Inequalities in influenza vaccine uptake among people aged over 74 years in Britain.
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.
Mangtani
Punam
P
London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. Punam.Mangtani@lshtm.ac.uk
Breeze
Elizabeth
E
Kovats
Sari
S
Ng
Edmond S W
ES
Roberts
Jennifer A
JA
Fletcher
Astrid
A
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*