Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China.
Department of Biology, McMaster University, Hamilton, ON, Canada; M.G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, ON, Canada.
Int J Infect Dis. 2017 Dec;65:122-127. doi: 10.1016/j.ijid.2017.10.004. Epub 2017 Oct 16.
Globally, influenza is a major cause of morbidity, hospitalization and mortality. Influenza vaccination has shown substantial protective effectiveness in the United States.
We investigated state-level patterns of coverage rates of seasonal and pandemic influenza vaccination, among the overall population (six months or older) in the U.S. and specifically among children (aged between 6 months and 17 years) and the elderly (aged 65 years or older), from 2009/10 to 2014/15, and associations with ecological factors. We obtained state-level influenza vaccination rates from national surveys, and state-level socio-demographic and health data from a variety of sources. We employed a retrospective ecological study design, and used both linear models and linear mixed-effect models to determine the levels of ecological association of the state-level vaccinations rates with these factors, both with and without region as a factor for the three populations.
Health-care access has a robust, positive association with state-level vaccination rates across all populations and models. This highlights a potential population-level advantage of expanding health-care access. We also found that prevalence of asthma in adults is negatively associated with mean influenza vaccination rates in the elderly populations.
在全球范围内，流感是导致发病、住院和死亡的主要原因。流感疫苗在美国已显示出显著的保护效力。
我们调查了美国普通人群（六个月或以上）以及儿童（六个月至十七岁）和老年人（六十五岁或以上）的季节性和大流行性流感疫苗接种覆盖率在各州的模式，并探讨了其与生态因素的关联。我们从全国性调查中获得了各州的流感疫苗接种率，从各种来源获得了各州的社会人口统计学和健康数据。我们采用回顾性生态研究设计，使用线性模型和线性混合效应模型，在考虑和不考虑地区因素的情况下，确定各州三种人群的疫苗接种率与这些因素的生态关联水平。
在所有人群和模型中，医疗保健的可及性与州级疫苗接种率呈正相关。这突出了扩大医疗保健可及性对人群的潜在优势。我们还发现，成年人中哮喘的流行与老年人群中平均流感疫苗接种率呈负相关。
