Multimorbidity is associated with uptake of influenza vaccination

Details

• Alternative Title:
  Vaccine
• Personal Author:
  Harrison, Samantha M. ; Wei, Melissa Y. ; Lamerato, Lois E. ; Petrie, Joshua G. ; Martin, Emily Toth
• Description:
  Objective:
  
  Patients with chronic conditions have higher rates of severe influenza-related illness and mortality. However, influenza vaccination coverage in high-risk populations continues to be suboptimal. We describe the association between cumulative disease morbidity, measured by a previously validated multimorbidity index, and influenza vaccination among community-dwelling adults.
  
  Methods:
  
  We obtained interview and medical record data for participants ≥18 years who sought outpatient care for influenza-like illness between 2011 and 2016 as part of an outpatient-based study of influenza vaccine effectiveness. We defined cumulative disease morbidity by using medical diagnosis codes to calculate a multimorbidity-weighted index (MWI) for each participant. MWI and influenza vaccination status was evaluated by logistic regression. Akaike information criterion was calculated for all models.
  
  Results:
  
  Overall, 1458 (48%) of participants out of a total of 3033 received influenza vaccination. The median MWI was 0.9 (IQR 0.00–3.5) and was higher among vaccinated participants (median 1.6 versus 0.0; p < 0.001). We found a positive linear association between MWI and vaccination, and vaccination percentages were compared between categories of MWI. Compared to patients with no multimorbidity (MWI = 0), odds of vaccination were 17% higher in the second category (MWI 0.01–1.50; [OR: 1.17, 95% CI: 0.92–1.50]), 58% higher in the third category (MWI 1.51–3.00; [OR: 1.58, 95% CI: 1.26–1.99]), 130% higher in the fourth category (MWI 3.01–6.00; [OR: 2.30, 95% CI: 1.78–2.98]) and 214% higher in the fifth category (MWI 6.01–45.00; [OR: 3.14, 95% CI: 2.41–4.10]). Participants defined as high-risk had 86% greater odds of being vaccinated than non-high-risk individuals (OR: 1.86, 95% CI: 1.56–2.21). The AIC was lowest for MWI compared with high-risk conditions.
  
  Conclusions:
  
  Our results suggest a dose response relationship between level of multimorbidity and likelihood of influenza vaccination. Compared with high-risk condition designations, MWI provided improved precision and a better model fit for the measurement of chronic disease and influenza vaccination.
  
  
• Subjects:
  Adult Ambulatory Care Female Humans Independent Living Influenza, Human Influenza Vaccines Logistic Models Male Michigan Middle Aged Models, Immunological Multimorbidity Odds Ratio Vaccination

  More +
• Keywords:
  Chronic Disease Influenza
• Source:
  Vaccine. 36(25):3635-3640
• Pubmed ID:
  29748031
• Pubmed Central ID:
  PMC6258008
• Document Type:
  Journal Article
• Funding:
  U01 IP000474/IP/NCIRD CDC HHSUnited States/ ; U01 IP001034/IP/NCIRD CDC HHSUnited States/ ; U01IP001034/ACL HHSUnited States/
• Volume:
  36
• Issue:
  25
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:17106640e187eb28cfa83f85311be1efcff7ba111b2c53d187697b063f97c53f
• Download URL:
  https://stacks.cdc.gov/view/cdc/60866/cdc_60866_DS1.pdf
• File Type:
  [PDF - 127.38 KB ]