System factors to explain 2009 pandemic H1N1 state vaccination rates for children and high-risk adults in US emergency response to pandemic

Details

• Alternative Title:
  Vaccine
• Personal Author:
  Davila-Payan, Carlo ; Swann, Julie ; Wortley, Pascale M.
• Description:
  Introduction:
  
  During the 2009–2010 H1N1 pandemic, children and high-risk adults had priority for vaccination. Vaccine in short supply was allocated to states pro-rata by population, but vaccination rates as of January 2010 varied among states from 21.3% to 84.7% for children and 10.4% to 47.2% for high-risk adults. States had different campaign processes and decisions.
  
  Objective:
  
  To determine program and system factors associated with higher state pandemic vaccination coverage for children and high-risk adults during an emergency response with short supply of vaccine.
  
  Methods:
  
  Regression analysis of factors predicting state-specific H1N1 vaccination coverage in children and high-risk adults, including state campaign information, demographics, preventive or health-seeking behavior, preparedness funding, providers, state characteristics, and surveillance data.
  
  Results:
  
  Our modeling explained variation in state-specific vaccination coverage with an adjusted R- squared of 0.82 for children and 0.78 for high-risk adults. We found that coverage of children was positively associated with programs focusing on school clinics and with a larger proportion of doses administered in public sites; negatively with the proportion of children in the population, and the proportion not visiting a doctor because of cost. The coverage for high-risk adults was positively associated with shipments of vaccine to “general access” locations, including pharmacy and retail, with the percentage of women with a Pap smear within the past 3 years and with past seasonal influenza vaccination. It was negatively associated with the expansion of vaccination to the general public by December 4, 2009. For children and high-risk adults, coverage was positively associated with the maximum number of ship-to-sites and negatively associated with the proportion of medically underserved population.
  
  Conclusion:
  
  Findings suggest that distribution and system decisions such as vaccination venues and providers targeted can positively impact vaccination rates for children and high-risk adults. Additionally, existing health infrastructure, health-seeking behaviors, and access affected coverage.
  
  
• Subjects:
  Adolescent Adult Child Child, Preschool Humans Immunization Programs Infant Influenza, Human Influenza A Virus, H1N1 Subtype Influenza Vaccines Middle Aged Vaccination

  More +
• Keywords:
  Children And High-risk Adults Coverage Estimates Factors Pandemic State-specific
• Source:
  Vaccine. 32(2):246-251
• Pubmed ID:
  24286836
• Pubmed Central ID:
  PMC6132055
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  32
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:6467079952f206f8a31e78c0fefa7431a8d70437671f4d4f8a62561a99aafde6
• Download URL:
  https://stacks.cdc.gov/view/cdc/58865/cdc_58865_DS1.pdf
• File Type:
  [PDF - 238.64 KB ]