Kim So-Hyun, Jung Minsoo
Department of Health Science, Dongduk Women's University, Seoul, South Korea.
Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts.
PLoS One. 2025 May 15;20(5):e0323184. doi: 10.1371/journal.pone.0323184. eCollection 2025.
Seasonal influenza vaccination (SIV) is influenced by various factors, including sociodemographic characteristics and socioeconomic status of the recipient. Nevertheless, in the post-COVID-19 era, the importance of vaccination and group immunity has grown. Therefore, applying an integrated model to identify behavioral determinants of vaccination is needed. This study aimed to identify contextual factors affecting SIV by applying Andersen's model. We utilized secondary national datasets (n = 14,535) from the 2022 Community Health Survey conducted by the Korea Disease Control and Prevention Agency. Predisposing factors were gender and age. Enabling factors were income, educational attainment, and marital status. Need factors were presence of chronic disease, health risk behaviors (smoking and/or drinking alcohol), physical activity, and coronavirus disease 2019 (COVID-19) vaccination status. Dependent variable was influenza vaccination status. Multiple binomial logistic regression analyses were performed to identify predictors of influenza vaccination status among Korean adults, stratified by gender and age. According to the results, in men, higher education increased the likelihood of influenza vaccination by 1.089 times (95% CI: 1.000-1.185), while being married increased it by 1.619 times (95% CI: 1.413-1.856); however, smoking and binge drinking reduced the likelihood by 0.822 times (95% CI: 0.732-0.923) and 0.749 times (95% CI: 0.650-0.864), respectively. Among young men, marriage (OR=1.480, 95% CI: 1.131-1.935) and physical activity (OR=1.381, 95% CI: 1.053-1.811) were significant positive factors, while among older men, chronic disease presence increased vaccination likelihood by 1.339 times (95% CI: 1.126-1.592). In women, higher education (OR=1.168, 95% CI: 1.075-1.270) and marriage (OR=2.242, 95% CI: 1.965-2.557) were strong positive predictors, while COVID-19 vaccination history consistently increased influenza vaccination likelihood (OR=1.852, 95% CI: 1.712-2.003). Among young women, smoking reduced vaccination likelihood (OR=0.551, 95% CI: 0.359-0.847), while among older women, having a chronic disease increased vaccination likelihood by 1.354 times (95% CI: 1.133-1.619). This study empirically reveals that SIV is affected by predisposing, enabling, and need factors. To effectively intervene in individual health behaviors, it is necessary to identify characteristics of the population, provide segmented messages, and apply customized strategies.
季节性流感疫苗接种(SIV)受多种因素影响,包括受种者的社会人口学特征和社会经济地位。然而,在新冠疫情后时代,疫苗接种和群体免疫的重要性日益凸显。因此,需要应用综合模型来确定疫苗接种的行为决定因素。本研究旨在通过应用安德森模型来确定影响SIV的背景因素。我们使用了韩国疾病控制与预防机构2022年社区健康调查的全国二级数据集(n = 14535)。 predisposing因素为性别和年龄。促成因素为收入、教育程度和婚姻状况。需求因素为慢性病的存在情况、健康风险行为(吸烟和/或饮酒)、身体活动以及2019冠状病毒病(COVID-19)疫苗接种状况。因变量为流感疫苗接种状况。进行了多项二项逻辑回归分析,以确定韩国成年人中流感疫苗接种状况的预测因素,并按性别和年龄进行分层。根据结果,在男性中,高等教育使流感疫苗接种的可能性增加1.089倍(95%置信区间:1.000 - 1.185),而结婚使接种可能性增加1.619倍(95%置信区间:1.413 - 1.856);然而,吸烟和暴饮分别使接种可能性降低0.822倍(95%置信区间:0.732 - 0.923)和0.749倍(95%置信区间:0.650 - 0.864)。在年轻男性中,婚姻(OR = 1.480,95%置信区间:1.131 - 1.935)和身体活动(OR = 1.381,95%置信区间:1.053 - 1.811)是显著的正向因素,而在老年男性中,患有慢性病使接种可能性增加1.339倍(95%置信区间:1.126 - 1.592)。在女性中,高等教育(OR = 1.168,95%置信区间:1.075 - 1.270)和婚姻(OR = 2.242,95%置信区间:1.965 - 2.557)是强有力的正向预测因素,而COVID-19疫苗接种史持续增加流感疫苗接种的可能性(OR = 1.852,95%置信区间:1.712 - 2.003)。在年轻女性中,吸烟降低了接种可能性(OR = 0.551,95%置信区间:0.359 - 0.847),而在老年女性中,患有慢性病使接种可能性增加1.354倍(95%置信区间:1.133 - 1.619)。本研究实证表明,SIV受predisposing、促成和需求因素的影响。为有效干预个体健康行为,有必要识别群体特征、提供分段信息并应用定制策略。