Barriers to influenza immunization in a low-income urban population

被引:132
作者
Armstrong, K
Berlin, M
Schwartz, JS
Propert, K
Ubel, PA
机构
[1] Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA
[2] Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA
[3] Univ Penn, Sch Med, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA
[4] Univ Penn, Sch Med, Dept Obstet & Gynecol, Philadelphia, PA 19104 USA
[5] Vet Affairs Med Ctr, Philadelphia, PA USA
关键词
influenza; patient compliance; socioeconomic factors; immunization;
D O I
10.1016/S0749-3797(00)00263-4
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 [公共卫生与预防医学]; 120402 [社会医学与卫生事业管理];
摘要
Background: Athough influenza immunization significantly reduces mortality from influenza, over one third of elderly Americans are not immunized each year. Low rates of immunization are particularly concerning among African-American low-income populations. Preliminary interviews suggested that fear of undisclosed ingredients in the influenza vaccine may impede vaccine acceptance in this vulnerable population. Objectives: To assess the role of concern about vaccine contents and other factors in the use of influenza immunization among a predominantly African-American low-income urban population. Methods: Cross-sectional, health-system-population-based, telephone survey of a random sample of West Philadelphia residents aged greater than or equal to 65 years. Results: Of 659 eligible individuals, 486 (73.8%) were successfully interviewed. Concern about undisclosed shot contents was reported by 132 (20%) respondents and was inversely associated with vaccine receipt (OR 0.49, 95% CI 0.26-0.91). This association was similar among African Americans and Caucasians. In addition, receipt of influenza vaccine was inversely associated with belief that immunization is inconvenient (OR 0.14, 95% CI 0.05-0.36), belief that immunization is painful (OR 0.21, 95% CI 0.08-0.54), and history of previous side effects (OR 0.33, 95% CI 0.18-0.60), and positively associated with physician recommendation (OR 3.22, 95% CI 1.76-5.93). Conclusions: In a low-income urban population, concern about undisclosed vaccine contents appears to impede acceptance of influenza immunization among both African Americans and Caucasians. Directly addressing this concern offers a new approach to increasing immunization in this vulnerable population. (C) 2001 American Journal of Preventive Medicine.
引用
收藏
页码:21 / 25
页数:5
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