Influenza vaccination coverage rates in Europe--covering five consecutive seasons (2001-2006) in five countries

Factors associated with influenza vaccine uptake in older adults living in the community in Singapore

In Singapore, influenza vaccination is recommended for persons at higher risk of complications of seasonal influenza, including those with chronic medical conditions and the elderly (individuals aged ⩾65 years). We investigated the factors associated with influenza vaccine uptake based on a nationally representative sample of community-dwelling adults aged >50 years. The data for this study were obtained from the National Health Surveillance Survey (NHSS) 2013. The association between influenza vaccine uptake and socio-demographic and health-related variables was analysed using univariable and multivariable logistic regression models. Of 3700 respondents aged ⩾50 years in the NHSS, 15·2% had received seasonal influenza vaccination in the past year. Older age, single marital status and economic inactivity were the socio-demographic variables independently associated with vaccine uptake. Health-related factors which were predictive of influenza vaccine uptake were sufficient total physical activity, better self-rated health, having at least one medical condition at risk of influenza complications and a regular family doctor/general practitioner. Influenza vaccine uptake in community-dwelling older adults was low. Our findings are of relevance in the formulation of public health policies and targeted health promotion strategies to increase vaccine uptake in this population group.

Vaccine history, gender and influenza vaccination in a household context

BACKGROUND

Few studies have investigated the effect of the history of vaccination on the current influenza vaccine uptake. The objective of this paper is to study the effects of vaccine history, for each sex separately, on the likelihood of vaccine uptake among single-head households and two-person households, controlling not only for the respondents' own prior vaccination history but also the history of vaccination among possible co-residents.

MATERIALS AND METHODS

We used logistic regression and data from a nationally representative telephone survey of the non-institutionalized Norwegian population aged ≥ 65 years to estimate our models (N=354). The survey was carried out in November 2008.

RESULTS

The lowest vaccine uptake was found among those who live alone with no prior history of vaccination and among those who live in two-person households where both members had no prior history of vaccination (10-22%). Those who live in two-person households where both members had previously been vaccinated had the highest vaccine uptake (86%). While a man who has previously been vaccinated has a higher likelihood of continued vaccination if his wife also has a prior history of vaccination, a woman with a prior history of vaccination is not dependent on her husband's prior practice with respect to the probability of continued vaccination. Of those who have no history of vaccination, more women than men are vaccinated for the first time when they have a spouse who has a history of vaccination.

CONCLUSION

Our study shows that the history of vaccination of a co-resident/spouse has an effect above and beyond the respondent's own vaccination history. The results indicate that there are gender differences in the willingness to encourage family members to be vaccinated or to embark upon a familial vaccination regime in order to protect the individual's own personal health and that of other family members from influenza. To the best of our knowledge such gender differences have never been shown before in research on influenza vaccine uptake. However, the finding is in accordance with a number of studies on the role of gender and the positive effect on health and mortality of social support and social control in marriage.

Seasonal influenza vaccine uptake in Germany 2007/2008 and 2008/2009: results from a national health update survey

In 2008/2009 a nationwide cross-sectional telephone survey was conducted to assess, among other health-relevant parameters, seasonal influenza vaccination coverage. Data from 21,262 household-interviews representative of the adult population in Germany were collected and analyzed. In seasons 2007/2008 and 2008/2009, vaccine uptake in individuals aged ≥60 years was 57% and 55% and in individuals with underlying chronic diseases 44% and 42%. Living in the eastern part of Germany, higher age, and medium household income level were independently associated with higher vaccine uptake in both target groups. Healthcare workers were significantly less frequently (21.9% in 2007/2008; 20.4% in 2008/2009) vaccinated than the general population (30.8% and 28.1%). Special effort must be undertaken to develop immunization strategies for improved vaccine uptake in target groups, especially in healthcare workers.

