Predisposing, enabling and need determinants of flu vaccination in the older Irish population

Abstract

Background: Flu vaccination is an effective strategy to reduce flurelated morbidity and mortality. In Ireland, as in other countries, it is recommended annually for particular groups including people aged > 65, or those with chronic conditions. The aim was to examine predisposing, enabling and need factors associated with flu vaccination among older Irish adults. Methods: Data were analysed from the 1st wave of The Irish Longitudinal Study on Ageing (TILDA), a population-based cohort study using stratified clustered sampling. A 62 % response rate was achieved among eligible households. The outcome was responses to 'have you ever had a flu shot'. Uptake was examined in recommended groups including those aged > 65, with lung disease, heart disease and/or diabetes, body mass index (BMI) of > 40 kg/m2, or in receipt of carer's allowance. Covariates were categorised into predisposing (age, sex, residence, marital status), enabling (education, employment, carer's allowance, medical card status, private health insurance) and need factors (self-rated health, disability, chronic disease status). Multivariate logistic regression was conducted using Stata 12. Results: 74 % of those aged > 65 (95 % CI = 73-76 %) and 58 % of those with heart disease and/or diabetes had been vaccinated in the past. Taking all recommended groups into account, uptake was 56 % (95 % CI = 54-57). Factors significantly associated with having ever had a vaccination were age (OR = 1.1), being separated/divorced (OR = 0.6), having 3rd level or higher education (OR = 1.24), having a medical card (OR = 2.2), good self-rated health (OR = 0.7), number of chronic diseases (> 3 OR = 2.8) and a diagnosis of chronic lung disease (OR = 2.4) (all p<0.05). A diagnosis of heart disease and/or diabetes and having a BMI > 40 kg/m2 were not significant predictors. Conclusions: In this study predisposing, enabling and need factors were determinants of vaccination uptake. Not having a medical card was associated with receipt of vaccination, suggesting a potential financial barrier to preventive services in Ireland.