Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

The influence of partial public reimbursement on vaccination uptake in the older population: a cross-sectional study

Authors: Sheena M Mc Hugh, John Browne, Ciaran O’Neill, Patricia M Kearney

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

Flu vaccination is recommended annually for high risk groups. However, in Ireland, free access to vaccination is not universal for those in high risk groups; the vaccine and consultation are only free for those with a medical card, a means tested scheme. Few private health insurance policies cover the cost of attendance for vaccination in general practice. The aim was to examine the influence of this reimbursement policy on vaccination coverage among older adults.

Methods

Cross-sectional wave 1 data from The Irish Longitudinal Study on Ageing (TILDA) were analysed (2009–2011). TILDA is a nationally representative prospective cohort study of adults aged ≥50, sampled using multistage stratified clustered sampling. Self-reported entitlement to healthcare was categorised as 1) medical card only 2) private health insurance only, 3) both and 4) neither. The outcome was responses to ‘have you ever had a flu shot’. Multivariate logistic regression was used, adjusting for age and need.

Results

68.6% of those defined as clinically high-risk received the flu vaccination in the past (95% CI = 67-71%). Those with a medical card were almost twice as likely to have been vaccinated, controlling for age and chronic illness (OR = 1.9, 95% CI = 1.5-2.5, p = <0.001).

Conclusions

Having a medical card increased the likelihood of being vaccinated, independent of age and need. The mismatch between vaccination guidelines and reimbursement policy is creating unequal access to recommended services among high risk groups.
Literature
1.
Nicoll A, Ciancio B, Tsolova S, Blank P, Yilmaz C. The scientific basis for offering seasonal influenza immunisation to risk groups in Europe. Euro surveillance. 2008;13(43).
2.
Osterholm MT, Kelley NS, Sommer A, Belongia EA. Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12:36–44.CrossRefPubMed
3.
Morens DM. Influenza-related mortality: considerations for practice and public health. JAMA. 2003;289:227–9.CrossRefPubMed
4.
Blank PR, Schwenkglenks M, Szucs TD. Vaccination coverage rates in eleven European countries during two consecutive influenza seasons. J Infect. 2009;58:446–58.CrossRefPubMed
5.
Sammon CJ, McGrogan A, Snowball J, de Vries CS. Factors associated with uptake of seasonal and pandemic influenza vaccine among clinical risk groups in the UK: an analysis using the general practice research database. Vaccine. 2012;30:2483–9.CrossRefPubMed
6.
Endrich MM, Blank PR, Szucs TD. Influenza vaccination uptake and socioeconomic determinants in 11 European countries. Vaccine. 2009;27:4018–24.CrossRefPubMed
7.
Jusot F, Or Z, Sirven N. Variations in preventive care utilisation in Europe. Eur J Ageing. 2012;9:15–25.CrossRef
8.
Barrett A, Savva G, Timonen V, Kenny RA. Fifty Plus in Ireland. In: Book Fifty Plus in Ireland 2011: First results from the Irish Longitudinal Study on Ageing (TILDA), Book Fifty Plus in Ireland. City: Trinity College Dublin; 2011.
9.
European Commission. Active ageing and solidarity between generations – A statistical portrait of the European Union 2012. In: Book Active ageing and solidarity between generations – A statistical portrait of the European Union 2012. City: European Union; 2011.
10.
Mereckiene J, Cotter S, D’Ancona F, Giambi C, Nicoll A, Levy-Bruhl D, et al. Differences in national influenza vaccination policies across the European Union, Norway and Iceland 2008–2009. Euro Surveillance. 2010;15(44).
11.
The Macroepidemiology of Influenza Vaccination (MIV) Study Group. The macroepidemiology of influenza vaccination in 56 countries, 1997–2003. Vaccine. 2005;23:5133–43.CrossRef
12.
Royal College of Physicians Ireland National Immunisation Advisory Committee. Immunisation Guidelines for Ireland 2008 edition. 2012.
13.
Kohlhammer Y, Schnoor M, Schwartz M, Raspe H, Schäfer T. Determinants of influenza and pneumococcal vaccination in elderly people: a systematic review. Public Health. 2007;121:742–51.CrossRefPubMed
14.
de Andres AL, Garrido PC, Hernández-Barrera V, del Pozo SV-F, de Miguel ÁG, Jiménez-García R. Influenza vaccination among the elderly Spanish population: trend from 1993 to 2003 and vaccination-related factors*. Eur J Public Health. 2007;17:272–7.CrossRefPubMed
15.
Chiatti C, Barbadoro P, Lamura G, Pennacchietti L, Di Stanislao F, D’Errico MM, et al. Influenza vaccine uptake among community-dwelling Italian elderly: results from a large cross-sectional study. BMC Public Health. 2011;11:207.CrossRefPubMedPubMedCentral
16.
Department of Health. Health in Ireland. Key Trends 2012. In: Book Health in Ireland. Key Trends 2012. City: Government of Ireland; 2012.
17.
National Consumer Agency. Doctors & Dentists Survey. In: Book Doctors & Dentists Survey. City: National Consumer Agency; 2010.
18.
19.
Kearney PM, Cronin H, O’Regan C, Kamiya Y, Savva GM, Whelan B, et al. Cohort profile: the Irish longitudinal study on ageing. Int J Epidemiol. 2011;40:884–7.CrossRef
20.
Whelan BJ, Savva GM. Design and methodology of the Irish longitudinal study on ageing. J Am Geriatr Soc. 2013;61:S265–8.CrossRefPubMed
21.
Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36(1):1–10.CrossRefPubMed
22.
Nolan A, Nolan B. Eligibility for free GP care, “need” and GP visiting in Ireland. Eur J Health Econ. 2008;9:157–63.CrossRefPubMed
23.
Behan B, Molony D, Beame C, Cullen W. Are Irish Adult General Practice Consultation Rates as Low as Official Records Suggest? A Cross Sectional Study at Six General Practices. 2013.
24.
Nagata JM, Hernandez-Ramos I, Kurup AS, Albrecht D, Vivas-Torrealba C, Franco-Paredes C. Social determinants of health and seasonal influenza vaccination in adults >/=65 years: a systematic review of qualitative and quantitative data. BMC Public Health. 2013;13:388.CrossRefPubMedPubMedCentral
25.
Evans MR, Watson PA. Why do older people not get immunised against influenza?: A community survey. Vaccine. 2003;21:2421–7.CrossRefPubMed
26.
Burns VE, Ring C, Carroll D. Factors influencing influenza vaccination uptake in an elderly, community-based sample. Vaccine. 2005;23:3604–8.CrossRefPubMed
27.
Blank P, Schwenkglenks M, Szucs TD. The impact of European vaccination policies on seasonal influenza vaccination coverage rates in the elderly. Hum Vaccin Immunother. 2012;8:328–35.CrossRefPubMed
28.
Ompad DC, Galea S, Vlahov D. Distribution of influenza vaccine to high-risk groups. Epidemiol Rev. 2006;28:54–70.CrossRefPubMed
29.
Jacobson Vann J, Szilagyi P. Patient reminder and recall systems to improve immunization rates. Cochrane Database Syst Rev. 2005;Issue 3:CD003941.
30.
Satterthwaite P. A randomised intervention study to examine the effect on immunisation coverage of making influenza vaccine available at no cost. N Z Med J. 1997;110:58–60.PubMed
31.
32.
Ryan J, Zoellner Y, Gradl B, Palache B, Medema J. Establishing the health and economic impact of influenza vaccination within the European Union 25 countries. Vaccine. 2006;24:6812–22.CrossRefPubMed
33.
Lu P, Singleton JA, Rangel MC, Wortley PM, Bridges C. Influenza vaccination trends among adults 65 years or older in the united states, 1989–2002. Arch Intern Med. 2005;165:1849–56.CrossRefPubMed
34.
Finn C, Harmon C. A dynamic model of demand for private health insurance in Ireland. Am Econ Rev. 2006;53:941–73.
35.
Madden D, Nolan A, Nolan B. GP reimbursement and visiting behaviour in Ireland. Health Econ. 2005;14:1047–60.CrossRefPubMed
36.
Zimmerman RK, Raymund M, Janosky JE, Nowalk MP, Fine MJ. Sensitivity and specificity of patient self-report of influenza and pneumococcal polysaccharide vaccinations among elderly outpatients in diverse patient care strata. Vaccine. 2003;21:1486–91.CrossRefPubMed
37.
Mac Donald R, Baken L, Nelson A, Nichol KL. Validation of self-report of influenza and pneumococcal vaccination status in elderly outpatients. Am J Prev Med. 1999;16:173–7.CrossRefPubMed
38.
Kamiya Y, Murphy C, Savva G, Timonen V. Profile of Community-Dwelling Older People with Disability and their Caregivers in Ireland. In: Book Profile of Community-Dwelling Older People with Disability and their Caregivers in Ireland. City: Trinity College Dublin; 2012.
Metadata
Title
The influence of partial public reimbursement on vaccination uptake in the older population: a cross-sectional study
Authors
Sheena M Mc Hugh
John Browne
Ciaran O’Neill
Patricia M Kearney
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1356-7

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue

Research article

Exclusive breast feeding in early infancy reduces the risk of inpatient admission for diarrhea and suspected pneumonia in rural Vietnam: a prospective cohort study

Research article

Body image and weight control in South Africans 15 years or older: SANHANES-1

Research article

Small-area spatio-temporal analyses of participation rates in the mammography screening program in the city of Dortmund (NW Germany)

Research article

Virtual field trips as physically active lessons for children: a pilot study

Research article

Prevalence of dyslipidemia and associated factors among the hypertensive population from rural Northeast China

Erratum

Erratum to: A novel antigen capture ELISA for the specific detection of IgG antibodies to elephant endotheliotropic herpes virus