title: Inequalities in influenza vaccine uptake among people aged over 74 years in Britain.
abstract: BACKGROUND
  In the UK, payments to providers (General Practitioners) for vaccinating all people aged over 64 years old against influenza commenced in 2000. Little information exists on the relationship between uptake and need. We assessed factors influencing uptake and equity in uptake in over 74 year olds.
  
  
  METHODS
  We analysed cohort data from 5572 subjects in a community-based trial. Analyses took into account clustering and location of general practices in terms of Underprivileged Area (UPA) Score and area Standardised Mortality Ratio (SMR).
  
  
  RESULTS
  Vaccine uptake in practices in the most deprived tertile was 0.88 (95% CI 0.80-0.96) that of the least deprived and mid tertile, adjusted for confounding. Within each deprivation tertile, uptake in the mid and highest SMR tertile was 0.86 (95% CI 0.79, 0.94) and 0.87 (95% CI 0.81, 0.95) that of the lowest respectively. Uptake was 10% lower at the most in individuals with poorer quality housing. Higher uptake if married or with respiratory conditions and lower uptake if smoked had cognitive impairment or depression did not explain the socioeconomic differentials.
  
  
  CONCLUSIONS
  Lower uptake in practices in deprived areas supports targeting of resources. At the individual level, those who are more isolated require support to access influenza vaccination.
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Punam.Mangtani@lshtm.ac.uk
authors.forename: Punam
authors.initials: P
authors.lastname: Mangtani
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Breeze
authors.forename: Sari
authors.initials: S
authors.lastname: Kovats
authors.forename: Edmond S W
authors.initials: ES
authors.lastname: Ng
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Roberts
authors.forename: Astrid
authors.initials: A
authors.lastname: Fletcher
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D016012:Poisson Distribution; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D006113:United Kingdom; D014611:Vaccination / Q000706:statistics & numerical data*