Department of Sociology, University of California, Merced, Merced, California, USA.
Health Sciences Research Institute, University of California, Merced, Merced, California, USA.
LGBT Health. 2023 Feb-Mar;10(2):138-147. doi: 10.1089/lgbt.2022.0191. Epub 2022 Oct 26.
LGBT older adults face challenges accessing and receiving culturally competent health care and may be more vulnerable to serious outcomes from vaccine-preventable diseases. This study examines whether sexual orientation and gender identity are associated with older adult influenza, zoster ("shingles"), and pneumococcal vaccine uptake. Data come from the 2020 Behavioral Risk Factor Surveillance System. The sample included older adults aged 50+ (eligible for influenza and shingles vaccination; = 136,528) and 65+ (eligible for pneumococcal vaccination; = 74,779). We calculated rates of influenza, shingles, and pneumococcal vaccine uptake by gender-stratified sexual orientation groups and for transgender versus cisgender populations. Logistic regression models tested for associations between sexual orientation, gender identity, and vaccine uptake, controlling for key sociodemographic characteristics. Transgender adults had the lowest rates of uptake across all three vaccines, including 46% lower odds of shingles vaccination and 61% lower odds of pneumococcal vaccination, when compared with cisgender adults. Gay (vs. straight) men had 1.5-1.9 times greater odds of flu and shingles vaccination. Bisexual (vs. straight) women had 32% lower odds of flu vaccination. Our findings indicate that vaccine uptake among LGBT older adults varies by sexual orientation, gender identity, and vaccine type. Bisexual women and transgender people are groups that tend to underutilize health care services and are at increased risk of nonvaccination, making them important targets for older adult vaccine promotion.
LGBT 老年人在获得和接受文化上适宜的医疗保健方面面临挑战，并且可能更容易因可预防疫苗的疾病而产生严重后果。本研究考察了性取向和性别认同是否与老年流感、带状疱疹（“带状疱疹”）和肺炎球菌疫苗接种有关。数据来自 2020 年行为风险因素监测系统。该样本包括 50 岁以上（有资格接种流感和带状疱疹疫苗；n=136528）和 65 岁以上（有资格接种肺炎球菌疫苗；n=74779）的老年人。我们按性别分层的性取向组计算了流感、带状疱疹和肺炎球菌疫苗接种率，并比较了跨性别者和顺性别者群体的疫苗接种率。逻辑回归模型检验了性取向、性别认同与疫苗接种之间的关联，同时控制了关键的社会人口特征。与顺性别成年人相比，所有三种疫苗的接种率均较低，包括带状疱疹疫苗接种的可能性低 46%，肺炎球菌疫苗接种的可能性低 61%，而跨性别成年人的接种率较低。与异性恋男性（vs. 异性恋）相比，男同性恋（vs. 异性恋）男性接种流感和带状疱疹疫苗的几率高 1.5-1.9 倍。与异性恋女性（vs. 异性恋）相比，双性恋（vs. 异性恋）女性接种流感疫苗的可能性低 32%。我们的研究结果表明，LGBT 老年人群的疫苗接种率因性取向、性别认同和疫苗类型而异。双性恋女性和跨性别者是倾向于利用医疗服务不足且未接种疫苗风险增加的群体，因此是老年疫苗推广的重要目标人群。
