Determinants of Seasonal Influenza Vaccine Uptake Among the Elderly in the United States: A Systematic Review and Meta-Analysis
Background: Despite the availability of a universal influenza vaccination program in the United States and Canada, seasonal influenza vaccine (SIV) uptake among the elderly remains suboptimal. Understanding the factors that determine SIV uptake in this important population subgroup is essential for...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2019-08-01
|
| Series: | Gerontology and Geriatric Medicine |
| Online Access: | https://doi.org/10.1177/2333721419870345 |
| _version_ | 1811324186566590464 |
|---|---|
| author | George N. Okoli MD, MSc Ahmed M. Abou-Setta MD, PhD Christine J. Neilson MLIS Ayman Chit PhD Edward Thommes PhD Salaheddin M. Mahmud MD, PhD |
| author_facet | George N. Okoli MD, MSc Ahmed M. Abou-Setta MD, PhD Christine J. Neilson MLIS Ayman Chit PhD Edward Thommes PhD Salaheddin M. Mahmud MD, PhD |
| author_sort | George N. Okoli MD, MSc |
| collection | DOAJ |
| description | Background: Despite the availability of a universal influenza vaccination program in the United States and Canada, seasonal influenza vaccine (SIV) uptake among the elderly remains suboptimal. Understanding the factors that determine SIV uptake in this important population subgroup is essential for designing effective interventions to improve seasonal influenza vaccination among the elderly. We evaluated the determinants of SIV uptake in the elderly in the United States and Canada. Methods: We systematically searched relevant bibliographic databases and websites from 2000 to 2017 for population-based clinical trials or observational studies conducted in community-based elderly individuals in the United States or Canada, irrespective of health status. Two reviewers independently screened the identified citations for eligibility using a two-stage sifting approach to review the title/abstract and full-text article. We gathered data on determinants of uptake (any vaccine receipt) and adherence (receipt of vaccine in more than one season) to seasonal influenza vaccination. Where possible, we pooled the data using inverse variance methods to minimize the variance of the weighted average. Results: Five cross-sectional studies on SIV uptake (none on adherence) from the United States met our eligibility criteria. Being older (pooled odds ratio [POR] = 1.44, 95% Confidence Interval [CI] = 1.11, 1.86); White (POR = 1.33, 95% CI = [1.10, 1.64]); and having higher income (POR = 1.06, 95% CI = [1.04, 1.09]); and health insurance (POR = 1.40, 95% CI = [1.25, 1.55]) were associated with increased SIV uptake. Conclusion: Older, ethnically White, higher income elderly individuals with access to health insurance coverage and a regular health care provider have higher SIV uptake in the United States. There was limited evidence for other socioeconomic and health-related determinants. Further studies are needed to provide an evidence base for planning more effective influenza vaccination programs in the United States. |
| first_indexed | 2024-04-13T14:09:39Z |
| format | Article |
| id | doaj.art-618875e3798244189936a89892203b26 |
| institution | Directory Open Access Journal |
| issn | 2333-7214 |
| language | English |
| last_indexed | 2024-04-13T14:09:39Z |
| publishDate | 2019-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Gerontology and Geriatric Medicine |
| spelling | doaj.art-618875e3798244189936a89892203b262022-12-22T02:43:49ZengSAGE PublishingGerontology and Geriatric Medicine2333-72142019-08-01510.1177/2333721419870345Determinants of Seasonal Influenza Vaccine Uptake Among the Elderly in the United States: A Systematic Review and Meta-AnalysisGeorge N. Okoli MD, MSc0Ahmed M. Abou-Setta MD, PhD1Christine J. Neilson MLIS2Ayman Chit PhD3Edward Thommes PhD4Salaheddin M. Mahmud MD, PhD5University of Manitoba, Winnipeg, CanadaUniversity of Manitoba, Winnipeg, CanadaUniversity of Manitoba, Winnipeg, CanadaSanofi Pasteur, Swiftwater, PA, USASanofi Pasteur, Swiftwater, PA, USAUniversity of Manitoba, Winnipeg, CanadaBackground: