Influenza and Pneumococcal Vaccine Receipt in Older Persons with Chronic Disease: A Population-Based Study

Rachel L. Petersen, Kenneth Saag, Robert B. Wallace, Bradley Doebbeling

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

OBJECTIVE. To identify factors associated with receipt of the pneumococcal and influenza vaccines among community-dwelling older persons with chronic disease. METHODS. A population-based sample of urban and rural Iowa adults age 65 years and older with one or more self-reported target medical conditions were interviewed by telephone. Information was obtained on aspects of health care access, which were examined as potential determinants of receipt of recommended vaccines. RESULTS. A total of 787 interviews were completed (response rate = 68%; completion rate for screened, eligible subjects = 91%). Two-thirds (n = 531, 68%) reported influenza vaccination in the last year, and one-half (51%, n = 393) reported ever receiving the pneumococcal vaccine. Both vaccines were received at recommended intervals by 347 subjects (44%). Multivariable logistic regression identified the following factors independently associated with receipt of both vaccines: age 70 or greater (OR = 1.64, CI95 = 1.15, 2.32); married (OR = 1.41, CI95 = 1.03, 1.92); self-owned residence (OR = 0.57, CI95 = 0.33, 0.97); working (OR = 2.94, CI95 = 1.38, 6.18); increased number of target medical conditions (OR = 1.3 for each, CI95 = 1.09, 1.54); current prescription medication (OR = 2.04, CI95 = 1.32, 3.14); and a physician visit in the last year (OR = 2.53, CI95 = 1.52-4.19). Receipt of the vaccines was unrelated to geographic location in a rural area. CONCLUSIONS. Despite their proven safety and efficacy, many persons with at least two indications to receive either vaccine remain unvaccinated. Among the elderly with chronic disease, predisposing and need factors were independently associated with receipt of both vaccines. Enabling factors assessed appeared less important in this population. Targeting of the elderly and those with chronic disease to receive recommended vaccines is needed to adequately protect these populations at risk.

Original languageEnglish (US)
Pages (from-to)502-509
Number of pages8
JournalMedical Care
Volume37
Issue number5
DOIs
StatePublished - May 1999
Externally publishedYes

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Pneumococcal Vaccines
Influenza Vaccines
contagious disease
Chronic Disease
Vaccines
Disease
medication
Population
vaccination
telephone
indication
Causality
rural area
logistics
physician
health care
determinants
regression
human being
Independent Living

Keywords

  • Aging
  • Bacterial vaccines
  • Comorbidity
  • Health services accessibility
  • Influenza vaccine
  • Pneumoccocal infections
  • Preventive health services
  • Vaccination

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

Influenza and Pneumococcal Vaccine Receipt in Older Persons with Chronic Disease : A Population-Based Study. / Petersen, Rachel L.; Saag, Kenneth; Wallace, Robert B.; Doebbeling, Bradley.

In: Medical Care, Vol. 37, No. 5, 05.1999, p. 502-509.

Research output: Contribution to journalArticle

Petersen, Rachel L. ; Saag, Kenneth ; Wallace, Robert B. ; Doebbeling, Bradley. / Influenza and Pneumococcal Vaccine Receipt in Older Persons with Chronic Disease : A Population-Based Study. In: Medical Care. 1999 ; Vol. 37, No. 5. pp. 502-509.
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abstract = "OBJECTIVE. To identify factors associated with receipt of the pneumococcal and influenza vaccines among community-dwelling older persons with chronic disease. METHODS. A population-based sample of urban and rural Iowa adults age 65 years and older with one or more self-reported target medical conditions were interviewed by telephone. Information was obtained on aspects of health care access, which were examined as potential determinants of receipt of recommended vaccines. RESULTS. A total of 787 interviews were completed (response rate = 68{\%}; completion rate for screened, eligible subjects = 91{\%}). Two-thirds (n = 531, 68{\%}) reported influenza vaccination in the last year, and one-half (51{\%}, n = 393) reported ever receiving the pneumococcal vaccine. Both vaccines were received at recommended intervals by 347 subjects (44{\%}). Multivariable logistic regression identified the following factors independently associated with receipt of both vaccines: age 70 or greater (OR = 1.64, CI95 = 1.15, 2.32); married (OR = 1.41, CI95 = 1.03, 1.92); self-owned residence (OR = 0.57, CI95 = 0.33, 0.97); working (OR = 2.94, CI95 = 1.38, 6.18); increased number of target medical conditions (OR = 1.3 for each, CI95 = 1.09, 1.54); current prescription medication (OR = 2.04, CI95 = 1.32, 3.14); and a physician visit in the last year (OR = 2.53, CI95 = 1.52-4.19). Receipt of the vaccines was unrelated to geographic location in a rural area. CONCLUSIONS. Despite their proven safety and efficacy, many persons with at least two indications to receive either vaccine remain unvaccinated. Among the elderly with chronic disease, predisposing and need factors were independently associated with receipt of both vaccines. Enabling factors assessed appeared less important in this population. Targeting of the elderly and those with chronic disease to receive recommended vaccines is needed to adequately protect these populations at risk.",
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T1 - Influenza and Pneumococcal Vaccine Receipt in Older Persons with Chronic Disease

