Characterization of seasonal influenza vaccination and assessment of individual factors associated with seasonal influenza vaccine uptake in Manitoba, Canada: a population-wide record-linkage study

Introduction: Seasonal influenza vaccine (SIV) uptake (receipt of vaccine) in Manitoba, Canada is consistently low notwithstanding vaccine availability and free-of-charge vaccination. Despite, there is a lack of published evidence on the determinants of uptake of the vaccine. We sought to assess the...

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Main Authors: Dr George Okoli, Dr Christiaan Righolt, Mr Geng Zhang, Dr Silvia Alessi-Severini, Dr Paul Van Caeseele, Dr I fan Kuo, Dr Salaheddin Mahmud
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:International Journal of Infectious Diseases
Online Access:http://www.sciencedirect.com/science/article/pii/S1201971224005939
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Summary:Introduction: Seasonal influenza vaccine (SIV) uptake (receipt of vaccine) in Manitoba, Canada is consistently low notwithstanding vaccine availability and free-of-charge vaccination. Despite, there is a lack of published evidence on the determinants of uptake of the vaccine. We sought to assess the association between SIV uptake and certain population and primary care physician (PCP) characteristics in Manitoba. Methods: We conducted a longitudinal study utilizing data from several linked anonymized Manitoba Health and Seniors Care (MH) administrative health databases. The study period was from September 01, 2000, to March 31, 2020. This study received the necessary approvals from the University of Manitoba Health Research Ethics Board (HS21763 (H2018:170)) and the Health Information Privacy Committee of MH (HIPC No. 2018/2019-04). We summarized SIV uptake from 2000/01–2019/20 influenza seasons across subpopulations defined by socioeconomic, health-related and PCP characteristics. Utilizing multivariable generalized estimating equation logistic regression models, we assessed the association between SIV uptake and the socioeconomic, health-related and PCP characteristics, stratified by age group (<5-, 5-17-, 18-44-, 45-64-, ≥65-year-olds) and sex. Results are adjusted odds ratios with associated 95% confidence intervals. Results: SIV uptake percentage increased over time with 4.4%, 13.1%, 17.5% and 21.7% of <5-year-olds, 2%, 4.9%, 9.7% and 13.1% of 5–17-year-olds, 5.4%, 8.8%, 10.7% and 13.5% of 18–44-year-olds, 16.8%, 21.3%, 23.6% and 24.6% of 45–64-year-olds receiving the SIV in 2000-2004, 2005-2009, 2010-2014 and 2015-2019, respectively. There was a decline among ≥65-year-olds from 58.5% to 53.5%. We observed a similar pattern across subpopulations. There was significantly increased odds of SIV uptake among females within the age groups ≥18 years, in higher income quintiles, mostly with increased contact with a PCP/hospitalization within age groups ≥18 years, among those who had older or female PCPs (the opposite observation among ≥65-year-olds) and whose PCP administered at least one SIV in prior influenza season. These observations were largely consistent irrespective of sex. Discussion: SIV uptake in Manitoba appears to increase with age, and many socioeconomic, health-related and PCP characteristics appear to be associated with it. While our findings may not be generalizable to the whole of Canada, they provide novel insights for Manitoba and may form the basis for further assessments of the individual and PCP characteristics that may determine SIV uptake especially within important subpopulations. Further, the observed decline in SIV uptake among ≥65-year-olds require public health attention and further investigations. Conclusion: Our findings may help inform targeted vaccination programs and public health education to optimize seasonal influenza vaccination in Manitoba and similar Canadian jurisdictions.
ISSN:1201-9712