• Journal of Preventive Medicine and Public Health
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• v.44 no.4
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• pp.141-148
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• 2011

Annual epidemics of seasonal influenza occur during autumn and winter in temperate regions and have imposed substantial public health and economic burdens. At the global level, these epidemics cause about 3-5 million severe cases of illness and about 0.25-0.5 million deaths each year. Although annual vaccination is the most effective way to prevent the disease and its severe outcomes, influenza vaccination coverage rates have been at suboptimal levels in many countries. For instance, the coverage rates among the elderly in 20 developed nations in 2008 ranged from 21% to 78% (median 65%). In the U.S., influenza vaccination levels among elderly population appeared to reach a "plateau" of about 70% after the late 1990s, and levels among child populations have remained at less than 50%. In addition, disparities in the coverage rates across subpopulations within a country present another important public health issue. New approaches are needed for countries striving both to improve their overall coverage rates and to eliminate disparities. This review article aims to describe a broad conceptual framework of vaccination, and to illustrate four potential determinants of influenza vaccination based on empirical analyses of U.S. nationally representative populations. These determinants include the ongoing influenza epidemic level, mass media reporting on influenza-related topics, reimbursement rate for providers to administer influenza vaccination, and vaccine supply. It additionally proposes specific policy implications, derived from these empirical analyses, to improve the influenza vaccination coverage rate and associated disparities in the U.S., which could be generalizable to other countries.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.7-15
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• 2017

Purpose: Influenza vaccination coverage in adolescents is an important goal of informed vaccination policies and programs. This study aimed to estimate the influenza vaccination coverage rate and investigate the factors influencing influenza vaccination coverage in Korean adolescents. Methods: The study population consisted of 5,213 adolescents (aged 12 to 18 years) who participated in the Korea National Health and Nutrition Examination Survey from 2007 to 2014 (except for 2013). We analyzed influenza vaccination coverage in relation to the demographics, lifestyle, and medical characteristics of the participants. Results: The influenza vaccination coverage rate, during the study period, was 23.2% (range, 21.1% to 24.7%). Logistic regression analysis revealed that factors influencing influenza vaccination were elementary school age (odds ratio [OR], 1.706; 95% confidence interval [CI], 1.526 to 1.906), good self-rated health status (OR, 1.192; 95% CI, 1.057 to 1.344), a drinking status of non-drinker (OR, 1.769; 95% CI, 1.474 to 2.122), a smoking status of non-smoker (OR, 1.459; 95% CI, 1.144 to 1.860), and a past diagnosis of pneumonia (OR, 1.469; 95% CI, 1.076 to 2.006). Conclusions: Influenza vaccination coverage in Korean adolescents is relatively low. Special efforts are needed to increase vaccination coverage for adolescent groups with low vaccination rates including adolescent smokers and drinkers, middle and high school age adolescents, and adolescents with a poor self-rated health status.

• Journal of the Korea Convergence Society
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• v.8 no.11
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• pp.151-158
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• 2017

Influenza vaccination in adolescents is crucial to prevent the influenza expansion. The aim of this study was to investigate the difference of personal factors and parental factors affected influenza vaccination coverage. Study data on 12-18 years old adolescents and their parents were obtained from the 6th Korea National Health and Nutrition Examination Survey. Rao-Scott Chi-square test and multivariate logistic regression were used for the analysis. The percentage of influenza vaccination coverage in adolescents was low (26.2%). The personal factors influencing influenza vaccination were age, discomfort within two weeks, history of pneumonia, and wearing safety belt in adolescents, and the parental factors were age and influenza vaccination. In order to increase the influenza vaccination coverage for adolescents, media and healthcare professionals should provide education to adolescents and their parents about influenza vaccination.

