (AOR 0.37, C.I. 0.26, 0.50) and Hispanics were 38% (AOR 0.62, C.I. 0.48, 0.80) less likely to receive influenza vaccinations at the pharmacy respectively when compared to Whites. Furthermore, those who did not live in a Metropolitan Statistical Area (MSA) were 33% (AOR 0.67, C.I 0.53, 0.84) less likely to receive influenza vaccinations at the pharmacy compared to those who lived in an MSA. While there was no observed difference in the likelihood of receiving influenza vaccination, the unemployed population were 40% (AOR 1.40, C.I 1.15, 1.71) more likely to be vaccinated in the pharmacy compared to the employed population. CONCLUSION There is potential for increased utilization of pharmacies as a source of influenza vaccination in Texas. Racial differences exist both for receiving influenza vaccinations and being vaccinated in the pharmacy. Influenza vaccination advocacy and education efforts may be necessary to improve pharmacy-based vaccination in Texas, especially for minorities and rural-dwelling Texans.
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Affiliation(s)
- Eniola A Olatunji
- Department of Health Policy and Management, Texas A&M University School of Public Health, United States.
| | - Ayobami S Ogunsola
- Department of Epidemiology and Biostatistics, Texas A&M University School of Public Health, United States
| | - Nima Khodakarami
- Department of Health Policy and Management, Texas A&M University School of Public Health, United States
| | - Timothy Callaghan
- Department of Health Policy and Management, Texas A&M University School of Public Health, United States
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Burns VM, Castillo FM, Coldren RL, Prosser T, Howell RL, Kabbur MB. Perceptions of Seasonal Influenza Vaccine Among U.S. Army Civilians and Dependents in the Kaiserslautern Military Community: A Mixed-Methods Survey. Mil Med 2021; 187:e394-e403. [PMID: 33547793 PMCID: PMC7928713 DOI: 10.1093/milmed/usaa572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/23/2020] [Accepted: 01/08/2021] [Indexed: 02/04/2023] Open
Abstract
Introduction Influenza is a globally occurring viral respiratory infection that can lead to hospitalizations and death. An influenza outbreak can interfere with combat readiness in a military setting, as the infection can incapacitate soldiers. Vaccination remains the most effective tool to prevent and mitigate seasonal influenza. Although influenza vaccinations for U.S. Army soldiers can be monitored through military health systems, those systems cannot capture DoD civilians and Army dependents who may not use military health services. This study aims to gauge flu vaccine uptake and perceptions in U.S. Army civilians and dependents. Materials and Methods An online survey was e-mailed to civilian and dependent enrollees of Landstuhl Regional Medical Center. The survey contained 24 questions pertaining to demographics, vaccine history, history of the flu, and beliefs toward vaccines. Chi-square tests, t-tests, and logistic regressions were performed to investigate the association between demographic, behavior, and belief factors with vaccine uptake. Free-text answers were coded and categorized by themes. Results Over 70% of respondents were vaccinated for the flu. There were differences between vaccinated and unvaccinated respondents regarding their perceptions of barriers to vaccination, benefits of the flu vaccine, severity of flu symptoms, and personal risk of getting ill with the flu. After controlling for confounders, flu vaccination in the previous season and healthcare worker status were associated with increased vaccine uptake, while perceived barriers to influenza vaccination were associated with decreased vaccine uptake. Conclusions Flu vaccine uptake may be increased by increasing access to vaccination, promoting vaccination and addressing concerns at the provider level, and engaging positively framed public messaging. Increasing flu vaccine uptake is of particular importance as the flu season approaches during the COVID-19 (Coronavirus disease 2019) pandemic.
