2010-2016 年美国成人季节性流感疫苗接种覆盖率趋势。
Seasonal Influenza Vaccination Coverage Trends Among Adult Populations, U.S., 2010-2016.
机构信息
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Leidos, Inc., Atlanta, Georgia.
出版信息
Am J Prev Med. 2019 Oct;57(4):458-469. doi: 10.1016/j.amepre.2019.04.007. Epub 2019 Aug 29.
INTRODUCTION
Influenza is a major cause of morbidity and mortality among adults. The most effective strategy for preventing influenza is annual vaccination. However, vaccination coverage has been suboptimal among adult populations. The purpose of this study is to assess trends in influenza vaccination among adult populations.
METHODS
Data from the 2010-2016 National Health Interview Survey were analyzed in 2018 to estimate vaccination coverage during the 2010-2011 through 2015-2016 seasons. Trends of vaccination in recent years were assessed. Vaccination coverage by race/ethnicity within each group was examined. Multivariable logistic regression and predictive marginal models were conducted to identify factors associated with vaccination, and interactions between race/ethnicity and other demographic and access-to-care characteristics were assessed.
RESULTS
Vaccination coverage among adults aged ≥18 years increased from 38.3% in the 2010-2011 season to 43.4% in the 2015-2016 season, with an average increase of 1.3 percentage points annually. From the 2010-2011 through 2015-2016 seasons, coverage was stable for adults aged ≥65 years and changed by -0.1 to 9.9 percentage points for all other examined subgroups. Coverage in 2015-2016 was 70.4% for adults aged ≥65 years, 46.4% for those aged 50-64 years, and 32.3% for those aged 18-49 years; 47.9% for people aged 18-64 years with high-risk conditions; 64.8% for healthcare personnel; and 50.3% for pregnant women. Among adults aged ≥18 years for the 2015-2016 season, coverage was significantly lower among non-Hispanic blacks and Hispanics compared with non-Hispanic whites.
CONCLUSIONS
Overall, influenza vaccination coverage among adults aged ≥18 years increased during 2010-2016, but it remained below the national target of 70%. Vaccination coverage varied by age, risk status, race/ethnicity, healthcare personnel, and pregnancy status. Targeted efforts are needed to improve coverage and reduce disparities.
引言
流感是导致成年人发病和死亡的主要原因之一。预防流感最有效的策略是每年接种疫苗。然而，成人人群的疫苗接种率一直不理想。本研究旨在评估成人人群中流感疫苗接种的趋势。
方法
对 2010-2016 年全国健康访谈调查的数据进行了 2018 年分析，以估算 2010-2011 年至 2015-2016 年期间的疫苗接种率。评估了近年来的疫苗接种趋势。检查了每个群体中按种族/族裔划分的疫苗接种率。进行了多变量逻辑回归和预测边际模型，以确定与接种相关的因素，并评估种族/族裔与其他人口统计学和获得医疗保健特征之间的相互作用。
结果
18 岁及以上成年人的疫苗接种率从 2010-2011 年的 38.3%增加到 2015-2016 年的 43.4%，平均每年增加 1.3 个百分点。从 2010-2011 年到 2015-2016 年，≥65 岁成年人的疫苗接种率保持稳定，所有其他检查亚组的疫苗接种率变化范围为-0.1%至 9.9%。2015-2016 年，≥65 岁成年人的接种率为 70.4%，50-64 岁为 46.4%，18-49 岁为 32.3%；18-64 岁有高风险疾病的人群为 47.9%；卫生保健人员为 64.8%；孕妇为 50.3%。在 2015-2016 年，≥18 岁的成年人中，与非西班牙裔白人相比，非西班牙裔黑人和西班牙裔的疫苗接种率明显较低。
结论
总体而言，2010-2016 年期间，≥18 岁成年人的流感疫苗接种率有所增加，但仍低于 70%的全国目标。疫苗接种率因年龄、风险状况、种族/族裔、卫生保健人员和怀孕状况而异。需要采取有针对性的措施来提高接种率并减少差异。
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