Yoo Byung-Kwang, Kasajima Megumi, Fiscella Kevin, Bennett Nancy M, Phelps Charles E, Szilagyi Peter G
Department of Community and Preventive Medicine, University of Rochester, School of Medicine and Dentistry, 601 Elmwood Avenue, Box 644, Rochester, NY 14642, USA.
Am J Public Health. 2009 Oct;99 Suppl 2(Suppl 2):S383-8. doi: 10.2105/AJPH.2009.172411.
We assessed short-term responsiveness of influenza vaccine demand to variation in timing and severity of influenza epidemics since 2000. We tested the hypothesis that weekly influenza epidemic activity is associated with annual and daily influenza vaccine receipt.
We conducted cross-sectional survival analyses from the 2000-2001 to 2004-2005 influenza seasons among community-dwelling elderly using the Medicare Current Beneficiary Survey (unweighted n = 2280-2822 per season; weighted n = 7.7-9.7 million per season). The outcome variable was daily vaccine receipt. Covariates included the biweekly changes of epidemic and vaccine supply at 9 census-region levels.
In all 5 seasons, biweekly epidemic change was positively associated with overall annual vaccination (e.g., 2.7% increase in 2003-2004 season) as well as earlier vaccination timing (P < .01). For example, unvaccinated individuals were 5%-29% more likely to receive vaccination after a 100% biweekly epidemic increase.
Accounting for short-term epidemic responsiveness in predicting demand for influenza vaccination may improve vaccine distribution and the annual vaccination rate, and might assist pandemic preparedness planning.
我们评估了自2000年以来流感疫苗需求对流感流行时间和严重程度变化的短期反应性。我们检验了每周流感流行活动与年度和每日流感疫苗接种情况相关的假设。
我们利用医疗保险当前受益人调查，对2000 - 2001年至2004 - 2005年流感季节期间居住在社区的老年人进行了横断面生存分析（每个季节未加权的样本量为2280 - 2822人；每个季节加权的样本量为770万 - 970万人）。结果变量是每日疫苗接种情况。协变量包括9个普查区域水平上流感流行和疫苗供应的双周变化。
在所有5个季节中，双周流行变化与总体年度疫苗接种呈正相关（例如，在2003 - 2004年季节增加了2.7%）以及更早的疫苗接种时间（P < 0.01）。例如，在双周流感流行增加100%后，未接种疫苗的个体接种疫苗的可能性增加了5% - 29%。
在预测流感疫苗接种需求时考虑短期流行反应性可能会改善疫苗分配和年度疫苗接种率，并可能有助于大流行防范规划。
