Determinants of influenza vaccination, 2003-2004: Shortages, fallacies and disparities
Determinants of influenza vaccination, 2003-2004: Shortages, fallacies and disparities
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DOI：
10.1086/427153
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发表时间：
2004-12-15
影响因子：
11.8
通讯作者：
Schaffner, W
中科院分区：
文献类型：
--
作者：
Jones, TF;Ingram, LA;Schaffner, W
背景2003-2004年的流感爆发得到了媒体的大量关注，包括关于流感季节严重和疫苗短缺的广泛报道。了解疫苗接种的决定因素对指导免疫政策具有重要意义。从2004年2月至6月，我们进行了结构化的电话调查，田纳西州的居民，使用随机数字拨号方法。4028人完成了疫苗接种，其中2077人（52%）在上一个爆发季节接受了流感疫苗接种。在这2077名疫苗接种者中，63%在私人诊所接种，14%在工作场所接种，11%在卫生部门接种，7%在药房接种。四分之三的受访者报告了疾病控制和预防中心建议接种疫苗的风险因素;其中，41%的人没有接种疫苗，其中26%的人在流感季节因其他原因看过医疗服务提供者。超过40%的年龄大于或等于50岁的人、超过一半的卫生保健工作者和70%的孕妇没有接种疫苗。黑人、农村居民和低收入受访者接种疫苗的可能性明显低于对照组。在接种疫苗的受访者中，6%的人报告难以获得疫苗（最常见的是，他们报告疫苗不容易获得）。四分之一未接种疫苗的人接受了疫苗接种，但拒绝了;其中35%的人认为没有必要，33%的人认为这会使他们生病。在那些没有接种疫苗的人中，8%的人报告说要求接种疫苗但没有得到，最常见的是因为疫苗无法获得。许多障碍造成流感疫苗接种率的差异，供应不足只是其中一个因素。关于流感疫苗接种的神话顽固地存在着。提高免疫接种率的多方面办法至关重要。
Background. The influenza outbreak of 2003-2004 received substantial media attention, including widespread reports of a severe season and vaccine shortages. Understanding the determinants of vaccine receipt is important for guiding immunization policies.Methods. From February through June 2004, we administered a structured telephone survey to Tennessee residents, using random-digit dialing methodology.Results. Questionnaires were completed by 4028 persons, of whom 2077 (52%) had received influenza vaccination during the previous outbreak season. Of these 2077 vaccine recipients, 63% received vaccine at a private medical clinic, 14% at a workplace, 11% at a health department, and 7% at a pharmacy. Three-fourths of respondents reported a risk factor for which the Centers for Disease Control and Prevention recommends vaccination; of those, 41% went unvaccinated, including 26% who had seen a medical provider for other reasons during the influenza season. More than 40% of persons aged greater than or equal to50, more than half of health care workers, and 70% of pregnant women were not immunized. Blacks, rural residents, and lower-income respondents were significantly less likely to be immunized than were comparison groups. Of respondents who were vaccinated, 6% reported difficulties obtaining vaccination (most commonly, they reported that vaccine was not readily available). One-fourth of unvaccinated persons had been offered vaccination but had declined it; of these, 35% thought it unnecessary and 33% believed it would make them ill. Of those not vaccinated, 8% reported requesting vaccination but not receiving it, most commonly because it was unavailable.Conclusions. Many barriers contribute to disparities in rates of influenza vaccination, of which inadequate supply is only one component. Myths regarding influenza vaccination persist tenaciously. A multifaceted approach to increasing immunization rates is critical.