北京市城市社区≥70岁体弱老年人流行性感冒疫苗接种率及影响因素

Influenza vaccination coverage and its influencing factors among frail individuals ≥70 years old in Beijing urban communities

目的了解北京市城市社区≥70岁体弱老年人流行性感冒（流感）疫苗接种率及其影响因素。方法采用多阶段分层抽样方法在北京市海淀区8个街道14个社区选取≥70岁、有一项以上工具性日常活动能力障碍的本地户籍老年人,调查过去一年自报的流感疫苗接种率,采用Logistic回归分析其影响因素。结果 558名调查对象的流感疫苗接种率为21.2%（95%CI：17.8%-24.6%）。中重度失能（OR=0.43,95%CI：0.21-0.86）、住所有外出障碍（OR=0.59,95%CI：0.35-0.98）、退休前在国有/集体企业（OR=0.38,95%CI：0.17-0.84）或事业单位工作（OR=0.34,95%CI：0.15-0.76）、独居（OR=0.38,95%CI：0.15-0.95）的老年人流感疫苗接种率显著低于有轻微失能、住所无外出障碍、退休前在党政机关/军队工作、与5个或以上家人同住的老年人。每月门诊就医≥1次（OR=2.61,95%CI：1.43-4.78）,或受过小学/非正规教育（OR=2.30,95%CI：1.06-4.97）的老年人流感疫苗接种率显著高于从未或很少到门诊就医,或不识字的老年人。结论北京市社区≥70岁体弱老年人流感疫苗接种率低,建议制定能够有效提高该老年群体免费流感疫苗接种的预防接种宣传及服务策略。

Objective To investigate influenza vaccination coverage and its influencing factors among frail people aged ≥70 years in urban communities of Beijing. Methods A multi-stage stratified sampling strategy was used to select local ≥70-year-olds from 14 communities of 8 sub-districts in Haidian district of Beijing who had at least one identifiable daily activity limitation. We estimated influenza vaccination coverage during the previous season using a survey; we analyzed factors influencing coverage using logistic regression. Results Among 558 subjects, influenza vaccination coverage was 21.2%（95% CI： 17.8%-24.6%）. Coverage was significantly lower among subjects with moderate/severe disability（OR=0.43, 95%CI： 0.21-0.86）, who had obstacles outside of home（OR=0.59, 95%CI： 0.35-0.98）, who previously worked in state/collective enterprises（OR=0.38, 95%CI： 0.17-0.84） or in public institutions（OR=0.34, 95%CI： 0.15-0.76）, and who lived alone（OR=0.38, 95%CI： 0.15-0.95） compared with subjects with slight disability, who had no obstacles outside of home, who previously worked in governmental/military sectors, and who lived with ≥5 family members. Coverage was significantly higher in subjects with at least one medical visit per month（OR=2.61, 95%CI： 1.43-4.78）, or who had primary/informal education（OR=2.30, 95%CI： 1.06-4.97） compared with subjects with no/few medical visits, or who were illiterate. Conclusions Influenza vaccination coverage was low among frail people aged ≥70 years in urban communities of Beijing. We suggest developing effective strategies for publicizing the availability of free influenza vaccination for this population.