Why are older adults and individuals with underlying chronic diseases in Germany not vaccinated against flu? A population-based study
Why are older adults and individuals with underlying chronic diseases in Germany not vaccinated against flu? A population-based study
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DOI：
10.1186/s12889-015-1970-4
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发表时间：
2015-07-07
影响因子：
4.5
通讯作者：
Wichmann, Ole
中科院分区：
文献类型：
--
作者：
Boedeker, Birte;Remschmidt, Cornelius;Wichmann, Ole
背景：老年人和有潜在慢性病的个体发生流感相关并发症的风险增加，是许多国家季节性流感疫苗接种的目标群体。在德国，每年开展一次全国宣传运动，以提高目标群体的流感疫苗接种率。然而，缺乏关于老年人和慢性病患者对流感疫苗接种的知识和态度的数据。本研究旨在(i)估计2012/13和2013/14季节的流感疫苗接种率，（ii）评估对流感疫苗接种的知识和态度，以及（iii）确定与两个风险群体的疫苗接种率相关的因素。方法：2014年3月至6月，我们采用计算机辅助电话访谈的方式，对居住在德国的成年人（bb0 = 18岁）进行了全国性的横断面调查。我们计算了两个高危组的加权疫苗接种率。第一组参与者年龄在18-59岁之间，有潜在的慢性疾病。第二组参与者年龄在60岁以上，不考虑潜在疾病。我们使用单变量和多变量逻辑回归分析来确定流感疫苗接种与社会人口学特征之间的关联，并评估态度和知识。结果：共进行了1519次访谈。在2012/2013年和2013/2014年，18-59岁慢性病患者的季节性流感疫苗接种率分别为24%和23%。在老年人中，2012/13年和2013/14年的吸收率分别为50%和49%。应答者之间存在相当大的疫苗接种相关知识差距。例如，年龄在60岁以上和/或患有潜在慢性疾病的参与者中，约有一半认为接种流感疫苗可能导致流感。不接种疫苗最常见的原因是不信任疫苗接种（22%）和认为流感不危险（21%）。在两组中，疫苗接种与性别、流感严重程度、疫苗接种有效性和疫苗副作用的可能性或严重程度独立相关。对于老年人，影响疫苗接种的其他因素是年龄、潜在的慢性疾病和最近通过医生咨询的建议。结论：德国流感疫苗接种率仍然很低。个人对危害和利益的看法在决策过程中至关重要。传播战略应侧重于增进对该病和疫苗接种引起的个人风险的理解和认识。
Background: Older adults and individuals with underlying chronic diseases are at increased risk of developing influenza-related complications and are target groups for seasonal influenza vaccination in many countries. In Germany, an annual national information campaign is conducted to increase influenza vaccination uptake in the target groups. However, data are lacking on knowledge and attitudes toward influenza vaccination among older adults and those with chronic diseases. The present study aimed to (i) estimate influenza vaccination uptake for the 2012/13 and 2013/14 seasons, (ii) assess knowledge and attitudes about influenza vaccination, and (iii) identify factors associated with vaccination uptake in two risk groups.Methods: Between March and June 2014, we conducted a nationwide cross-sectional survey in adults (>= 18 years) living in Germany using computer-assisted telephone interviewing. We calculated weighted vaccination coverage rates in two at-risk groups. Group 1 comprised participants aged 18-59 years with underlying chronic diseases. Group 2 comprised participants aged 60+, irrespective of underlying disease. We used univariate and multivariable logistic regression analyses to identify associations between influenza vaccination uptake and sociodemographic characteristics, and to evaluate attitudes and knowledge.Results: In total, 1,519 interviews were conducted. Seasonal influenza vaccination uptake in people with underlying chronic diseases aged 18-59 years was 24 % in 2012/2013 and 23 % in 2013/2014. In older adults, uptake was 50 % and 49 % in 2012/13 and 2013/14 respectively. There were considerable vaccination-related knowledge gaps among respondents. For example, about half of the participants who aged >= 60 years and/or suffered from underlying chronic diseases believed that influenza vaccination could cause influenza. The most commonly stated reasons for not being immunized were mistrust of the vaccination (22 %) and the perception that influenza is not dangerous (21 %). For both groups, vaccination uptake was independently associated with sex, perceived severity of influenza, perceived vaccination effectiveness, and the perceived likelihood or severity of vaccination side effects. For older adults, additional factors influencing vaccination uptake were age, underlying chronic diseases, and recent advice through physician consultation.Conclusions: Influenza vaccination coverage rates in Germany remain low. Individual perceptions regarding harms and benefits are crucial in the decision-making process. Communication strategies should focus on improving understanding and perception of personal risks arising from the disease and the vaccination.