• Korean Journal of Clinical Pharmacy
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• v.15 no.2
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• pp.89-93
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• 2005

This study was aimed to determine influenza vaccination coverage in 2004 in Koreans and investigate the factors associated with vaccination. Documentation of vaccination status and baseline data was conducted by a survey using questionnaire sheets. Baseline data and vaccination status were documented on 1465 people out of whom 60.1% received the influenza vaccine. Forty-seven percent of the responders were male; 4% were aged 1-12, 32% were aged 13-39, 32% were aged 40-64 and 32% were aged 65 or older. Twenty-three percent reported a chronic illness, increasing their risk for complications from influenza. Predictors of influenza vaccination were: older age (OR=11.7, 95% CI 5.1-26.8), the presence of chronic illness (OR=2.3, 95% CI 1.1-4.7), previous vaccination (OR=1.8, 95% CI 1.1-2.8), belief that influenza vaccine is effective in preventing influenza (OR=2.5, 95% CI 1.1-5.7) and education level (OR=1.7, 95% CI 1.0-2.7). Immunization rates were much higher in those who will take immunization again (OR=10.4, 95% CI 5.5-19.6). Factors affecting the decision on immunization were self-determination (43.6%), public relations (24.1%), recommendation from family members or friends (22.4%) and consulting with health professionals (5.8%). The main reason not to take influenza vaccine was the thought that they are healthy (50.1%). Overall, influenza vaccine coverage was high in those aged 65 or older. Immunization against influenza was influenced more by existing medical problem and belief about the vaccine's effectiveness, rather than sex or residence.

• Research in Community and Public Health Nursing
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• v.21 no.4
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• pp.502-511
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• 2010

Purpose: The purpose of this study was to investigate the influencing factors of influenza vaccination in the elderly participating in lifetime transitional health examination. Methods: This study was a secondary analysis of data collected from lifetime transitional health examination (for 66-year-old people) conducted by the National Health Insurance Corporation (NHIC) from January 1 to December 31, 2008. Questionnaires were received from NHIC to obtain information regarding gender, chronic diseases, health-related behaviors, and ADL. A total of 255,333 participants who responded all the questions in the questionnaire were included in the analysis. Collected data were analyzed by descriptive statistics, ${\chi}^2$ test, and multiple logistic regression. Results: The influenza vaccine coverage rate in 66-year-old people was 66.1%. The influenza vaccine coverage rate was higher in female elders and those with hypertension, diabetes, heart disease or past smoking, and lower in those with stroke, current smoking, drinking, no-exercise or ADL-dependency. Conclusion: Strategies for improving the influenza vaccination coverage rate in the elderly are needed. The strategies should give priority to the elderly with current smoking, drinking, and no-exercise, and home visiting programs are needed for the elderly with stroke and ADL-dependency.

• Clinical and Experimental Pediatrics
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• v.60 no.8
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• pp.254-260
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• 2017

Purpose: Seasonal influenza can be prevented by vaccination. Disease prevention in children aged <60 months is of particular importance because of the associated familial and societal burden. Considering that caretakers make the decision to vaccinate their children, the identification of drivers and barriers to vaccination is essential to increase influenza vaccination coverage. Methods: A total of 639 parents participated in the pre- and posteducational survey and 450 parents participated in the study via telephone interviews. The participating parents were asked to rank their agreement with each statement of the survey questionnaire on a scale from 1 (strongly disagree) to 5 (strongly agree), and the scores between pre- and postintervention were compared. Results: Before the educational intervention, 105 out of 639 participants reported not to agree to vaccinate their children against influenza. After the intervention, 46 out of the 105 parents changed their opinions about childhood vaccination. The physicians' recommendation received the highest agreement score and was the most important driver to vaccination, whereas the cost of vaccination was the strongest factor for not vaccinating children. In general, the participants significantly changed the agreement scores between pre- and postintervention. However, the unfavorable opinions about vaccination and the convenience of receiving the influenza vaccine did not change significantly. Conclusion: The results of this study indicate that a specific educational intervention involving caregivers is very effective in increasing the influenza vaccination coverage of children aged less than 60 months.

