Influenza and Pneumococcal Vaccination in Older Veterans: Results from the Behavioral Risk Factor Surveillance System

Ru‐Chien Chi · Gayle E. Reiber · Kathleen Maletic Neuzil

39 citations0/0 files storedJournal of the American Geriatrics Society

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Vaccine Coverage and Hesitancy Pneumonia and Respiratory Infections Immune responses and vaccinations

Abstract

OBJECTIVES: To compare influenza and pneumococcal vaccination rates of older veterans with those of nonveterans and to compare vaccination rates of veterans who receive care at U.S. Department of Veterans Affairs (VA) medical centers with those of veterans who do not. DESIGN: Cross-sectional population-based study. SETTING: United States and territories. PARTICIPANTS: Persons aged 65 and older who participated in the 2003 Behavioral Risk Factor Surveillance System. MEASUREMENTS: Telephone survey of sociodemographics factors, including veteran status and VA care, health and behavioral characteristics, and influenza and pneumococcal vaccine use. RESULTS: Thirty percent of adults aged 65 and older were veterans, and 21% of veterans reported receiving care at VA health facilities. Veterans, especially VA users, were older and described poorer self-perceived health than nonveterans. Influenza and pneumococcal vaccination rates were higher for veterans than for nonveterans (74% vs 68% and 68% vs 63%, respectively, P < .001 for both) and for VA users than non-VA users (80% vs 72% and 81% vs 64%, respectively, P < .001 for both). For veterans, VA care was independently associated with influenza (odds ratio (OR) = 1.8, 95% confidence interval (CI) = 1.5-2.2) and pneumococcal (OR = 2.4, 95% CI = 2.0-2.9) vaccine use after adjusting for sociodemographics factors, perceived health status, diabetes mellitus, asthma, and smoking. Current smoking and black race were independent predictors of low influenza vaccine uptake. CONCLUSION: VA care was associated with improved influenza and pneumococcal vaccine coverage, although vaccination rates for all elderly veterans fell short of Healthy People 2010 goals. Increased efforts to reach undervaccinated groups, particularly blacks and smokers, are warranted.

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2008Recommendations of the Advisory Committee on Immunization Practices (ACIP)1999Validation of self-report of influenza and pneumococcal vaccination status in elderly outpatients 2001Generalist and Subspecialist Physicians' Knowledge, Attitudes, and Practices Regarding Influenza and Pneumococcal Vaccinations for Elderly and Other High-Risk Patients 2003What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and veterans affairs practices 2001Racial Disparity in Influenza Vaccination 2005The Causes of Racial and Ethnic Differences in Influenza Vaccination Rates among Elderly Medicare Beneficiaries 2003Barriers and facilitators of pneumococcal vaccination among the elderly 2004The Association of Sociodemographic Factors and Patient Attitudes on Influenza Vaccination Rates in Older Persons

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2018Evidence Review—Social Determinants of Health for Veterans 2010Interventions to increase influenza vaccination rates of those 60 years and older in the community 2009Does Sex Influence Immunization Status for Influenza and Pneumonia in Older Veterans?2009Patient and family education in HSCT: improving awareness of respiratory virus infection and influenza vaccination. A descriptive study and brief intervention

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