Despite the availability of a universal influenza vaccination program in the United States and Canada, seasonal influenza vaccine (SIV) uptake among the elderly remains suboptimal. Understanding the factors that determine SIV uptake in this important population subgroup is essential for designing effective interventions to improve seasonal influenza vaccination among the elderly. We evaluated the determinants of SIV uptake in the elderly in the United States and Canada. Methods: We systematically searched relevant bibliographic databases and websites from 2000 to 2017 for population-based clinical trials or observational studies conducted in community-based elderly individuals in the United States or Canada, irrespective of health status. Two reviewers independently screened the identified citations for eligibility using a two-stage sifting approach to review the title/abstract and full-text article. We gathered data on determinants of uptake (any vaccine receipt) and adherence (receipt of vaccine in more than one season) to seasonal influenza vaccination. Where possible, we pooled the data using inverse variance methods to minimize the variance of the weighted average. Results: Five cross-sectional studies on SIV uptake (none on adherence) from the United States met our eligibility criteria. Being older (pooled odds ratio [POR] = 1.44, 95% Confidence Interval [CI] = 1.11, 1.86); White (POR = 1.33, 95% CI = [1.10, 1.64]); and having higher income (POR = 1.06, 95% CI = [1.04, 1.09]); and health insurance (POR = 1.40, 95% CI = [1.25, 1.55]) were associated with increased SIV uptake. Conclusion: Older, ethnically White, higher income elderly individuals with access to health insurance coverage and a regular health care provider have higher SIV uptake in the United States. There was limited evidence for other socioeconomic and health-related determinants. Further studies are needed to provide an evidence base for planning more effective influenza vaccination programs in the United States.https://doi.org/10.1177/2333721419870345 |
| spellingShingle | George N. Okoli MD, MSc Ahmed M. Abou-Setta MD, PhD Christine J. Neilson MLIS Ayman Chit PhD Edward Thommes PhD Salaheddin M. Mahmud MD, PhD Determinants of Seasonal Influenza Vaccine Uptake Among the Elderly in the United States: A Systematic Review and Meta-Analysis Gerontology and Geriatric Medicine |
| title | Determinants of Seasonal Influenza Vaccine Uptake Among the Elderly in the United States: A Systematic Review and Meta-Analysis |
| title_full | Determinants of Seasonal Influenza Vaccine Uptake Among the Elderly in the United States: A Systematic Review and Meta-Analysis |
| title_fullStr | Determinants of Seasonal Influenza Vaccine Uptake Among the Elderly in the United States: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Determinants of Seasonal Influenza Vaccine Uptake Among the Elderly in the United States: A Systematic Review and Meta-Analysis |
| title_short | Determinants of Seasonal Influenza Vaccine Uptake Among the Elderly in the United States: A Systematic Review and Meta-Analysis |
| title_sort | determinants of seasonal influenza vaccine uptake among the elderly in the united states a systematic review and meta analysis |
| url | https://doi.org/10.1177/2333721419870345 |
| work_keys_str_mv | AT georgenokolimdmsc determinantsofseasonalinfluenzavaccineuptakeamongtheelderlyintheunitedstatesasystematicreviewandmetaanalysis AT ahmedmabousettamdphd determinantsofseasonalinfluenzavaccineuptakeamongtheelderlyintheunitedstatesasystematicreviewandmetaanalysis AT christinejneilsonmlis determinantsofseasonalinfluenzavaccineuptakeamongtheelderlyintheunitedstatesasystematicreviewandmetaanalysis AT aymanchitphd determinantsofseasonalinfluenzavaccineuptakeamongtheelderlyintheunitedstatesasystematicreviewandmetaanalysis AT edwardthommesphd determinantsofseasonalinfluenzavaccineuptakeamongtheelderlyintheunitedstatesasystematicreviewandmetaanalysis AT salaheddinmmahmudmdphd determinantsofseasonalinfluenzavaccineuptakeamongtheelderlyintheunitedstatesasystematicreviewandmetaanalysis |