Factors associated with vaccination of medicare beneficiaries in five US Communities: Results from the racial and ethnic adult disparities in immunization initiative survey, 2003

被引:136
作者
Winston, CA [1 ]
Wortley, PM [1 ]
Lees, KA [1 ]
机构
[1] Ctr Dis Control & Prevent, Immunizat Serv Div, Hlth Serv Res & Evaluat Branch, Natl Immunizat Program, Atlanta, GA 30333 USA
关键词
influenza vaccines; pneumococcal vaccines; African Americans; Hispanic Americans; health behavior;
D O I
10.1111/j.1532-5415.2005.00585.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
OBJECTIVES: To examine vaccination in seniors in the five U.S. communities of the Racial and Ethnic Adult Disparities in Immunization Initiative. DESIGN: Cross-sectional telephone survey in spring 2003 using stratified sampling by ZIP code and race/ethnicity. SETTING: New York, Texas, Wisconsin, Illinois, and Mississippi. PARTICIPANTS: Four thousand five hundred seventy-seven Medicare beneficiaries. MEASUREMENTS: Outcomes were pneumococcal vaccination ever and influenza vaccination in 2002/03 and were determined according to race/ethnicity, awareness of vaccination, and provider recommendation. Survey questions also asked about future plans for vaccination, whether respondents believed they had become sick from prior influenza vaccination, and whether unvaccinated respondents would be vaccinated if a health professional recommended it. RESULTS: Pneumococcal vaccination coverage was 70.3% for whites, 40.8% for blacks, and 53.2% for Hispanics, and the proportion reporting provider recommendation for vaccination differed significantly according to race/ethnicity. In multivariate regression, provider recommendation (risk ratio (RR)=2.32, 95% confidence intervals (CI)=2.10-2.57) and awareness of vaccination (RR=1.60, 95% CI=1.40-1.82) were associated with greater pneumococcal vaccination. Influenza vaccination coverage was 76.2% for whites, 50.7% for blacks, and 65.7% for Hispanics. A little more than half of respondents reported provider recommendation for influenza vaccination, with no differences according to race/ethnicity. Provider recommendation was associated with influenza vaccination (RR=1.31, 95% CI=1.25-1.38). More blacks and Hispanics believed they had become sick from prior influenza vaccination than whites, and this belief was associated with lower vaccination rates. CONCLUSION: This survey details vaccination patterns in an ethnically and geographically diverse sample of seniors and identifies some differences between blacks, Hispanics, and whites that may contribute to disparities in vaccination coverage. Survey findings highlight the importance of provider vaccination recommendations.
引用
收藏
页码:303 / 310
页数:8
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