Differences in Influenza Vaccination Coverage between Adult Immigrants and Italian Citizens at Risk for Influenza-Related Complications: A Cross-Sectional StudyReportar como inadecuado




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Background

Due to their increased vulnerability, immigrants are considered a priority group for communicable disease prevention and control in Europe. This study aims to compare influenza vaccination coverage IVC between regular immigrants and Italian citizens at risk for its complications and evaluate factors affecting differences.

Methods

Based on data collected by the National Institute of Statistics during a population-based cross-sectional survey conducted in Italy in 2012–2013, we analysed information on 42,048 adult residents ≥ 18 years at risk for influenza-related complications and with free access to vaccination elderly residents ≥ 65 years and residents with specific chronic diseases. We compared IVC between 885 regular immigrants and 41,163 Italian citizens using log-binomial models and stratifying immigrants by area of origin and length of stay in Italy recent: < 10 years; long-term: ≥ 10 years.

Results

IVC among all immigrants was 16.9% compared to 40.2% among Italian citizens vaccination coverage ratio VCR = 0.42, 95% confidence interval CI: 0.36–0.49. Adjusting for sex, age and area of residence, this difference was greatly reduced but remained statistically significant VCR = 0.71, 95 CI: 0.61–0.81. Further adjustment for socio-economic factors education, occupation, family composition and economic status and a composite indicator of health-services utilization did not affect the difference VCR = 0.78, 95% CI: 0.68–0.90. However, after adjustments, only long-term immigrants from Africa VCR = 0.49, 95% CI: 0.28–0.85 and recent immigrants VCR = 0.58, 95% CI: 0.43–0.78 showed a significantly different IVC compared to Italian citizens.

Conclusions

Differences in demographic characteristics, socio-economic conditions and health-services utilization explained the reduced IVC in most long-term immigrants compared to Italian citizens. By contrast, these differences did not explain the reduced IVC in long-term immigrants from Africa and recent immigrants. This suggests that IVC in these sub-groups is affected by other informal barriers e.g., cultural and linguistic that need to be investigated to promote effective immunization access strategies.



Autor: Massimo Fabiani , Flavia Riccardo, Anteo Di Napoli, Lidia Gargiulo, Silvia Declich, Alessio Petrelli

Fuente: http://plos.srce.hr/



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