Disparities in influenza vaccine coverage in the United States, 2008.
OBJECTIVE
To determine the distribution of influenza vaccine coverage in the United States in 2008.


METHODS
Cross-sectional analysis.


METHODS
The 2008 Behavioral Risk Factor Surveillance Survey, which employs random-digit dialing to interview noninstitutionalized adults in the United States and territories.


METHODS
Two hundred forty-nine thousand seven hundred twenty-three persons aged 50 and older.


METHODS
Participants were asked whether they had had an influenza vaccination during the previous 12 months.


RESULTS
In 2008, 42.0% of adults aged 50 to 64 and 69.5% of adults aged 65 and older reported receiving an influenza vaccination in the past 12 months. Vaccine coverage generally increased with advancing age (P<.001), higher levels of education (P<.001) and total household income (P<.001), and greater morbidity (P<.001). In participants aged 50 to 64, vaccine prevalence was lower in men (39.9%) than in women (44.1%; P<.001), although no significant differences were observed in older adults. Within each 5-year interval of age, non-Hispanic blacks and Hispanics had significantly lower vaccine prevalence than non-Hispanic whites (P<.001 for all comparisons). For participants aged 65 and older, non-Hispanic blacks and Hispanics were 56% (adjusted prevalence ratio (PR)=1.56, 95% confidence interval (CI)=1.48, 1.64) and 44% (adjusted PR=1.44, 95% CI=1.35, 1.54) more likely, respectively, to be unvaccinated than non-Hispanic whites, adjusting for age and sex. Racial and ethnic disparities in vaccine coverage narrowed with increasing number of diseases, although these disparities remained significant in older adults with two or more diseases (P<.05).


CONCLUSIONS
There were large disparities in influenza vaccine coverage in 2008, particularly across race and ethnicity and socioeconomic position. Accordingly, more targeted interventions are needed to improve vaccine delivery to disadvantaged segments of the U.S. population.
Linn
Shauna T
ST
Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institute of Health, Bethesda, MD, USA.
Guralnik
Jack M
JM
Patel
Kushang V
KV
D000367:Age Factors; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000208:ethnology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data*
D007252:Influenza Vaccines