Factors associated with performance of influenza immunization among the elderly.
BACKGROUND
Influenza is a major cause of morbidity and mortality in the elderly. While immunization has been shown to reduce these complications, many of the elderly are not immunized.


OBJECTIVE
To identify correlates for under-utilization of influenza immunization among the elderly.


METHODS
A telephone survey was conducted among a random sample of patients aged 65 and over registered at a Jerusalem primary care community clinic. The 626 questionnaires were analyzed for associations of immunization receipt for the latest influenza season. Multivariate logistic regression was performed to identify independent correlates. Respondents were also asked what factors had influenced their decision about immunization.


RESULTS
The most frequently reported influence on getting immunized was a physician's recommendation. Immunization was independently associated with the identity of the primary care physician (P < 0.0001) and with having visited the physician during the previous 3 months (P = 0.0006). Immunization was more likely among persons who believed that it provides complete protection from influenza (P < 0.0001) and less likely among those who believed immunization can cause influenza (P < 0.0001). Higher immunization rates were also associated with being married (P = 0.0031).


CONCLUSIONS
Through their influence on patient knowledge and the effect of their recommendation, primary care physicians play a pivotal role in determining immunization rates. Physicians should routinely discuss the effects of immunization and recommend it to the elderly.
Abramson
Z H
ZH
Beit Hakerem Community Health Clinic of Kupat Holim Clalit, Jerusalem, Israel. zviabr@md2.huji.ac.il
Cohen-Naor
V
V
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D016009:Chi-Square Distribution; D005260:Female; D006266:Health Education / Q000458:organization & administration; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D007557:Israel; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011314:Preventive Health Services / Q000592:standards / Q000639:trends; D011336:Probability; D012307:Risk Factors; D012494:Sampling Studies; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*
D007252:Influenza Vaccines