The University of Southampton
University of Southampton Institutional Repository

Factors influencing influenza, pneumococcal and shingles vaccine uptake and refusal in older adults: a population-based cross-sectional study in England

Factors influencing influenza, pneumococcal and shingles vaccine uptake and refusal in older adults: a population-based cross-sectional study in England
Factors influencing influenza, pneumococcal and shingles vaccine uptake and refusal in older adults: a population-based cross-sectional study in England

Objectives: uptake of influenza, pneumococcal and shingles vaccines in older adults vary across regions and socioeconomic backgrounds. In this study, we study the coverage and factors associated with vaccination uptake, as well as refusal in the unvaccinated population and their associations with ethnicity, deprivation, household size and health conditions. 

Design, setting and participants: this is a cross-sectional study of adults aged 65 years or older in England, using a large primary care database. Associations of vaccine uptake and refusal in the unvaccinated with ethnicity, deprivation, household size and health conditions were modelled using multivariable logistic regression. 

Outcome measure: influenza, pneumococcal and shingles vaccine uptake and refusal (in the unvaccinated). 

Results: this study included 2 054 463 patients from 1318 general practices. 1 711 465 (83.3%) received at least one influenza vaccine, 1 391 228 (67.7%) pneumococcal vaccine and 690 783 (53.4%) shingles vaccine. Compared with White ethnicity, influenza vaccine uptake was lower in Chinese (OR 0.49; 95% CI 0.45 to 0.53), 'Other ethnic' groups (0.63; 95% CI 0.60 to 0.65), black Caribbean (0.68; 95% CI 0.64 to 0.71) and black African (0.72; 95% CI 0.68 to 0.77). There was generally lower vaccination uptake among more deprived individuals, people living in larger household sizes (three or more persons) and those with fewer health conditions. Among those who were unvaccinated, higher odds of refusal were associated with the black Caribbean ethnic group and marginally with increased deprivation, but not associated with higher refusal in those living in large households or those with lesser health conditions. 

Conclusion: certain ethnic minority groups, deprived populations, large households and 'healthier' individuals were less likely to receive a vaccine, although higher refusal was only associated with ethnicity and deprivation but not larger households nor healthier individuals. Understanding these may inform tailored public health messaging to different communities for equitable implementation of vaccination programmes.

Epidemiology, EPIDEMIOLOGY, PRIMARY CARE, Public health
2044-6055
Tan, Pui San
66f64b43-84a2-4362-afdd-f68e410f6571
Patone, Martina
51bbd4cc-1c19-4a64-a0c2-1534b076fa79
Clift, Ashley Kieran
b36d3e2a-7236-4767-ae10-0ee97b3026f9
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Saatci, Defne
21cdc621-8420-4437-8f3e-1e41cf4ebf5b
Ranger, Tom A
d7ca11dc-975e-4e65-a5e9-cafa98076472
Garriga, Cesar
fa2cba58-6872-45dc-97b8-e4005bca1601
Zaccardi, Francesco
8d31a980-3db1-4477-9514-c18087cf886a
Shah, Baiju R.
a1e92ef6-9367-4aa5-b73f-807534eb2036
Coupland, Carol
6efd69d5-8f84-45ac-9777-d4b07feeb2e2
Griffin, Simon J.
1f8d5095-3c10-4973-a2c4-84ce6415d118
Khunti, Kamlesh
3e64e5f4-0cc9-4524-aa98-3c74c25101c3
Hippisley-Cox, Julia
7be524e3-9066-4179-b58f-cb2e16cd02ec
Tan, Pui San
66f64b43-84a2-4362-afdd-f68e410f6571
Patone, Martina
51bbd4cc-1c19-4a64-a0c2-1534b076fa79
Clift, Ashley Kieran
b36d3e2a-7236-4767-ae10-0ee97b3026f9
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Saatci, Defne
21cdc621-8420-4437-8f3e-1e41cf4ebf5b
Ranger, Tom A
d7ca11dc-975e-4e65-a5e9-cafa98076472
Garriga, Cesar
fa2cba58-6872-45dc-97b8-e4005bca1601
Zaccardi, Francesco
8d31a980-3db1-4477-9514-c18087cf886a
Shah, Baiju R.
a1e92ef6-9367-4aa5-b73f-807534eb2036
Coupland, Carol
6efd69d5-8f84-45ac-9777-d4b07feeb2e2
Griffin, Simon J.
1f8d5095-3c10-4973-a2c4-84ce6415d118
Khunti, Kamlesh
3e64e5f4-0cc9-4524-aa98-3c74c25101c3
Hippisley-Cox, Julia
7be524e3-9066-4179-b58f-cb2e16cd02ec

