title: Does sex influence immunization status for influenza and pneumonia in older veterans?
abstract: OBJECTIVE
  To compare the prevalence of influenza and pneumococcal immunization rates according to sex in a national sample of older veterans in the Department of Veterans Affairs (VA) healthcare system.
  
  
  METHODS
  Retrospective, cross-sectional.
  
  
  METHODS
  VA healthcare system.
  
  
  METHODS
  Current VA healthcare system users aged 65 and older eligible for immunization in fiscal years 2001 to 2003 (N=48,424 patient records).
  
  
  METHODS
  Generalized estimating equations were performed to analyze combined chart review and administrative data to determine effect of sex on receipt of influenza and pneumococcal immunizations.
  
  
  RESULTS
  Unadjusted immunization rates were higher for men than women for influenza (73% vs 69%) and pneumococcal (87% vs 83%) vaccine. Adjusting for demographics, clinical comorbidities, use, and region, women had significantly lower odds of influenza (odds ratio (OR)=0.85, 95% confidence interval (CI=0.79-0.92) and pneumococcal (OR=0.77, 95% CI=0.71-0.84) immunization.
  
  
  CONCLUSIONS
  Older female veterans have lower rates of immunization than older male veterans in VA settings. Although VA remains above community levels for immunization, older female veterans will benefit from targeted efforts to increase immunization prevalence.
authors.affiliation: Veterans Affairs Greater Los Angeles Health Services Research and Development Center of Excellence, Center for Study of Health Care Provider Behavior, Sepulveda, California, USA. bevanne.bean-mayberry@va.gov
authors.forename: Bevanne
authors.initials: B
authors.lastname: Bean-Mayberry
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Yano
authors.forename: Maria K
authors.initials: MK
authors.lastname: Mor
authors.forename: Nichole K
authors.initials: NK
authors.lastname: Bayliss
authors.forename: Xiangyan
authors.initials: X
authors.lastname: Xu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fine
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D014728:Veterans
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines