新型冠状病毒肺炎疫情期间上海某养老社区居民流感疫苗接种现况分析

Status of influenza vaccination in an elderty community in Shanghai during the COVID-19 pandemic

目的了解新型冠状病毒肺炎疫情期间上海某养老社区老年人流感疫苗接种情况,探讨阻碍接种的原因,以及提高疫苗接种率的方法。方法于2020年11月9—16日向上海市泰康养老社区居民进行问卷调查,收集其人口统计学特征,对流感和疫苗的认识、未接种疫苗的原因和改进措施。采用多元logistic回归模型,分析老年人流感疫苗接种的影响因素。结果520例受访者流感疫苗接种率为30.58%(159/520),与未接种组比较,接种组的年龄更大(t=16.04,P=0.003),受教育程度更高(χ^(2)=8.16,P=0.043)。在合并基础疾病的老年人中,流感疫苗接种与患有心脏病、慢性阻塞性肺疾病、肿瘤、哮喘、帕金森病等均有关(OR=1.45、2.16、1.23、1.64、5.83,P<0.05)。未接种疫苗的主要原因是担心疫苗不良反应(46.26%,167/361),缺乏全科医生的推荐(24.10%,87/361)以及认为健康人群不需要接种疫苗(19.39%,70/361)。多因素logistic回归分析发现,医务人员推荐(OR=9.18,95%CI:5.47~16.32)、上门疫苗接种(OR=11.79,95%CI:6.87~21.66)、居住社区有疫苗接种(OR=8.08,95%CI:8.08~15.45)、国家要求全员接种(OR=4.61,95%CI:4.61~10.11)、疫苗完全免费(OR=7.48,95%CI:4.08~15.12)是老年人流感疫苗接种的影响因素。结论在新型冠状病毒肺炎疫情期间,上海老年人的流感疫苗接种覆盖率仍较低。可以从行政、科普和人力资源3个方面采取措施,提高疫苗接种覆盖率。

Objective To investigate the status and the influencing factors of influenza vaccination during the COVID-19 pandemic among community-dwelling elderly in Shanghai.Methods A questionnaire survey on influenza vaccination among community-dwelling elderly was conducted in Shanghai Taikang elderly community in November 2020.The information on demographic characteristics,reasons for refusal of vaccination,and measures for increasing vaccination rates were collected.Multiple logistic regression was used to analyze the correlation between influenza vaccination and sociodemographic and health-related characteristics.Results Among 520 respondents,the vaccination rate was 30.58%(159/520).Compared with unvaccinated group,elderly in vaccinated group was older(t=16.04,P=0.003)and more educated(χ^(2)=8.16,P=0.043).The elderly with comorbid heart disease,chronic obstructive pulmonary disease,tumor,asthma,Parkinson′s disease were likely to have vaccination(OR=1.45,2.16,1.23,1.64,5.83;all P<0.05).The reasons for the elderly not to be vaccinated were concerns of side effects(46.26%,167/361),lack of doctors′recommendations(24.10%,87/361),and unnecessary for people with good health conditions(19.39%,70/361).The independent factors of influenza vaccine awareness rate were healthcare providers′recommendations(OR=9.18,95%CI:5.47-16.32),vaccination at home(OR=11.79,95%CI:6.87-21.66),vaccination available in community(OR=8.08,95%CI:8.08-15.45),the mandatory requirement(OR=4.61,95%CI:4.61-10.11),free of charge(OR=7.48,95%CI:4.08-15.12).Conclusion Influenza vaccination coverage among the elderly in Shanghai is still low even during the COVID-19 pandemic.Policy interventions,awareness education and strengthening the primary healthcare resources may contribute to achieving a high influenza vaccine coverage rate in the community-dwelling elderly。