Lu Peng-Jun, Singleton James A, Rangel María C, Wortley Pascale M, Bridges Carolyn Buxton
Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Ga. 30333, USA.
Arch Intern Med. 2005 Sep 12;165(16):1849-56. doi: 10.1001/archinte.165.16.1849.
Influenza vaccination of elderly individuals (65 years or older) has been recommended in the United States since 1961, and consistent surveillance of vaccine use has been conducted since 1989. We examined national trends in influenza vaccination coverage in the United States from 1989 to 2002 among noninstitutionalized elderly individuals and identified factors associated with receipt of influenza vaccine.
We analyzed data from the 1989-2002 National Health Interview Surveys, weighted to reflect the civilian, noninstitutionalized US population to determine self-reported levels of influenza vaccination. We conducted multivariable logistic regression modeling of 2002 data to identify factors independently associated with self-reported influenza vaccination.
Among the elderly, influenza vaccination coverage increased from 30.5% in 1989 to 65.6% in 2002, with only a 2.4% increase from 1997 to 2002. In 2002, coverage remained lower for the non-Hispanic black (49.6%) and Hispanic (48.5%) populations compared with non-Hispanic whites (68.6%). Characteristics associated with a lower likelihood of influenza vaccination included fewer than 4 physician contacts in the past year and whether a person (1) was divorced or separated, (2) was non-Hispanic black or Hispanic, (3) had no regular physician, and (4) had less than a high school education. Individuals with chronic medical conditions and those 75 years or older were more likely to be vaccinated.
By 1997, influenza vaccination coverage exceeded the Healthy People 2000 objective of 60% for the elderly overall, but even by 2002, this objective was still not achieved in the elderly black and Hispanic populations. Vaccination coverage seems to be leveling off, and innovative initiatives are needed to reach the Healthy People 2010 target of 90%, especially among racial and ethnic minorities.
自1961年起，美国就建议对65岁及以上的老年人进行流感疫苗接种，并且自1989年起就持续开展了疫苗使用监测。我们研究了1989年至2002年美国非机构化老年人流感疫苗接种覆盖率的全国趋势，并确定了与接种流感疫苗相关的因素。
我们分析了1989 - 2002年全国健康访谈调查的数据，进行加权以反映美国平民非机构化人口情况，从而确定自我报告的流感疫苗接种水平。我们对2002年的数据进行多变量逻辑回归建模，以确定与自我报告的流感疫苗接种独立相关的因素。
在老年人中，流感疫苗接种覆盖率从1989年的30.5%上升至2002年的65.6%，而从1997年至2002年仅上升了2.4%。2002年，与非西班牙裔白人（68.6%）相比，非西班牙裔黑人（49.6%）和西班牙裔（48.5%）人群的接种覆盖率仍然较低。与流感疫苗接种可能性较低相关的特征包括过去一年看医生次数少于4次，以及一个人是否（1）离婚或分居，（2）是非西班牙裔黑人或西班牙裔，（3）没有固定的医生，（4）受教育程度低于高中。患有慢性疾病的个体以及75岁及以上的个体更有可能接种疫苗。
到1997年，总体上老年人的流感疫苗接种覆盖率超过了《健康人民2000》设定的60%的目标，但即使到2002年，老年黑人和西班牙裔人群仍未实现这一目标。疫苗接种覆盖率似乎趋于平稳，需要采取创新举措以实现《健康人民2010》设定的90%的目标，尤其是在少数种族和族裔群体中。
