title: Low vaccination coverage for seasonal influenza and pneumococcal disease among adults at-risk and health care workers in Ireland, 2013: The key role of GPs in recommending vaccination.
abstract: The World Health Organization (WHO), and European Agencies recommend influenza vaccination for individuals at-risk due to age (≥65 years), underlying diseases, pregnancy and for health care workers (HCWs) in Europe. Pneumococcal vaccine is recommended for those at-risk of pneumococcal disease. In Ireland, vaccination uptake among at-risk adults is not routinely available. In 2013, we conducted a national survey among Irish residents ≥18 years of age, to estimate size and vaccination coverage of at-risk groups, and identify predictive factors for influenza vaccination. We used computer assisted telephone interviews to collect self-reported information on health, vaccination status, attitudes towards vaccination. We calculated prevalence and prevalence ratios (PR) using binomial regression. Overall, 1770 individuals participated. For influenza, among those aged 18-64 years, 22% (325/1485) [95%CI: 17%-20%] were at-risk; 28% [95%CI: 23%-33%] were vaccinated. Among those aged ≥65 years, 60% [95%CI: 54%-66%] were vaccinated. Influenza vaccine uptake among HCWs was 28% [95%CI: 21%-35%]. For pneumococcal disease, among those aged 18-64 years, 18% [95%CI: 16%-20%] were at-risk; 16% [95%CI: 12%-21%] reported ever-vaccination; among those aged ≥65 years, 36% [95%CI: 30%-42%] reported ever-vaccination. Main reasons for not receiving influenza vaccine were perceptions of not being at-risk, or not thinking of it; and among HCWs thinking that vaccination was not necessary or they were not at-risk. At-risk individuals were more likely to be vaccinated if their doctor had recommended it (PR 3.2; [95%CI: 2.4%-4.4%]) or they had access to free medical care or free vaccination services (PR 2.0; [95%CI: 1.5%-2.8%]). Vaccination coverage for both influenza and pneumococcal vaccines in at-risk individuals aged 18-64 years was very low. Influenza vaccination coverage among individuals ≥65 years was moderate. Influenza vaccination status was associated with GP vaccination recommendation and free access to vaccination services. Doctors should identify and recommend vaccination to at-risk patients to improve uptake.
authors.affiliation: European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; HSE Health Protection Surveillance Centre, Dublin, Ireland.
authors.forename: Coralie
authors.initials: C
authors.lastname: Giese
authors.affiliation: HSE Health Protection Surveillance Centre, Dublin, Ireland.
authors.forename: Jolita
authors.initials: J
authors.lastname: Mereckiene
authors.affiliation: European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
authors.forename: Kostas
authors.initials: K
authors.lastname: Danis
authors.affiliation: HSE Health Protection Surveillance Centre, Dublin, Ireland.
authors.forename: Joan
authors.initials: J
authors.lastname: O'Donnell
authors.affiliation: HSE Health Protection Surveillance Centre, Dublin, Ireland.
authors.forename: Darina
authors.initials: D
authors.lastname: O'Flanagan
authors.affiliation: HSE Health Protection Surveillance Centre, Dublin, Ireland. Electronic address: suzanne.cotter@hse.ie.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Cotter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control; D007494:Ireland; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*; D035862:Vulnerable Populations; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines
keywords: At-risk; Elderly; Immunisation; Influenza; Pneumococcal; Vaccination