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Affiliation(s)
- Veronica M Burns
- U.S. Army Public Health Command Europe, Preventive Medicine Services, Landstuhl, Rhineland-Palatinate 66849, Germany
| | - Fritz M Castillo
- Department of Pathology & Area Laboratory Services, Landstuhl Regional Medical Center, Landstuhl, Rhineland-Palatinate 66849, Germany
| | - Rodney L Coldren
- U.S. Army Public Health Command Europe, Preventive Medicine Services, Landstuhl, Rhineland-Palatinate 66849, Germany
| | | | - Renee L Howell
- U.S. Army Public Health Command Europe, Preventive Medicine Services, Landstuhl, Rhineland-Palatinate 66849, Germany
| | - Mahendra B Kabbur
- U.S. Army Public Health Command Europe, Preventive Medicine Services, Landstuhl, Rhineland-Palatinate 66849, Germany
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12
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Zhai Y, Santibanez TA, Kahn KE, Srivastav A, Walker TY, Singleton JA. Rural, urban, and suburban differences in influenza vaccination coverage among children. Vaccine 2020; 38:7596-7602. [PMID: 33071004 DOI: 10.1016/j.vaccine.2020.10.030] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 10/02/2020] [Accepted: 10/08/2020] [Indexed: 11/30/2022]
Abstract
Influenza vaccination is the primary way to prevent influenza, yet influenza vaccination coverage remains low in the United States. Previous studies have shown that children residing in rural areas have less access to healthcare and lower vaccination coverage for some vaccines. Influenza vaccination coverage among children 6 months-17 years by rural/urban residence during the 2011-12 through 2018-19 influenza seasons was examined using National Immunization Survey-Flu data. The Council of American Survey Research Organizations response rates for National Immunization Survey-Flu ranged from 48% to 65% (2011-12 through the 2017-18 seasons) for the landline sample and 20%-39% (2011-12 through the 2018-19 seasons) for the cellular telephone sample. Children residing in rural areas had influenza vaccination coverage that ranged from 7.9 (2012-13 season) to 12.6 (2016-17 season) percentage points lower than children residing in urban areas, and ranged from 4.5 (2012-13 season) to 7.4 (2016-17 season) percentage points lower than children residing in suburban areas. The differences in influenza vaccination coverage among rural, suburban, and urban children were consistent over the eight seasons studied. Lower influenza vaccination coverage was observed among rural children regardless of child's age, mother's education, household income, or number of children under 18 years of age in the household. Rural versus urban and suburban differences in influenza vaccination coverage remained statistically significant while adjusting for selected sociodemographic characteristics. A better understanding of the reasons for lower childhood influenza vaccination coverage for children in rural and suburban areas is needed.
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Affiliation(s)
- Yusheng Zhai
- Leidos, Inc., Atlanta, GA, USA; National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Tammy A Santibanez
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Katherine E Kahn
- Leidos, Inc., Atlanta, GA, USA; National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anup Srivastav
- Leidos, Inc., Atlanta, GA, USA; National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tanja Y Walker
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James A Singleton
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Pharmacy patronage and service utilization: Associations with patient sociodemographic and health characteristics. J Am Pharm Assoc (2003) 2019; 59:660-669.e2. [DOI: 10.1016/j.japh.2019.04.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 04/26/2019] [Accepted: 04/29/2019] [Indexed: 11/24/2022]
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Dabestani NM, Leidner AJ, Seiber EE, Kim H, Graitcer SB, Foppa IM, Bridges CB. A review of the cost-effectiveness of adult influenza vaccination and other preventive services. Prev Med 2019; 126:105734. [PMID: 31152830 PMCID: PMC6778688 DOI: 10.1016/j.ypmed.2019.05.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/21/2019] [Accepted: 05/27/2019] [Indexed: 12/29/2022]
Abstract
The Centers for Disease Control and Prevention recommend annual influenza vaccination of persons ≥6 months old. However, in 2016-17, only 43.3% of U.S. adults reported receiving an influenza vaccination. Limited awareness about the cost-effectiveness (CE) or the economic value of influenza vaccination may contribute to low vaccination coverage. In 2017, we conducted a literature review to survey estimates of the CE of influenza vaccination of adults compared to no vaccination. We also summarized CE estimates of other common preventive interventions that are recommended for adults by the U.S. Preventive Services Task Force. Results are presented as costs in US$2015 per quality-adjusted life-year (QALY) saved. Among adults aged 18-64, the CE of influenza vaccination ranged from $8000 to $39,000 per QALY. Assessments for adults aged ≥65 yielded lower CE ratios, ranging from being cost-saving to $15,300 per QALY. Influenza vaccination was cost-saving to $85,000 per QALY for pregnant women in moderate or severe influenza seasons and $260,000 per QALY in low-incidence seasons. For other preventive interventions, CE estimates ranged from cost-saving to $170,000 per QALY saved for breast cancer screening among women aged 50-74, from cost-saving to $16,000 per QALY for colorectal cancer screening, and from $27,000 to $600,000 per QALY for hypertension screening and treatment. Influenza vaccination in adults appears to have a similar CE profile as other commonly utilized preventive services for adults. Efforts to improve adult vaccination should be considered by adult-patient providers, healthcare systems and payers given the health and economic benefits of influenza vaccination.
