title: Comparison of self-report influenza vaccination coverage with data from a population based computerized vaccination registry and factors associated with discordance.
abstract: OBJECTIVE
  We aim to compare influenza vaccination coverages obtained using two different methods; a population based computerized vaccination registry and self-reported influenza vaccination status as captured by a population survey.
  
  
  METHODS
  The study was conducted in the Autonomous Community of Madrid (ACM), Spain, and refers to the 2011/12 influenza vaccination campaign. Information on influenza vaccination status according to a computerized registry was extracted from the SISPAL database and crossed with the electronic clinical records in primary care (ECRPC). Self-reported vaccine uptake was obtained from subjects living in the ACM included in the 2011-12 Spanish National Health Survey (SNHS). Independent study variables included: age, sex, immigrant status and the presence of high risk chronic conditions. Vaccination coverages were calculated according to study variables. Crude and adjusted prevalence ratios were computed to assess concordance.
  
  
  RESULTS
  The study population included 5,245,238 adults living in the ACM in year 2011 with an individual ECRPC and 1449 adult living the ACM and interviewed in the SNHS from October 2011 to June 2012. The weighted vaccination coverage for the study population according to self-reported data was 19.77% and 15.04% from computerized registries resulting in a crude prevalence ratio (cPR) of 1.31 (95% CI 1.20-1.44) so self-reported data significantly overestimated 31% the registry coverage. Self-reported coverages are always higher than registry based coverages when the study population is stratified by the study variables. Self-reported overestimation was higher among men than women, younger age groups, immigrants and those without chronic conditions. Both methods provide the most concordant estimations for the target population of the influenza vaccine.
  
  
  CONCLUSIONS
  Self-report influenza vaccination uptake overestimates vaccination registries coverages. The validity of self-report seems to be negatively affected by socio-demographic variables and the absence of chronic conditions. Possible strategies must be considered and implemented to improve both coverage estimation methods.
authors: Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: rodrigo.jimenez@urjc.es.
authors: Rodrigo
authors: R
authors: Jiménez-García
authors: Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: valentin.hernandez@urjc.es.
authors: Valentín
authors: V
authors: Hernandez-Barrera
authors: Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: rodriguezrieiro@gmail.com.
authors: Cristina
authors: C
authors: Rodríguez-Rieiro
authors: Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: pilar.carrasco@urjc.es.
authors: Pilar
authors: P
authors: Carrasco Garrido
authors: Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: ana.lopez@urjc.es.
authors: Ana
authors: A
authors: López de Andres
authors: Preventive Medicine and Public Health Department, Rey Juan Carlos University, Avda de Atenas s/n, Alcorcón, 28922 Madrid, Spain. Electronic address: Isabel.jimenez@urjc.es.
authors: Isabel
authors: I
authors: Jimenez-Trujillo
authors: Department of Epidemiology, Directorate of Health Promotion and Prevention, Ministry of Health, Community of Madrid, C/ Julián Camarillo, 4B, 28037 Madrid, Spain. Electronic address: maria.estebanv@salud.madrid.org.
authors: María D
authors: MD
authors: Esteban-Vasallo
authors: Department of Epidemiology, Directorate of Health Promotion and Prevention, Ministry of Health, Community of Madrid, C/ Julián Camarillo, 4B, 28037 Madrid, Spain. Electronic address: felicitas.dominguez@salud.madrid.org.
authors: Maria Felicitas
authors: MF
authors: Domínguez-Berjón
authors: Department of Respiratory Medicine, Gregorio Marañon Hospital, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain. Electronic address: javier.miguel@salud.madrid.org.
authors: Javier
authors: J
authors: de Miguel-Diez
authors: Department of Epidemiology, Directorate of Health Promotion and Prevention, Ministry of Health, Community of Madrid, C/ Julián Camarillo, 4B, 28037 Madrid, Spain. Electronic address: jenaro.astray@salud.madrid.org.
authors: Jenaro
authors: J
authors: Astray-Mochales
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data; D057566:Self Report; D013030:Spain; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: Coverage; Influenza; Registries; Self-report; Vaccines