Factors Associated With Vaccination Against Influenza In The Elderly [fatores Associados à Vacinação Contra A Influenza Em Idosos]

Objective. To investigate the epidemiologic profile of elderly persons who do or do not participate in influenza vaccination campaigns and to identify the variables that bear an influence on participation. Method. A cross-sectional population-based study was performed using data on individuals aged 60 years or older who were living in the municipalities of São Paulo, Itapecerica da Serra, Embu, Taboão da Serra, Campinas and Botucatu, Brazil, in 2001 and 2002. A stratified random sample of 1 908 elderly individuals was selected by means of two-stage cluster sampling. Exploratory data analysis was performed, including bivariate analysis and multiple logistic regression. Results. Sixty-six percent of the elderly subjects reported having received vaccination against influenza. After adjustment, the following factors were found to be associated with having received vaccination, based on self-report: age (OR = 1.47; 95% CI = 1.09 to 1.99), self-reported hypertension (OR = 1.39; 95% CI = 1.03 to 1.87) and educational level (OR = 0.64; 95% CI = 0.41 to 0.98). The highest number of vaccinated individuals was observed in the group = 70 years of age and in the hypertension group. Individuals with 9 or more years of schooling reported less adherence to influenza vaccination. Conclusions. The results suggest the need for campaigns to make information on the benefits of influenza vaccination more easily accessible to the elderly and health professionals.194259264Chaimowicz, F., Greco, D.B., Dinâmica da institucionalização de idosos em Belo Horizonte, Brasil (1999) Rev Saúde Pública, 33 (5), pp. 454-460(2002) Redes Estaduais de Atenção Ao Idoso. Guia Operacional e Portarias Relacionadas, , Brasília, DF: Ministério da SaúdeSerie A: Normas TécnicasRamos, L.R., Garcia, J.T., Terapêutica medicamentosa no idoso (2003) Atualização Terapêutica, pp. 555-558. , Prado FC, Ramos JA, Valle JR, eds. São Paulo: Artes Médicas;Fabra, A.R., Neumonías en el anciano (1996) Antibiot Infecc, 4 (2), pp. 5-13Dodet, B., Immunity in the elderly (2000) Vaccine, 18 (16), p. 1565Cruz, A.M., Bravo, J., Rojas, V., Conocimientos, creencias y prácticas respecto a las infecciones respiratorias agudas en adultos mayores de 65 años (1999) Cad Saude Publica, 15 (4), pp. 851-857Prevention and Control of Influenza - Recommendations of the Advisory Committee on Immunization Practices (ACIP) (2005) MMWR, 54 (8), pp. 1-40(2005) Campanha de Vacinação para O Idoso - 2005, , São Paulo: SESInforme TécnicoFrancisco, P.M.S.B., Donalisio, M.R.C., Latorre, M.R.O., Internações por doenças respiratórias em idosos e a intervenção vacinal contra influenza no Estado de São Paulo (2004) Rev Bras Epidemiol, 7 (2), pp. 220-227Francisco, P.M.S.B., Donalisio, M.R.C., Latorre, M.R.O., Vacinação contra influenza e mortalidade por doenças respiratórias em idosos, 1980-2000 (2005) Rev Saude Publica, 39 (1), pp. 75-81Fedson, D.S., Wajda, A., Nicol, J.P., Hammond, G.W., Kaiser, D.L., Roos, L.L., Clinical effectiveness of influenza vaccination in Manitoba (1993) JAMA, 270 (16), pp. 1956-1961Ahmed, A.E., Nicholson, K.G., Nguyen-Van-Tam, J.S., Reduction in mortality associated with influenza vaccine during 1989-90 epidemic (1995) Lancet, 346 (8975), pp. 591-595Gross, P.A., Hermogenes, A.W., Sacks, H.S., Lau, J., Levandowski, R.A., The efficacy of influenza vaccine in elderly persons. A meta-analysis and review if the literature (1995) Ann Intern Med, 123 (7), pp. 518-527Nichol, K.L., Margolis, K.L., Wuorenma, J., Von Sternberg, T., The efficacy and cost effectiveness of vaccination against influenza