Tan, Pui San, Patone, Martina, Clift, Ashley Kieran, Dambha-Miller, Hajira, Saatci, Defne, Ranger, Tom A, Garriga, Cesar, Zaccardi, Francesco, Shah, Baiju R., Coupland, Carol, Griffin, Simon J., Khunti, Kamlesh and Hippisley-Cox, Julia (2023) Factors influencing influenza, pneumococcal and shingles vaccine uptake and refusal in older adults: a population-based cross-sectional study in England. BMJ Open, 13 (3), [e058705]. (doi:10.1136/bmjopen-2021-058705).

Record type: Article

Abstract

Objectives: uptake of influenza, pneumococcal and shingles vaccines in older adults vary across regions and socioeconomic backgrounds. In this study, we study the coverage and factors associated with vaccination uptake, as well as refusal in the unvaccinated population and their associations with ethnicity, deprivation, household size and health conditions. 

Design, setting and participants: this is a cross-sectional study of adults aged 65 years or older in England, using a large primary care database. Associations of vaccine uptake and refusal in the unvaccinated with ethnicity, deprivation, household size and health conditions were modelled using multivariable logistic regression. 

Outcome measure: influenza, pneumococcal and shingles vaccine uptake and refusal (in the unvaccinated). 

Results: this study included 2 054 463 patients from 1318 general practices. 1 711 465 (83.3%) received at least one influenza vaccine, 1 391 228 (67.7%) pneumococcal vaccine and 690 783 (53.4%) shingles vaccine. Compared with White ethnicity, influenza vaccine uptake was lower in Chinese (OR 0.49; 95% CI 0.45 to 0.53), 'Other ethnic' groups (0.63; 95% CI 0.60 to 0.65), black Caribbean (0.68; 95% CI 0.64 to 0.71) and black African (0.72; 95% CI 0.68 to 0.77). There was generally lower vaccination uptake among more deprived individuals, people living in larger household sizes (three or more persons) and those with fewer health conditions. Among those who were unvaccinated, higher odds of refusal were associated with the black Caribbean ethnic group and marginally with increased deprivation, but not associated with higher refusal in those living in large households or those with lesser health conditions. 

Conclusion: certain ethnic minority groups, deprived populations, large households and 'healthier' individuals were less likely to receive a vaccine, although higher refusal was only associated with ethnicity and deprivation but not larger households nor healthier individuals. Understanding these may inform tailored public health messaging to different communities for equitable implementation of vaccination programmes.

Text
e058705.full - Version of Record
Available under License Creative Commons Attribution.
Download (945kB)

More information

Accepted/In Press date: 18 July 2022
Published date: 16 March 2023
Additional Information: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.
Keywords: Epidemiology, EPIDEMIOLOGY, PRIMARY CARE, Public health

Identifiers

Local EPrints ID: 476594
URI: http://eprints.soton.ac.uk/id/eprint/476594
ISSN: 2044-6055
PURE UUID: 5043e8e5-10cb-45b8-a851-e744dd8c52e7
ORCID for Hajira Dambha-Miller: ORCID iD orcid.org/0000-0003-0175-443X

Catalogue record

Date deposited: 09 May 2023 16:58
Last modified: 06 Jun 2024 02:05

Export record

Altmetrics

Contributors

Author: Pui San Tan
Author: Martina Patone
Author: Ashley Kieran Clift
Author: Defne Saatci
Author: Tom A Ranger
Author: Cesar Garriga
Author: Francesco Zaccardi
Author: Baiju R. Shah
Author: Carol Coupland
Author: Simon J. Griffin
Author: Kamlesh Khunti
Author: Julia Hippisley-Cox

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×