Predictors of Influenza and Pneumococcal Vaccination Among Participants in the Women's Health Initiative. (March 2023)

• Record Type: Journal Article
• Authors: Fix, Jonathan; Donneyong, Macarius M.; Rapp, Stephen R.; Sattari, Maryam; Snively, Beverly M.; Wactawski-Wende, Jean; Gower, Emily W.
• Is Part Of: Public health reports. Volume 138:Number 2(2023)
• Page Start: 281
• Page End: 291
• Publication Date: 2023-03
• Subjects: vaccination -- predictors -- influenza -- pneumococcal pneumonia -- older adults; Public health -- United States -- Periodicals; 614.0973
• DOI: 10.1177/00333549221081817
• Languages: English
• ISSNs: 0033-3549

Abstract

Objective: Older adults typically experience higher rates of severe disease and mortality than the general population after contracting an infectious disease. Vaccination is critical for preventing disease and severe downstream outcomes; however, vaccination rates among older adults are suboptimal. We assessed predictors associated with pneumococcal and seasonal influenza vaccination among older women. Methods: We used data from the Women's Health Initiative, a nationwide cohort of women. We ascertained seasonal influenza and pneumococcal vaccination status through a questionnaire administered in 2013. We limited analyses to women aged ≥65 years at questionnaire administration. We used logistic regression to estimate associations between demographic, lifestyle, and health-related factors and vaccination and explored stratification by race. Results: Of participants who responded to each question, 84.3% (n = 60 578) reported being vaccinated for influenza and 85.5% (n = 59 015) for pneumonia. The odds of reporting influenza vaccination were significantly lower among non-Hispanic Black participants than among non-Hispanic White participants (odds ratio [OR] = 0.53; 95% CI, 0.49-0.58), women with no health insurance versus private health insurance (OR = 0.61; 95% CI, 0.54-0.68), and women living in rural versus urban settings (OR = 0.84; 95% CI, 0.73-0.96). Current smoking, lower education levels, and having comorbid conditions were associated with lower likelihood of being vaccinated for influenza (than not); past pneumonia diagnosis and being currently married were associated with a higher likelihood. We observed similar associations for pneumococcal vaccination coverage. Conclusions: These findings reinforce the need to enact policy and implement programs to improve access to, education and awareness about, and provider recommendations for these critical disease-prevention tools. Results from our study should guide strategies for SARS-CoV-2 vaccination.