among elderly persons in the community (1994) N Engl J Med, 331 (12), pp. 778-784Nichol, K.L., Wuorenma, J., Von Sternberg, T., Benefits of influenza vaccination for low-, intermediate-, and high-risk senior citizens (1998) Arch Intern Med, 158 (16), pp. 1769-1776Bridges, C.B., Winquist, A.G., Fukuda, K., Cox, N.J., Singleton, J.A., Stikas, R.A., Prevention and control of influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP) (2003) MMWR Recomm Rep, 52 (RR-8), pp. 1-34. , quiz CE1-4Cesar, C.L.G., Carandina, L., Alves, M.C.G.P., Barros, M.B.A., Goldbaum, M., (2005) Saúde e Condições de Vida Em São Paulo - Inquérito Multicêntrico de Saúde No Estado de São Paulo (ISA-SP), , São Paulo: USP/FSPLima-Costa, M.F., Barreto, M.S., Giatti, L., Condições de saúde, capacidade funcional, uso de serviços de saúde e gastos com medicamentos da população idosa brasileira: Um estudo descritivo baseado na Pesquisa Nacional por Amostra de Domicílios (2003) Cad Saude Publica, 19 (3), pp. 735-743Hosmer, D.W., Lemeshow, S., (1989) Applied Logistic Regression, , New York: John Wiley & SonsCochran, W.G., (1977) Sampling Techniques, , New York: John Wiley & SonsKorn, E.L., Graubard, B.I., Epidemiologic studies utilizing surveys: Accounting for sampling design (1991) Am J Public Health, 81 (9), pp. 1166-1173Mac Donald, R., Baken, L., Nelson, A., Nichol, K.L., Validation of self-report of influenza and pneumococcal vaccination status in elderly outpatients (1999) Am J Prev Med, 16 (3), pp. 173-177Pesquisas indicam pequena participação dos médicos no incentivo à vacinação contra influenza (2004) Rev Saude Publica, 38 (4), pp. 607-608Bovier, P.A., Chamot, E., Gallacchi, M.B., Loutan, L., Importance of patients' perceptions and general practitioners' recommendations in understanding missed opportunities for immunisations in Swiss adults (2001) Vaccine, 19 (32), pp. 4760-4767Evans, M.R., Watson, P.A., Why do older people not get immunised against influenza? A community survey (2003) Vaccine, 21 (19-20), pp. 2421-2427Pena-Rey, I., Perez-Farinos, N., Sarria-Santamera, A., Factors associated with influenza vaccination among elderly Spanish women (2004) Public Health, 118 (8), pp. 582-587Berquó, E., Baeninger, R., Os Idosos No Brasil: Considerações Demográficas, , http://www.nepo.unicamp.br/textos_publish/textos_nepo_37.pdf, Textos Nepo [site da Internet]Becket, M., Converging health inequalities in later life - An artifact of mortality selection? (2000) J Health Soc Behav, 41 (1), pp. 106-119Pregliasco, F., Sodano, L., Mensi, C., Selvaggi, M.T., Adamo, B., D'Argenio, P., Influenza vaccination among the elderly in Italy (1999) Bull World Health Organ, 77 (2), pp. 127-131Dannetun, E., Tegnell, A., Normann, B., Garpenholt, O., Giesecke, J., Influenza vaccine coverage and reasons for non vaccination in a sample of people above 65 years of age, in Sweden, 1998-2000 (2003) Scand J Infect Dis, 35 (6-7), pp. 389-393Piccini, R.X., Victora, C.G., Hipertensão arterial sistêmica em área urbana no sul do Brasil: Prevalência e fatores de risco (1994) Rev Saude Publica, 28 (4), pp. 261-267Firmo, J.O.A., Lima-Costa, M.F., Uchôa, E., Projeto Bambuí: Maneiras de pensar e agir de idosos hipertensos (2004) Cad Saude Publica, 20 (4), pp. 1029-1040Rocha, J.L.L., Baggio, H.C.C., Cunha, C.A., Niclewicz, E.A., Leite, S.A.O., Baptista, M.I.D.K., Aspectos relevantes da interface entre diabetes mellitus e infecção (2002) Arq Bras Endocrinol Metab, 46 (3), pp. 221-229Govaert, T.M., Thijs, C.T., Masurel, N., Sprenger, M.J., Dinant, G.J., Knottnerus, J.A., The efficacy of influenza vaccination in elderly individuals - A randomized double-blind placebo-controlled trial (1994) JAMA, 272 (21), pp. 1661-166