Jiménez-García Rodrigo, Hernandez-Barrera Valentín, Rodríguez-Rieiro Cristina, Carrasco Garrido Pilar, López de Andres Ana, Jimenez-Trujillo Isabel, Esteban-Vasallo María D, Domínguez-Berjón Maria Felicitas, de Miguel-Diez Javier, Astray-Mochales Jenaro
Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain.
Department of Epidemiology, Directorate of Health Promotion and Prevention, Ministry of Health, Community of Madrid, C/ Julián Camarillo, 4B, 28037 Madrid, Spain.
Vaccine. 2014 Jul 31;32(35):4386-4392. doi: 10.1016/j.vaccine.2014.06.074. Epub 2014 Jun 23.
We aim to compare influenza vaccination coverages obtained using two different methods; a population based computerized vaccination registry and self-reported influenza vaccination status as captured by a population survey.
The study was conducted in the Autonomous Community of Madrid (ACM), Spain, and refers to the 2011/12 influenza vaccination campaign. Information on influenza vaccination status according to a computerized registry was extracted from the SISPAL database and crossed with the electronic clinical records in primary care (ECRPC). Self-reported vaccine uptake was obtained from subjects living in the ACM included in the 2011-12 Spanish National Health Survey (SNHS). Independent study variables included: age, sex, immigrant status and the presence of high risk chronic conditions. Vaccination coverages were calculated according to study variables. Crude and adjusted prevalence ratios were computed to assess concordance.
The study population included 5,245,238 adults living in the ACM in year 2011 with an individual ECRPC and 1449 adult living the ACM and interviewed in the SNHS from October 2011 to June 2012. The weighted vaccination coverage for the study population according to self-reported data was 19.77% and 15.04% from computerized registries resulting in a crude prevalence ratio (cPR) of 1.31 (95% CI 1.20-1.44) so self-reported data significantly overestimated 31% the registry coverage. Self-reported coverages are always higher than registry based coverages when the study population is stratified by the study variables. Self-reported overestimation was higher among men than women, younger age groups, immigrants and those without chronic conditions. Both methods provide the most concordant estimations for the target population of the influenza vaccine.
Self-report influenza vaccination uptake overestimates vaccination registries coverages. The validity of self-report seems to be negatively affected by socio-demographic variables and the absence of chronic conditions. Possible strategies must be considered and implemented to improve both coverage estimation methods.
我们旨在比较使用两种不同方法获得的流感疫苗接种覆盖率；一种是基于人群的计算机化疫苗接种登记系统，另一种是通过人群调查获取的自我报告的流感疫苗接种状况。
该研究在西班牙马德里自治区（ACM）进行，涉及2011/12年度流感疫苗接种活动。根据计算机化登记系统获取的流感疫苗接种状况信息从SISPAL数据库中提取，并与初级保健电子临床记录（ECRPC）进行交叉核对。自我报告的疫苗接种率来自2011 - 12年西班牙国家健康调查（SNHS）中纳入的居住在ACM的受试者。独立研究变量包括：年龄、性别、移民身份以及高危慢性病的存在情况。根据研究变量计算疫苗接种覆盖率。计算粗患病率和调整患病率以评估一致性。
研究人群包括2011年居住在ACM且拥有个人ECRPC的5,245,238名成年人，以及居住在ACM且在2011年10月至2012年6月期间接受SNHS访谈的1449名成年人。根据自我报告数据，研究人群的加权疫苗接种覆盖率为19.77%，而计算机化登记系统得出的覆盖率为15.04%，粗患病率比（cPR）为1.31（95% CI 1.20 - 1.44），因此自我报告数据显著高估了登记系统覆盖率31%。当按研究变量对研究人群进行分层时，自我报告的覆盖率始终高于基于登记系统的覆盖率。男性、较年轻年龄组、移民以及无慢性病者的自我报告高估情况更高。两种方法对流感疫苗目标人群的估计最为一致。
自我报告的流感疫苗接种率高估了疫苗接种登记系统的覆盖率。自我报告的有效性似乎受到社会人口统计学变量和无慢性病情况的负面影响。必须考虑并实施可能的策略以改进这两种覆盖率估计方法。
