Breeze Elizabeth, Mangtani Punam, Fletcher Astrid E, Price Gill M, Kovats Sari, Roberts Jenny
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
BMC Fam Pract. 2004 Apr 20;5:8. doi: 10.1186/1471-2296-5-8.
Influenza vaccination policy for elderly people in Britain has changed twice since 1997 to increase protection against influenza but there is no information available on how this has affected vaccine uptake, and socioeconomic variation therein, among people aged over 74 years.
Vaccination information for 1997-2000 was collected directly from general practices taking part in a MRC-funded Trial of the Assessment and Management of Older People in the Community. This was linked to information collected during assessments carried out as part of the Trial. Regression modelling was used to assess relative probabilities (as relative risks, RR) of having vaccination according to year, gender, age, area and individual socioeconomic characteristics.
Out of 106 potential practices, 73 provided sufficient information to be included in the analysis. Uptake was 48% (95% CI 45%, 55%) in 1997 and did not increase substantially until 2000 when the uptake was a third higher at 63% (50%, 66%). Vaccination uptake was lower among women than men (RR 0.9), people aged 85 or more compared to people aged under 80 (RR 0.9), those in the most deprived areas (RR 0.8) compared to the least deprived, and was relatively high for those in owner-occupied homes with central heating compared to other non-supported housing (RR for remainder = 0.9). This pattern did not change over the years studied.
Increased uptake in 2000 may have resulted from the additional financial resources given to practices; it was not at the expense of more disadvantaged socioeconomic groups but nor did they benefit disproportionately.
自1997年以来，英国针对老年人的流感疫苗接种政策已变更两次，以增强对流感的防护，但目前尚无关于这对74岁以上人群疫苗接种率及其社会经济差异产生何种影响的信息。
1997 - 2000年的疫苗接种信息直接从参与医学研究委员会资助的社区老年人评估与管理试验的普通诊所收集。这与作为试验一部分进行评估期间收集的信息相关联。回归模型用于根据年份、性别、年龄、地区和个人社会经济特征评估接种疫苗的相对概率（以相对风险，RR表示）。
在106家潜在诊所中，73家提供了足够信息以纳入分析。1997年的接种率为48%（95%置信区间45%，55%），直到2000年才大幅上升，当时接种率高出三分之一，为63%（50%，66%）。女性的疫苗接种率低于男性（RR 0.9），85岁及以上人群低于80岁以下人群（RR 0.9），最贫困地区的人群低于最不贫困地区的人群（RR 0.8），与其他无资助住房相比，自有中央供暖住房的人群疫苗接种率相对较高（其余人群的RR = 0.9）。在研究的这些年里，这种模式没有改变。
2000年接种率的提高可能是由于给予诊所的额外财政资源；这并非以更弱势的社会经济群体为代价，但他们也没有获得不成比例的益处。