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Affiliation(s)
- Nazila M Dabestani
- Battelle Memorial Institute, Public Health and Advanced Analytics, Seattle, WA, USA.
| | | | - Eric E Seiber
- Battelle Memorial Institute, Public Health and Advanced Analytics, Seattle, WA, USA
| | - Hyoshin Kim
- Battelle Memorial Institute, Public Health and Advanced Analytics, Seattle, WA, USA
| | - Samuel B Graitcer
- Centers for Disease Control and Prevention, Immunization Services Division, Atlanta, GA, USA
| | - Ivo M Foppa
- Battelle Memorial Institute, Public Health and Advanced Analytics, Seattle, WA, USA
| | - Carolyn B Bridges
- Centers for Disease Control and Prevention, Immunization Services Division, Atlanta, GA, USA; Immunization Action Coalition, St. Paul, MN, USA
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15
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Do we consider paid sick leave when deciding to get vaccinated? Soc Sci Med 2018; 198:1-6. [DOI: 10.1016/j.socscimed.2017.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/29/2017] [Accepted: 12/11/2017] [Indexed: 11/18/2022]
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Kagashe I, Yan Z, Suheryani I. Enhancing Seasonal Influenza Surveillance: Topic Analysis of Widely Used Medicinal Drugs Using Twitter Data. J Med Internet Res 2017; 19:e315. [PMID: 28899847 PMCID: PMC5617904 DOI: 10.2196/jmir.7393] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/09/2017] [Accepted: 07/26/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Uptake of medicinal drugs (preventive or treatment) is among the approaches used to control disease outbreaks, and therefore, it is of vital importance to be aware of the counts or frequencies of most commonly used drugs and trending topics about these drugs from consumers for successful implementation of control measures. Traditional survey methods would have accomplished this study, but they are too costly in terms of resources needed, and they are subject to social desirability bias for topics discovery. Hence, there is a need to use alternative efficient means such as Twitter data and machine learning (ML) techniques. OBJECTIVE Using Twitter data, the aim of the study was to (1) provide a methodological extension for efficiently extracting widely consumed drugs during seasonal influenza and (2) extract topics from the tweets of these drugs and to infer how the insights provided by these topics can enhance seasonal influenza surveillance. METHODS From tweets collected during the 2012-13 flu season, we first identified tweets with mentions of drugs and then constructed an ML classifier using dependency words as features. The classifier was used to extract tweets that evidenced consumption of drugs, out of which we identified the mostly consumed drugs. Finally, we extracted trending topics from each of these widely used drugs' tweets using latent Dirichlet allocation (LDA). RESULTS Our proposed classifier obtained an F1 score of 0.82, which significantly outperformed the two benchmark classifiers (ie, P<.001 with the lexicon-based and P=.048 with the 1-gram term frequency [TF]). The classifier extracted 40,428 tweets that evidenced consumption of drugs out of 50,828 tweets with mentions of drugs. The most widely consumed drugs were influenza virus vaccines that had around 76.95% (31,111/40,428) share of the total; other notable drugs were Theraflu, DayQuil, NyQuil, vitamins, acetaminophen, and oseltamivir. The topics of each of these drugs exhibited common themes or experiences from people who have consumed these drugs. Among these were the enabling and deterrent factors to influenza drugs uptake, which are keys to mitigating the severity of seasonal influenza outbreaks. CONCLUSIONS The study results showed the feasibility of using tweets of widely consumed drugs to enhance seasonal influenza surveillance in lieu of the traditional or conventional surveillance approaches. Public health officials and other stakeholders can benefit from the findings of this study, especially in enhancing strategies for mitigating the severity of seasonal influenza outbreaks. The proposed methods can be extended to the outbreaks of other diseases.
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Affiliation(s)
- Ireneus Kagashe
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
| | - Zhijun Yan
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Imran Suheryani
- School of Life Science, Department of Biomedical Engineering, Beijing Institute of Technology, Beijing, China
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