title: Factors associated to vaccination against influenza among elderly in a large Brazilian metropolis.
abstract: BACKGROUND
  This study aimed to estimate coverage and identify factors associated to vaccination against influenza in the elderly population.
  
  
  METHODS
  The study design was cross-sectional and population based. Data was collected in 2010 by the Health, Well-Being and Aging Study. Sample consisted of 1,341 community-dwelling elderly, in São Paulo, Brazil. Association between vaccination and covariates was evaluated by means of prevalence ratios estimated by Poisson regression models.
  
  
  RESULTS
  Self-reported vaccination coverage was 74.2% (95% confidence interval: 71.3-76.9). Remaining physically active and having had recent interaction with health services, mainly with public units of healthcare, were the main incentives to increase vaccination coverage among the elderly; whereas lower age, living alone and absent interaction with health services were the main constraints to influenza vaccination at the community level. These covariates had already been reported to influence influenza vaccination of elders in previous years.
  
  
  CONCLUSIONS
  Previous knowledge already available on the main constraints to influenza vaccination has not allowed to remove them. Influenza campaigns should be strengthened to increase vaccination coverage, especially in the group more reticent to vaccination. Instructing healthcare providers to recommend vaccine uptake is an important piece of this puzzle.
authors: Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
authors: Ana Paula Sayuri
authors: AP
authors: Sato
authors: Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
authors: José Leopoldo Ferreira
authors: JL
authors: Antunes
authors: Center for Epidemiological Surveillance "Professor Alexandre Vranjac" of the São Paulo State, São Paulo, Brazil.
authors: Roudom Ferreira
authors: RF
authors: Moura
authors: Center for Studies in Public Health and Aging, Rene Rachou Research Institute, Oswaldo Cruz Foundation, Belo Horizonte, Brazil.
authors: Fabíola Bof
authors: FB
authors: de Andrade
authors: Department of Medical-Surgical Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil.
authors: Yeda Aparecida Oliveira
authors: YA
authors: Duarte
authors: Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
authors: Maria Lúcia
authors: ML
authors: Lebrão
mesh_terms: D000368:Aged; D001938:Brazil; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D015995:Prevalence; D012923:Social Class; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines