Charles R Drew University of Medicine and Science (CDU), 1731 East 120th Street, Los Angeles, CA, 90059, USA.
University of California, Los Angeles, 1100 Glendon Ave. Suite 900, Los Angeles, CA, USA.
BMC Public Health. 2022 May 6;22(1):907. doi: 10.1186/s12889-022-13121-z.
Vaccination is a powerful tool in the fight against seasonal influenza, among underserved, middle-age and older, Latinx adults. Yet, vaccine hesitancy and inconsistent uptake in this population continues to represent a substantial challenge to public health. A better understanding of factors impacting influenza vaccination behaviors in this group could result in more effective messaging and initiatives promoting universal vaccination among Latinx.
In this cross-sectional survey, we explore correlates of influenza vaccination uptake among underserved, Latinx, older adults. Our focus was on the role of socio-demographics, living arrangements, financial strain, access and satisfaction with medical care, and the presence of major chronic conditions in terms of vaccine uptake. Middle-aged and older Latinx residents diagnosed with diabetes and/or hypertension (n=165), were recruited from the South Los Angeles Service Plan Area (SPA), a historically under-resourced community. Bi-variate and multi-variate logistical regression were performed on survey data to explore independent correlates of influenza vaccination.
Almost half of underserved Latinx older adults in our study (45%) reported influenza vaccination within the 12 months prior to the study. The majority (~85%) reported receiving this recommendation from their primary care provider. However, thirty percent (30%) of those receiving this advice did not get the vaccine. A decreased likelihood of vaccination was significantly associated with living alone (p-value=0.026), lacking Medicare coverage (0.028), or higher levels of financial strain (0.020). Difficulty accessing medical care (p-value=0.008) or dissatisfaction with these experiences (p-value=0.001) were also strongly associated with decreased likelihood of vaccination. Participants diagnosed with COPD had 9.5 (CI: 1.76 - 51.3) higher odds of being vaccinated compared to those without; no correlation was detected for other chronic conditions.
The high number of unvaccinated Latinx participants receiving a vaccine recommendation from a provider is consistent with studies among other ethnic/racial minority older adults and highlights the pivotal role of the provider in influenza vaccine adoption. Additional findings reflect negative impact of Social Determinates of Health on preventive care efforts in this group. Further efforts to quantify these associations are needed to explore structural and human factors impacting influenza vaccine uptake.
疫苗接种是应对服务不足的中老年人和拉丁裔成年人季节性流感的有力工具。然而，在这一人群中，疫苗犹豫和接种不一致的情况仍然是公共卫生的重大挑战。更好地了解影响这一群体流感疫苗接种行为的因素，可以促使拉丁裔人群更有效地推广普遍接种疫苗。
在这项横断面调查中，我们探讨了服务不足的拉丁裔老年人中流感疫苗接种率的相关因素。我们关注的是社会人口统计学因素、居住安排、经济压力、医疗保健的可及性和满意度，以及主要慢性疾病的存在对疫苗接种率的影响。从中洛杉矶服务计划区（SPA）招募了 165 名被诊断患有糖尿病和/或高血压的中年和老年拉丁裔居民，该地区历史上资源匮乏。对调查数据进行双变量和多变量逻辑回归，以探讨流感疫苗接种的独立相关因素。
在我们的研究中，近一半的服务不足的拉丁裔老年人（45%）在研究前 12 个月内报告接种了流感疫苗。大多数人（约 85%）报告从他们的初级保健提供者那里得到了这一建议。然而，有 30%的人得到了这一建议但没有接种疫苗。接种疫苗的可能性显著降低与独居（p 值=0.026）、缺乏医疗保险覆盖（0.028）或经济压力较高（0.020）有关。难以获得医疗保健（p 值=0.008）或对这些体验不满意（p 值=0.001）也与接种疫苗的可能性降低密切相关。与没有慢性阻塞性肺病（COPD）的参与者相比，被诊断患有 COPD 的参与者接种疫苗的可能性高 9.5 倍（95%置信区间：1.76-51.3）；而其他慢性疾病则没有相关性。
大量接受提供者疫苗建议但未接种疫苗的拉丁裔参与者与其他族裔/种族少数族裔老年人的研究结果一致，这突显了提供者在流感疫苗接种中的关键作用。进一步的研究发现反映了社会决定因素对这一群体预防保健工作的负面影响。需要进一步努力量化这些关联，以探讨影响流感疫苗接种率的结构和人为因素。