T2 - A Population-Based Study

AU - Petersen, Rachel L.

AU - Saag, Kenneth

AU - Wallace, Robert B.

AU - Doebbeling, Bradley

PY - 1999/5

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N2 - OBJECTIVE. To identify factors associated with receipt of the pneumococcal and influenza vaccines among community-dwelling older persons with chronic disease. METHODS. A population-based sample of urban and rural Iowa adults age 65 years and older with one or more self-reported target medical conditions were interviewed by telephone. Information was obtained on aspects of health care access, which were examined as potential determinants of receipt of recommended vaccines. RESULTS. A total of 787 interviews were completed (response rate = 68%; completion rate for screened, eligible subjects = 91%). Two-thirds (n = 531, 68%) reported influenza vaccination in the last year, and one-half (51%, n = 393) reported ever receiving the pneumococcal vaccine. Both vaccines were received at recommended intervals by 347 subjects (44%). Multivariable logistic regression identified the following factors independently associated with receipt of both vaccines: age 70 or greater (OR = 1.64, CI95 = 1.15, 2.32); married (OR = 1.41, CI95 = 1.03, 1.92); self-owned residence (OR = 0.57, CI95 = 0.33, 0.97); working (OR = 2.94, CI95 = 1.38, 6.18); increased number of target medical conditions (OR = 1.3 for each, CI95 = 1.09, 1.54); current prescription medication (OR = 2.04, CI95 = 1.32, 3.14); and a physician visit in the last year (OR = 2.53, CI95 = 1.52-4.19). Receipt of the vaccines was unrelated to geographic location in a rural area. CONCLUSIONS. Despite their proven safety and efficacy, many persons with at least two indications to receive either vaccine remain unvaccinated. Among the elderly with chronic disease, predisposing and need factors were independently associated with receipt of both vaccines. Enabling factors assessed appeared less important in this population. Targeting of the elderly and those with chronic disease to receive recommended vaccines is needed to adequately protect these populations at risk.

AB - OBJECTIVE. To identify factors associated with receipt of the pneumococcal and influenza vaccines among community-dwelling older persons with chronic disease. METHODS. A population-based sample of urban and rural Iowa adults age 65 years and older with one or more self-reported target medical conditions were interviewed by telephone. Information was obtained on aspects of health care access, which were examined as potential determinants of receipt of recommended vaccines. RESULTS. A total of 787 interviews were completed (response rate = 68%; completion rate for screened, eligible subjects = 91%). Two-thirds (n = 531, 68%) reported influenza vaccination in the last year, and one-half (51%, n = 393) reported ever receiving the pneumococcal vaccine. Both vaccines were received at recommended intervals by 347 subjects (44%). Multivariable logistic regression identified the following factors independently associated with receipt of both vaccines: age 70 or greater (OR = 1.64, CI95 = 1.15, 2.32); married (OR = 1.41, CI95 = 1.03, 1.92); self-owned residence (OR = 0.57, CI95 = 0.33, 0.97); working (OR = 2.94, CI95 = 1.38, 6.18); increased number of target medical conditions (OR = 1.3 for each, CI95 = 1.09, 1.54); current prescription medication (OR = 2.04, CI95 = 1.32, 3.14); and a physician visit in the last year (OR = 2.53, CI95 = 1.52-4.19). Receipt of the vaccines was unrelated to geographic location in a rural area. CONCLUSIONS. Despite their proven safety and efficacy, many persons with at least two indications to receive either vaccine remain unvaccinated. Among the elderly with chronic disease, predisposing and need factors were independently associated with receipt of both vaccines. Enabling factors assessed appeared less important in this population. Targeting of the elderly and those with chronic disease to receive recommended vaccines is needed to adequately protect these populations at risk.

KW - Aging

KW - Bacterial vaccines

KW - Comorbidity

KW - Health services accessibility

KW - Influenza vaccine

KW - Pneumoccocal infections

KW - Preventive health services

KW - Vaccination

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