Increasing influenza vaccination coverage in recommended population groups in Europe

The clinical and economic burden of seasonal influenza is frequently underestimated. The cornerstone of controlling and preventing influenza is vaccination. National and international guidelines aim to implement immunization programs and targeted vaccination-coverage rates, which should help to enhance the vaccine uptake, especially in the at-risk population. This review purposes to highlight the vaccination guidelines and the actual vaccination situation in four target groups (the elderly, people with underlying chronic conditions, healthcare workers and children) from a European point of view.

[Spectrum of tuberculous diseases in a pulmonary outpatient clinic]

BACKGROUND

Although the incidence of 6.6 newly diagnosed tuberculosis (TB) cases per 100,000 inhabitants is in decline in Germany, TB remains a disease of significant epidemiologic importance.

PATIENTS AND METHODS

From 04/2001 to 07/2008, a total of 75 TB patients of an internal-pulmonary outpatient clinic had been treated (0.5% of all patients). 58 (77.3%) patients fulfilled the criteria of an active TB, 17 (22.7%) of latent tuberculous infection (LTBI). 68.0% were male (average age men 39.3 +/- 16.9 years [mean +/- standard deviation], women 46.8 +/- 21.5 years; p = not significant). 69.3% of the patients were born in Germany, 30.7% abroad. 84.5% patients had isolated pulmonary, 8.6% additional organ involvement, and 6.9% isolated extrapulmonary TB. 62.1% of active TB cases were microbiologically proven (51.7% microscopically, 43.1% in addition culturally, 6.9% exclusively culturally, 19.0% by polymerase chain reaction [PCR]).

RESULTS

Of 23 tests, 52.2% were fully sensitive against the most important first-line drugs ethambutol (M), isoniazid (H), rifampicin (R), pyrazinamide (Z), und streptomycin (S). 13.0% had an isolated resistance against H (4.4%) or S (8.6%), 4.4% a multiple drug resistance (MDR) against R und H, 30.4% a polyresistance (S and H). Symptoms were quite often unspecific, not taken care of, or misinterpreted.

CONCLUSION

Diagnosis and therapy of an active or latent TB illness remains, an important task and challenge, necessitating an effective cooperation of outpatient, hospital, and health authority institutions.

Influenza vaccination coverage rates in five European countries during season 2006/07 and trends over six consecutive seasons

BACKGROUND

The objectives of the survey were to identify the level of influenza vaccination coverage in five European countries between 2001 and 2007, to understand the drivers and barriers to vaccination, to assess vaccination intentions for the winter 2007/08 as well as major encouraging factors for vaccination.

METHODS

Between 2001 and 2007, representative household surveys were performed with telephone or mailed (France) interviews of individuals aged 14 and above. The questionnaire used in the UK, Germany, Italy, France and Spain was essentially the same in all seasons. The data were subsequently pooled. Four target groups were defined for the analysis: 1) persons aged 65 years and over; 2) persons working in the medical field; 3) chronically ill persons and 4) combined target group composed of individuals belonging to one or more of the previous groups 1, 2 or 3.

RESULTS

In 2006/07, vaccination coverage was, 25.0% in UK, 27.4% in Germany, 21.8% in Spain, 24.2% in France and 24.4% in Italy. During six influenza seasons (2001-2007), vaccination coverage showed a slight positive trend in the five countries (p < or = 0.0001). In the elderly (> or = 65 years), across all countries, no significant trend was seen; the vaccination rate decreased non-significantly from a peak of 64.2% in season 2005/06 to 61.1% in season 2006/07. The most frequent reason for getting vaccinated was a recommendation by the family doctor or nurse (51%), and this was also perceived as the major encouraging factor for vaccination (61%). The main reason for not getting vaccinated was feeling unlikely to catch the flu (36%).

CONCLUSION

In the UK, Germany and Spain, influenza vaccination coverage rates in season 2006/07 dropped slightly compared to the previous season. However, a trend of increasing vaccination coverage was observed from 2001/02 to 2006/07 across Europe. The family doctor is the major source of encouragement for individuals getting vaccinated. Efforts to overcome the barriers to vaccination need to be put in place to reach the WHO objective of 75% coverage in the elderly by 2010. This is a major challenge to be faced by governments, healthcare workers and healthcare organisations.