Eilat-Tsanani Sophia, Vashitz-Giwnewer Ayelet
The Department of Family Medicine, Clalit Health Services, Northern Region, POB 685, Nof Hagalil 17106 Israel.
Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
Prev Med Rep. 2021 Sep 8;24:101553. doi: 10.1016/j.pmedr.2021.101553. eCollection 2021 Dec.
The 23-valent pneumococcal vaccine is recommended for people aged 65 years and over, to prevent pneumonia, a leading cause of infectious morbidity in older people. This study assessed pneumococcal vaccination in people aged 65-74 years living in northern Israel who were eligible for the pneumococcal vaccine since introduction free of charge. This retrospective study used the database of Clalit Health Services, the largest health maintenance organization in Israel. We fitted a Cox regression model to assess associations of vaccine uptake with sociodemographic and clinical characteristics, and a Wilcoxon rank-sum test and Chi-square test to assess associations of vaccine uptake with the performance of other health-related activities. The analysis included 20,591 people. People aged 65-70 were more likely to take the vaccine than people aged 71-74 [HR = 1.8; CI: 1.6-1.9]. Jews were more likely to take it than Arabs [HR = 1.1; CI: 1.0-1.2], and men were more likely to take it than women [HR = 1.1; CI: 1.0-1.2]. In women who took the vaccine, the rate of performance of mammography was higher (61.9 % ± 45.3 vs 50.3% ± 44.5, p < 0.0001). A similar trend was found for men and women with respect to occult blood tests (36.3% ± 31.5 vs 31.7% ± 30, p < 0.0001). Frequency of visits to family medicine clinics was negatively associated with vaccination. Uptake of the pneumococcal vaccine was associated with some parameters indicative of self-care but not with the level of exposure to the primary health care staff. After-hours health promotion activities by trained personnel may be an effective way to cope with the gap in performance.
23价肺炎球菌疫苗推荐给65岁及以上人群，以预防肺炎，肺炎是老年人感染性发病的主要原因。本研究评估了以色列北部65至74岁符合免费接种肺炎球菌疫苗条件的人群的肺炎球菌疫苗接种情况。这项回顾性研究使用了以色列最大的健康维护组织——克拉利特医疗服务机构的数据库。我们拟合了Cox回归模型来评估疫苗接种率与社会人口统计学和临床特征之间的关联，并使用Wilcoxon秩和检验和卡方检验来评估疫苗接种率与其他健康相关活动执行情况之间的关联。分析纳入了20,591人。65至70岁的人群比71至74岁的人群更有可能接种疫苗[风险比（HR）=1.8；置信区间（CI）：1.6 - 1.9]。犹太人比阿拉伯人更有可能接种[HR = 1.1；CI：1.0 - 1.2]，男性比女性更有可能接种[HR = 1.1；CI：1.0 - 1.2]。接种疫苗的女性中，乳房X光检查的执行率更高（61.9% ± 45.3对50.3% ± 44.5，p < 0.0001）。在男性和女性中，隐血试验也发现了类似趋势（36.3% ± 31.5对31.7% ± 30，p < 0.0001）。家庭医学诊所就诊频率与疫苗接种呈负相关。肺炎球菌疫苗的接种与一些自我护理指标相关，但与初级卫生保健人员的接触水平无关。由受过培训的人员在非工作时间开展健康促进活动可能是弥补执行差距的有效方法。
