Bhattacharyya Ruemon, Katz Samuel J, Bhattacharyya Mehul, Miller Anna L, Miller Larry E
University of California Los Angeles. Los Angeles, CA.
Arizona State University, Tempe, AZ.
Medicine (Baltimore). 2025 Mar 14;104(11):e41854. doi: 10.1097/MD.0000000000041854.
The purpose of this study was to determine the prevalence and factors associated with influenza vaccine nonreceipt among adults in the United States. This nationally representative, cross-sectional study analyzed self-reported data on influenza vaccination status and sociodemographic, physical health, and health care access factors among 27,189 adults from the 2022 National Health Interview Survey. The primary outcome was influenza vaccination nonreceipt in the past 12 months. A multivariable logistic regression model evaluated associations between 19 sociodemographic, physical health, and health care access variables with influenza vaccine nonreceipt. Shapley Additive Explanations assessed the relative importance of covariates associated with nonreceipt in the regression model. The population-weighted analysis indicated 52.8% influenza vaccination nonreceipt among US adults. The logistic regression model identified 15 covariates as significantly associated with vaccine nonreceipt. When evaluating the relative importance of the variables, the key determinants of vaccine nonreceipt were younger age, lack of doctor visits in the past year, and lower educational attainment. Influenza vaccine nonreceipt was 92.4% among adults with all 3 characteristics compared to only 16.0% among those with none of the characteristics. In conclusion, influenza vaccine coverage in the overall US adult population remains well below public health goals. Significant disparities persist among subgroups like younger adults, those without recent health care visits, and individuals with lower educational attainment. There is an urgent need for expanded outreach efforts targeting vulnerable populations to address disparities in vaccine uptake.
本研究的目的是确定美国成年人中流感疫苗未接种的患病率及其相关因素。这项具有全国代表性的横断面研究分析了来自2022年国家健康访谈调查的27189名成年人关于流感疫苗接种状况、社会人口统计学、身体健康和医疗保健可及性因素的自我报告数据。主要结果是过去12个月内未接种流感疫苗。一个多变量逻辑回归模型评估了19个社会人口统计学、身体健康和医疗保健可及性变量与未接种流感疫苗之间的关联。夏普利加法解释评估了回归模型中与未接种相关的协变量的相对重要性。人口加权分析表明，美国成年人中流感疫苗未接种率为52.8%。逻辑回归模型确定了15个协变量与未接种疫苗显著相关。在评估变量的相对重要性时，未接种疫苗的关键决定因素是年龄较小、过去一年没有看医生以及教育程度较低。具有所有这三个特征的成年人中流感疫苗未接种率为92.4%，而没有任何这些特征的成年人中这一比例仅为16.0%。总之，美国成年人群体的流感疫苗接种率仍远低于公共卫生目标。在年轻成年人、近期未就医者以及教育程度较低的人群等亚组之间，显著差异仍然存在。迫切需要针对弱势群体扩大外展工作，以解决疫苗接种方面的差异。
