Dyda Amalie, Karki Surendra, Kong Marlene, Gidding Heather F, Kaldor John M, McIntyre Peter, Banks Emily, MacIntyre C Raina, Liu Bette
School of Public Health and Community Medicine, UNSW, Sydney, NSW, Australia
Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
Commun Dis Intell (2018). 2019 Jul 16;43. doi: 10.33321/cdi.2019.43.30.
There is limited information on vaccination coverage and characteristics associated with vaccine uptake in Aboriginal and/or Torres Strait Islander adults. We aimed to provide more current estimates of influenza vaccination coverage in Aboriginal adults.
Self-reported vaccination status (n=559 Aboriginal and/or Torres Strait Islander participants, n=80,655 non-Indigenous participants) from the 45 and Up Study, a large cohort of adults aged 45 years or older, was used to compare influenza vaccination coverage in Aboriginal and/or Torres Strait Islander adults with coverage in non-Indigenous adults.
Of Aboriginal and non-Indigenous respondents aged 49 to <65 years, age-standardised influenza coverage was respectively 45.2% (95% CI 39.5–50.9%) and 38.5%, (37.9–39.0%), p-value for heterogeneity=0.02. Coverage for Aboriginal and non-Indigenous respondents aged ≥65 years was respectively 67.3% (59.9–74.7%) and 72.6% (72.2–73.0%), p-heterogeneity=0.16. Among Aboriginal adults, coverage was higher in obese than in healthy weight participants (adjusted odds ratio (aOR)=2.38, 95%CI 1.44–3.94); in those aged <65 years with a medical risk factor than in those without medical risk factors (aOR=2.13, 1.37–3.30); and in those who rated their health as fair/poor compared to those who rated it excellent (aOR=2.57, 1.26–5.20). Similar associations were found among non-Indigenous adults.
In this sample of adults ≥65 years, self-reported influenza vaccine coverage was not significantly different between Aboriginal and non-Indigenous adults whereas in those <65 years, coverage was higher among Aboriginal adults. Overall, coverage in the whole cohort was suboptimal. If these findings are replicated in other samples and in the Australian Immunisation Register, it suggests that measures to improve uptake, such as communication about the importance of influenza vaccine and more effective reminder systems, are needed among adults.
关于原住民和/或托雷斯海峡岛民成年人的疫苗接种覆盖率以及与疫苗接种相关的特征的信息有限。我们旨在提供原住民成年人流感疫苗接种覆盖率的最新估计值。
来自“45岁及以上研究”（一个由45岁及以上成年人组成的大型队列）的自我报告的疫苗接种状况（559名原住民和/或托雷斯海峡岛民参与者，80,655名非原住民参与者）被用于比较原住民和/或托雷斯海峡岛民成年人与非原住民成年人的流感疫苗接种覆盖率。
在49至<65岁的原住民和非原住民受访者中，年龄标准化的流感疫苗接种覆盖率分别为45.2%（95%可信区间39.5 - 50.9%）和38.5%（37.9 - 39.0%），异质性p值 = 0.02。≥65岁的原住民和非原住民受访者的疫苗接种覆盖率分别为67.3%（59.9 - 74.7%）和72.6%（72.2 - 73.0%）。p异质性 = 0.16。在原住民成年人中，肥胖者的接种覆盖率高于健康体重者（调整后的优势比（aOR）= 2.38，95%可信区间1.44 - 3.94）；年龄<65岁且有医疗风险因素者的接种覆盖率高于无医疗风险因素者（aOR = 2.13，1.37 - 3.30）；与自评为健康状况极佳者相比，自评为健康状况一般/较差者的接种覆盖率更高（aOR = 2.57，1.26 - 5.20）。在非原住民成年人中也发现了类似的关联。
在这个65岁及以上成年人的样本中，自我报告的流感疫苗接种覆盖率在原住民和非原住民成年人之间没有显著差异，而在65岁以下的人群中，原住民成年人的接种覆盖率更高。总体而言，整个队列的接种覆盖率不理想。如果这些结果在其他样本和澳大利亚免疫接种登记系统中得到重复，这表明需要采取措施来提高接种率，例如宣传流感疫苗的重要性以及建立更有效的提醒系统。
