Guthrie Jennifer L, Fisman David, Gardy Jennifer L
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
PLoS One. 2017 Feb 16;12(2):e0172117. doi: 10.1371/journal.pone.0172117. eCollection 2017.
While seasonal influenza vaccination is recommended for individuals with asthma, uptake in this population is low. We examined how self-rated health impacts reasons for not being immunized against influenza in Canadian adults with asthma, focusing on those who have never been immunized.
We pooled four cycles of the Canadian Community Health Survey (cycles 3.1(2005), 2007/08, 2009/10 and 2011/12), grouping individuals by whether their reasons for not having been vaccinated were perceptual or technical. We used a multivariable logistic regression model, adjusted for confounders, to quantify the relationship between self-rated health and their reported reasons for not vaccinating.
Among the 9,836 respondents, 84.4% cited perceptual barriers as a reason for not being vaccinated. After adjusting for socio-demographic characteristics and province of residence, we determined that reporting perceptual barriers was associated with self-rated health status, with the adjusted odds ratios ranging from 1.42 (95%CI: 0.97, 2.09) to 2.64 (95%CI: 1.74, 3.99) for fair and excellent health versus poor health, respectively. Each increase in self-rated health category was associated with greater odds of citing a perceptual rather than technical barrier as a reason for non-vaccination.
Self-reported health influences people's perception of the need for influenza vaccination. Viewing the results through the lens of the precaution adoption process model suggests that personalizing communication around both the risk of influenza and the effectiveness of the vaccine may improve uptake amongst adults with asthma.
虽然建议哮喘患者接种季节性流感疫苗,但该人群的疫苗接种率较低。我们研究了自我评估健康状况如何影响加拿大成年哮喘患者未接种流感疫苗的原因,重点关注那些从未接种过疫苗的患者。
我们汇总了四个周期的加拿大社区健康调查(2005年第3.1周期、2007/08年、2009/10年和2011/12年),根据未接种疫苗的原因是认知性还是技术性对个体进行分组。我们使用多变量逻辑回归模型,并对混杂因素进行调整,以量化自我评估健康状况与报告的未接种疫苗原因之间的关系。
在9836名受访者中,84.4%的人将认知障碍作为未接种疫苗的原因。在调整了社会人口特征和居住省份后,我们确定报告认知障碍与自我评估健康状况相关,健康状况为“一般”和“良好”的人与健康状况“较差”的人相比,调整后的优势比分别为1.42(95%置信区间:0.97,2.09)至2.64(95%置信区间:1.74,3.99)。自我评估健康类别每提高一级,将认知障碍而非技术障碍作为未接种疫苗原因的可能性就越大。
自我报告的健康状况会影响人们对流感疫苗接种必要性的认知。从预防措施采用过程模型的角度来看,针对流感风险和疫苗有效性进行个性化沟通可能会提高成年哮喘患者的疫苗接种率。