• The Journal of the Korea Contents Association
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• v.13 no.4
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• pp.300-311
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• 2013

The aim of this study was to investigate the factors influencing on influenza vaccination among socio-demographic characteristics and health behaviors. Data of 18,299 adults of age between 19 and 65 years who answered to the survey on National Health and Nutrition and influenza vaccination from 2007 to 2010 was used and analyzed. Overall influenza vaccination rate was 21.7%. Logistic regression analysis revealed that factors influencing on influenza vaccination were an increasing age, a residence in rural area, a high personal income, a low educational level, jobless women, experience of hospital visits, and morbidity of chronic illnesses. In conclusion, influenza vaccination rate in Korea is low and influenced by multiple socio-demographic factors and health behaviors. It is needed to seek a strategy to develop a vaccination program in consideration of factors associated with influenza vaccination.

• Research in Community and Public Health Nursing
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• v.22 no.1
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• pp.45-55
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• 2011

Purpose: This study aimed to investigate the rate of and factors associated with influenza vaccination in Korean elderly people. Methods: For this retrospective cross-sectional study, we used data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008. A total of 1,516 men and women aged 65 or above were included. The data were analyzed using descriptive statistics and logistic regression. Results: The overall rate of influenza vaccination in 2008 was 73.6%. The vaccination rate was lower in women (73.2%) than in men (74.2%; p<.001). It was lower in the elderly aged 80 and above, those living in metropolitan areas, smokers, those who did not receive regular health screening, those who had no history of hospitalization within one year, and those who had liver diseases than in the other groups. The rate of vaccination was higher in those with cancer. Logistic regression analysis revealed that for both men and women, the significant correlates associated with vaccination were demographic factors, chronic disease and health behavior. Conclusion: The influenza vaccination coverage needs to be improved. Efforts should be made to reach the elderly population with relatively low influenza vaccination rates and to increase awareness about the importance of vaccination at a personal and community level.

• The Journal of the Convergence on Culture Technology
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• v.8 no.2
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• pp.299-307
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• 2022

This study is to understand the status of influenza vaccination in patients with chronic obstructive pulmonary disease and to analyze factors affecting vaccination behavior. The aim of this study was to investigate the factors influencing influenza vaccination among Chronic Obstructive Pulmonary Disease (COPD) patients over 40 years, sociodemographic characteristics and health behaviors. Data of 2,370 adults of over 40 years who answered to the survey on National Health and Nutrition and influenza vaccination from 2014 to 2018 was used and analyzed. Overall influenza vaccination rate was 59.2%. Logistic regression analysis revealed that factors influencing on influenza vaccination were over 65 age, a low income, Never/past smoker, experience of health screening. It is needed to seek a strategy to develop a vaccination program in consideration of factors associated with influenza vaccination among COPD patient over 40 years.

• Pediatric Infection and Vaccine
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• v.19 no.1
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• pp.1-11
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• 2012

Purpose : Although influenza is regarded as one of the major causes of morbidity and mortality in children with cancer, the actual vaccine coverage remains poor. We conducted evaluation of immunogenicity and safety of influenza vaccine in children with cancer. Methods : In this study, 25 children with cancer who received influenza vaccine (SK influenza IX vaccine$^{(R)}$) at the Korea Cancer Center Hospital between October and December 2009 were analyzed. Blood samples of patients were collected twice (at the beginning of this study and at 30th day after vaccination) and their antibody titers were measured using the hemagglutination-inhibition (HI) assay. Immunogenicity of the influenza vaccine was assessed by seroprotection rate on days 0 and 30, seroconversion rate on day 30, and mean fold increase (MFI) of geometric mean titer (GMT) of HI between days 0 and 30. Results : Any of the subjects in our study did not experienced serious adverse events after influenza vaccination. Seroprotection rates were 68% for H1N1, 40% for H3N2, and 36% for B. Seroconversion rates were 12% for H1N1, 16% for H3N2, and 20% for B. MFIs were 0.9 for H1N1, 1.2 for H3N2, and 1.8 for B. Conclusion : In the study, we found a limited protective immune response to influenza vaccine, among subjects with cancer. However, some subjects showed seroconversion, and there were no severe adverse events among all subjects, supporting the recommendation of annual influenza vaccination in children with cancer.