PDF(Pubmed)
Abstract：
BACKGROUND: The European-wide statistics show that the use of flu vaccination remains low and the differences between countries are significant, as are those between different population groups within each country. Considerable research has focused on explaining vaccination uptake in relation to socio-economic and demographic characteristics, health promotion and health behavior factors. Nevertheless, few studies have aimed to analyze between-country differences in the use of flu vaccination for the EU population. To address this gap, this study examines the socio-economic inequalities in the use of influenza vaccination for the population aged 15 years and over in all 27 EU Member States and two other non-EU countries (Iceland and Norway).
METHODS: Using data from the third wave of European Health Interview Survey (EHIS) 2019, we employed a multilevel logistic model with a random intercept for country, which allows controlling simultaneously the variations in individuals\' characteristics and macro-contextual factors which could influence the use of flu vaccination. In addition, the analysis considers the population stratified into four age groups, namely adolescents, young adults, adults and elderly, to better capture heterogeneities in flu vaccination uptake.
RESULTS: The main findings confirm the existence of socio-economic inequalities between individuals in different age groups, but also of significant variation between European countries, particularly for older people, in the use of influenza vaccination. In this respect, income and education are strong proxy of socio-economic status associated with flu vaccination uptake. Moreover, these disparities within each population group are also explained by area of residence and occupational status. Particularly for the elderly, the differences between individuals in vaccine utilization are also explained by country-level factors, such as the type of healthcare system adopted in each country, public funding, personal health expenditure burden, or the availability of generalist practitioners.
CONCLUSIONS: Overall, our findings reveal that vaccination against seasonal influenza remains a critical public health intervention and bring attention to the relevance of conceiving and implementing context-specific strategies to ensure equitable access to vaccines for all EU citizens.
METHODS: Using data from the third wave of European Health Interview Survey (EHIS) 2019, we employed a multilevel logistic model with a random intercept for country, which allows controlling simultaneously the variations in individuals\' characteristics and macro-contextual factors which could influence the use of flu vaccination. In addition, the analysis considers the population stratified into four age groups, namely adolescents, young adults, adults and elderly, to better capture heterogeneities in flu vaccination uptake.
RESULTS: The main findings confirm the existence of socio-economic inequalities between individuals in different age groups, but also of significant variation between European countries, particularly for older people, in the use of influenza vaccination. In this respect, income and education are strong proxy of socio-economic status associated with flu vaccination uptake. Moreover, these disparities within each population group are also explained by area of residence and occupational status. Particularly for the elderly, the differences between individuals in vaccine utilization are also explained by country-level factors, such as the type of healthcare system adopted in each country, public funding, personal health expenditure burden, or the availability of generalist practitioners.
CONCLUSIONS: Overall, our findings reveal that vaccination against seasonal influenza remains a critical public health intervention and bring attention to the relevance of conceiving and implementing context-specific strategies to ensure equitable access to vaccines for all EU citizens.
摘要：
背景：整个欧洲的统计数据表明，流感疫苗的使用仍然很低，国家之间的差异很大，每个国家的不同人口群体之间也是如此。大量研究集中在解释与社会经济和人口特征相关的疫苗接种吸收，健康促进和健康行为因素。然而，很少有研究旨在分析欧盟人口使用流感疫苗的国家之间的差异。为了解决这个差距，本研究调查了所有27个欧盟成员国和另外两个非欧盟国家(冰岛和挪威)15岁及以上人口在使用流感疫苗方面的社会经济不平等.
方法：使用来自2019年第三波欧洲健康访谈调查（EHIS）的数据，我们采用了具有随机截距的多水平逻辑模型，这允许同时控制可能影响流感疫苗接种使用的个体特征和宏观背景因素的变化。此外,分析认为人口分为四个年龄组，即青少年，年轻人,成年人和老年人,更好地捕获流感疫苗接种中的异质性。
结果：主要发现证实了不同年龄组个体之间存在社会经济不平等，但欧洲国家之间也有很大差异，特别是对于老年人来说，在使用流感疫苗接种。在这方面,收入和教育是与流感疫苗接种相关的社会经济地位的有力代表。此外，每个人口群体中的这些差异也可以通过居住地和职业状况来解释。尤其是老年人,个人在疫苗利用方面的差异也是由国家层面的因素解释的，例如每个国家采用的医疗保健系统类型，公共资金,个人卫生支出负担，或通才实践者的可用性。
结论：总体而言，我们的研究结果表明,针对季节性流感的疫苗接种仍然是一项重要的公共卫生干预措施,并提请注意构思和实施针对具体情况的策略的相关性,以确保所有欧盟公民公平获得疫苗.
方法：使用来自2019年第三波欧洲健康访谈调查（EHIS）的数据，我们采用了具有随机截距的多水平逻辑模型，这允许同时控制可能影响流感疫苗接种使用的个体特征和宏观背景因素的变化。此外,分析认为人口分为四个年龄组，即青少年，年轻人,成年人和老年人,更好地捕获流感疫苗接种中的异质性。
结果：主要发现证实了不同年龄组个体之间存在社会经济不平等，但欧洲国家之间也有很大差异，特别是对于老年人来说，在使用流感疫苗接种。在这方面,收入和教育是与流感疫苗接种相关的社会经济地位的有力代表。此外，每个人口群体中的这些差异也可以通过居住地和职业状况来解释。尤其是老年人,个人在疫苗利用方面的差异也是由国家层面的因素解释的，例如每个国家采用的医疗保健系统类型，公共资金,个人卫生支出负担，或通才实践者的可用性。
结论：总体而言，我们的研究结果表明,针对季节性流感的疫苗接种仍然是一项重要的公共卫生干预措施,并提请注意构思和实施针对具体情况的策略的相关性,以确保所有欧盟公民公平获得疫苗.
