Influenza-associated hospitalisation, vaccine uptake and socioeconomic deprivation in an English city region: an ecological study



Hungerford, Daniel ORCID: 0000-0002-9770-0163, Ibarz-Pavon, Ana, Cleary, Paul and French, Neil ORCID: 0000-0003-4814-8293
(2018) Influenza-associated hospitalisation, vaccine uptake and socioeconomic deprivation in an English city region: an ecological study. BMJ OPEN, 8 (12). e023275-.

This is the latest version of this item.

Access the full-text of this item by clicking on the Open Access link.
[img] Text
20180802_BMJ_open v1.0revision_unmarked.docx - Author Accepted Manuscript

Download (1MB)
[img] Text
FluMersey BMJOpen 2018.pdf - Published version

Download (2MB)

Abstract

<h4>Objectives</h4>Every year, influenza poses a significant burden on the National Health Service in England. Influenza vaccination is an effective measure to prevent severe disease, hence, maximising vaccine coverage in the most vulnerable is a priority. We aimed to identify the extent to which socioeconomic status is associated with influenza-associated illness (IAI) and influenza vaccine coverage.<h4>Design</h4>Retrospective observational study using hospital episode statistics.<h4>Setting</h4>Merseyside, North-West of England, including the city of Liverpool.<h4>Participants</h4>Residents of Merseyside hospitalised with IAI between April 2004 and March 2016, and Merseyside general practice registered patients eligible for influenza vaccination in 2014/2015 and 2015/2016 influenza seasons.<h4>Exposures</h4>Socioeconomic deprivation based on lower super output area English Indices of Deprivation scores.<h4>Primary and secondary outcome measures</h4>Incidence and risk of IAI hospitalisation, and vaccine uptake.<h4>Results</h4>There were 89 058 hospitalisations related to IAI among Merseyside residents (mean yearly rate=4.9 per 1000 population). Hospitalisations for IAI were more frequent in the most socioeconomically deprived areas compared with the least deprived in adults aged 15-39 years (incidence rate ratio (IRR) 2.08;95% CI 1.76 to 2.45; p<0.001), 60-64 years (IRR 2.65; 95% CI 2.35 to 2.99; p<0.001) and 65+ years (IRR 1.90; 95% CI 1.73 to 2.10; p<0.001), whereas rates in children were more homogeneous across deprivation strata. Vaccine uptake was lower than the nationally set targets in most neighbourhoods. The odds of vaccine uptake were 30% lower (OR 0.70; 95% CI 0.66 to 0.74; p<0.001) and 10% lower (OR 0.90; 95% CI 0.88 to 0.92; p<0.001) in the most socioeconomically deprived quintile compared with the least deprived, among children aged 24-59 months and 65+ years, respectively.<h4>Conclusions</h4>Higher rates of IAI hospitalisations and lower vaccine uptake in the most socioeconomically deprived populations suggest that health promotion policies and interventions that target these populations should be a priority.

Item Type: Article
Uncontrolled Keywords: Humans, Influenza Vaccines, Hospitalization, Retrospective Studies, Cross-Sectional Studies, Cost of Illness, Poverty Areas, Adolescent, Adult, Aged, Middle Aged, Child, Child, Preschool, Infant, Urban Population, State Medicine, England, Female, Male, Influenza, Human, Young Adult
Depositing User: Symplectic Admin
Date Deposited: 20 Dec 2018 10:59
Last Modified: 07 Feb 2024 19:23
DOI: 10.1136/bmjopen-2018-023275
Open Access URL: http://dx.doi.org/10.1136/bmjopen-2018-023275
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3030288

Available Versions of this Item