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The European Journal of Public Health Advance Access published online on October 27, 2006
The European Journal of Public Health, doi:10.1093/eurpub/ckl242
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© The Author 2006. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Received June 27, 2006
Accepted September 14, 2006

Article

Influenza vaccination among the elderly Spanish population: trend from 1993 to 2003 and vaccination-related factors*

Ana Lopez de Andres 1, Pilar Carrasco Garrido 2, Valentín Hernández-Barrera 2, Silvia Vázquez-Fernández del Pozo 2, Ángel Gil de Miguel 2, and Rodrigo Jiménez-García 2 *

1 Preventive Medicine Unit, Alfonso X el Sabio University, Villanueva de la Cañada Campus, Madrid, Spain
2 Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Avda de Atenas s/n, Alcorcón 28922, Spain

* To whom correspondence should be addressed.
Rodrigo Jiménez-García, E-mail: rodrigo.jimenez{at}urjc.es


  Abstract

Background: Influenza is an important public health problem that particularly affects elderly subjects and influenza vaccination is a safe, effective and efficient method for prevention of influenza-related complications in elderly individuals with or without underlying chronic conditions. This study aims to analyze adjusted time trends in the coverage of influenza vaccination among elderly Spanish subjects and to identify which variables were associated with the probability of having been vaccinated in 2003. Methods: We undertook a cross-sectional study using data of individuals aged ≥65 years drawn from the 1993, 1995, 1997, 2001, and 2003 Spanish National Health Surveys. The answer to the question ‘Did you have a 'flu shot in the latest campaign‘ was used as the dependent variable, and socio-demographic and health-related characteristics were analyzed as independent variables. Coverage of vaccination for each year was adjusted by the direct method for both age and gender. Multivariate logistic regression was used to estimate the independent effect of variables on the receipt of influenza vaccine. Results: 15 989 records were analyzed. Adjusted influenza coverage increased from 50.1% in 1993 to 63.7% in 2003 (P < 0.001). The variables that were significantly associated with a higher likelihood of being vaccinated were older age, suffering a chronic disease, residence in towns with <10 000 inhabitants, ‘worse’ self-perceived health and non-smokers. Conclusions: Coverage among the Spanish elderly has increased significantly from 1993 to 2003. Still, there is room for improvement, particularly, among the subjects with ‘good’ self-perceived health, those with no concomitant medical conditions, and smokers.

Keywords: epidemiology; influenza; survey; vaccine.
*This study forms part of a research project funded by a FIS (Fondo de Investigaciones Sanitarias-Health Research Fund) grant PI041662 from the Carlos III Institute of Public Health. Madrid, Spain
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