School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada.
Health Promot Chronic Dis Prev Can. 2023 Feb;43(2):87-97. doi: 10.24095/hpcdp.43.2.04.
Annual influenza vaccination is recommended for individuals with a history of cardiovascular disease (CVD) events. We aimed to examine (1) the time trends for influenza vaccination among Canadians with a CVD event history between 2009 and 2018, and (2) the determinants of receiving the vaccination in this population over the same period.
We used data from the Canadian Community Health Survey (CCHS). The study sample included respondents from 2009 to 2018 who were 30 years of age or more with a CVD event (heart attack or stroke) and who indicated their flu vaccination status. Weighted analysis was used to determine the trend of vaccination rate. We used linear regression analysis to examine the trend and multivariate logistic regression analysis to examine determinants of influenza vaccination, including sociodemographic factors, clinical characteristics, health behaviour and health system variables.
Over the study period, in our sample of 42 400, the influenza vaccination rate was overall stable around 58.9%. Several determinants for vaccination were identified, including older age (adjusted odds ratio [aOR] = 4.28; 95% confidence interval [95% CI]: 4.24-4.32], having a regular health care provider (aOR = 2.39; 95% CI: 2.37-2.41), and being a nonsmoker (aOR = 1.48; 95% CI: 1.47-1.49). Factors associated with decreased likelihood of vaccination included working full time (aOR = 0.72; 95% CI: 0.72-0.72).
Influenza vaccination is still at less than the recommended level in patients with CVD. Future research should consider the impact of interventions to improve vaccination uptake in this population.
有心血管疾病（CVD）病史的个体推荐接种年度流感疫苗。我们旨在研究（1）2009 年至 2018 年期间有 CVD 病史的加拿大人接种流感疫苗的时间趋势，以及（2）在此期间该人群接种疫苗的决定因素。
我们使用了加拿大社区健康调查（CCHS）的数据。研究样本包括 2009 年至 2018 年 30 岁及以上、有 CVD 事件（心脏病发作或中风）并表明其流感疫苗接种状况的受访者。采用加权分析确定疫苗接种率的趋势。我们使用线性回归分析来研究趋势，使用多变量逻辑回归分析来研究流感疫苗接种的决定因素，包括社会人口因素、临床特征、健康行为和卫生系统变量。
在研究期间，在我们的 42400 名样本中，流感疫苗接种率总体保持在 58.9%左右。确定了几个疫苗接种的决定因素，包括年龄较大（调整后的优势比 [aOR] = 4.28；95%置信区间 [95%CI]：4.24-4.32）、有常规医疗保健提供者（aOR = 2.39；95%CI：2.37-2.41）和不吸烟（aOR = 1.48；95%CI：1.47-1.49）。与降低疫苗接种可能性相关的因素包括全职工作（aOR = 0.72；95%CI：0.72-0.72）。
CVD 患者的流感疫苗接种率仍低于推荐水平。未来的研究应考虑干预措施对提高该人群疫苗接种率的影响。
