title: Status of influenza and pneumococcal vaccination among older American Indians and Alaska Natives.
abstract: OBJECTIVE
  We sought to estimate the influenza and pneumococcal vaccination coverage among older American Indian and Alaska Native (AIAN) adults nationally and the impact of sociodemographic factors, variations by geographic region, and access to services on vaccination coverage.
  
  
  METHODS
  We obtained our sample of 1981 AIAN and 179845 White respondents 65 years and older from Behavioral Risk Factor Surveillance System data from 2003 to 2005. Logistic regression provided predictive marginal vaccination coverage for each covariate and adjusted for demographic characteristics and access to care.
  
  
  RESULTS
  Unadjusted influenza coverage estimates were similar between AIAN and White respondents (68.1% vs 69.5%), but pneumococcal vaccination was lower among AIAN respondents (58.1% vs 67.2%; P<.01). After multivariable adjustment for sociodemographic characteristics, self-reported coverage for both vaccines was statistically similar between AIAN and White adults.
  
  
  CONCLUSIONS
  Although there was no disparity in influenza coverage, pneumococcal coverage was lower among AIAN than among White respondents, probably because of sociodemographic risk factors. Regional variation indicates a need to monitor coverage and target interventions to reduce disparities within geographically and culturally diverse subpopulations of AIAN persons.
authors.affiliation: National Center for Immunization and Respiratory Diseases, 1600 Clifton Road NE, Mailstop E-52, Atlanta, GA 30333, USA. mlindley@cdc.gov
authors.forename: Megan C
authors.initials: MC
authors.lastname: Lindley
authors.forename: Amy V
authors.initials: AV
authors.lastname: Groom
authors.forename: Pascale M
authors.initials: PM
authors.lastname: Wortley
authors.forename: Gary L
authors.initials: GL
authors.lastname: Euler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000413:Alaska; D005260:Female; D006801:Humans; D007198:Indians, North American; D007252:Influenza Vaccines / Q000008:administration & dosage*; D016015:Logistic Models; D008297:Male; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D012307:Risk Factors; D018571:Sentinel Surveillance; D012923:Social Class; D014481:United States; D044465:White People
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines