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. 2023 Feb;43(2):87-97.
doi: 10.24095/hpcdp.43.2.04.

The trends and determinants of seasonal influenza vaccination after cardiovascular events in Canada: a repeated, pan-Canadian, cross-sectional study

[Article in English, French]
Hanna Cho  1 , Sherilyn J D Houle  1 , Wasem Alsabbagh  1
Affiliations

The trends and determinants of seasonal influenza vaccination after cardiovascular events in Canada: a repeated, pan-Canadian, cross-sectional study

[Article in English, French]
Hanna Cho et al. Health Promot Chronic Dis Prev Can. 2023 Feb.

Abstract
in English, French

Introduction: Annual influenza vaccination is recommended for individuals with a history of cardiovascular disease (CVD) events. We aimed to examine (1) the time trends for influenza vaccination among Canadians with a CVD event history between 2009 and 2018, and (2) the determinants of receiving the vaccination in this population over the same period.

Methods: We used data from the Canadian Community Health Survey (CCHS). The study sample included respondents from 2009 to 2018 who were 30 years of age or more with a CVD event (heart attack or stroke) and who indicated their flu vaccination status. Weighted analysis was used to determine the trend of vaccination rate. We used linear regression analysis to examine the trend and multivariate logistic regression analysis to examine determinants of influenza vaccination, including sociodemographic factors, clinical characteristics, health behaviour and health system variables.

Results: Over the study period, in our sample of 42 400, the influenza vaccination rate was overall stable around 58.9%. Several determinants for vaccination were identified, including older age (adjusted odds ratio [aOR] = 4.28; 95% confidence interval [95% CI]: 4.24-4.32], having a regular health care provider (aOR = 2.39; 95% CI: 2.37-2.41), and being a nonsmoker (aOR = 1.48; 95% CI: 1.47-1.49). Factors associated with decreased likelihood of vaccination included working full time (aOR = 0.72; 95% CI: 0.72-0.72).

Conclusion: Influenza vaccination is still at less than the recommended level in patients with CVD. Future research should consider the impact of interventions to improve vaccination uptake in this population.

Introduction: La vaccination annuelle contre la grippe est recommandée aux personnes ayant des antécédents de maladie cardiovasculaire. Nous avons étudié 1) l’évolution de la vaccination antigrippale entre 2009 et 2018 chez les Canadiens ayant été victimes d’une maladie cardiovasculaire et 2) les déterminants de la vaccination dans cette population au cours de la période.

Méthodologie: Nous avons utilisé des données de l’Enquête sur la santé dans les collectivités canadiennes (ESCC). L’échantillon à l’étude était constitué de répondants de 2009 à 2018, âgés de 30 ans et plus, ayant été victimes d’une maladie cardiovasculaire (infarctus du myocarde ou accident vasculaire cérébral) et ayant fourni leur statut vaccinal contre la grippe. Une analyse pondérée a été effectuée pour déterminer l’évolution du taux de vaccination. Nous avons utilisé une analyse de régression linéaire pour l’évolution et une analyse de régression logistique à plusieurs variables pour les déterminants de la vaccination antigrippale. Les variables choisies étaient des facteurs sociodémographiques, des caractéristiques cliniques, des comportements liés à la santé et les interactions avec le système de santé.

Résultats: Durant la période à l’étude, le taux de vaccination a été généralement stable dans notre échantillon de 42 000 sujets, se situant aux alentours de 58,9 %. Plusieurs déterminants de la vaccination ont été établis : un âge avancé (rapport de cotes ajusté [RCA] = 4,28; intervalle de confiance à 95 % [IC à 95 %] : 4,24 à 4,32], un accès régulier à un professionnel de la santé (RCA = 2,39; IC à 95 % : 2,37 à 2,41) et le fait de ne pas fumer (RCA = 1,48; IC à 95 % : 1,47 à 1,49). Le seul facteur associé à une diminution de la probabilité de vaccination était le travail à temps plein (RCA = 0,72; IC à 95 % : 0,72 à 0,72).

Conclusion: Le taux de vaccination antigrippale reste inférieur au niveau recommandé pour les patients ayant des antécédents de maladie cardiovasculaire. D’autres recherches sont à mener sur l’efficacité des interventions pour augmenter la vaccination dans cette population.

Keywords: cardiovascular diseases; determinants; secondary prevention; sinfluenza vaccines; trend; utilization.

Plain language summary

Vaccine uptake in the post-CVD Canadian population from 2009 to 2018 was found to be suboptimal and is a potential area for optimization of health outcomes in these patients. Factors associated with increased likelihood of vaccination include older age, having a regular health care provider and being a nonsmoker.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1. Selection process of study respondents
Figure 2
Figure 2. Weighted percentage of Canadians with a CVD event history vaccinated against influenza, from 2009 to 2018
Figure 3
Figure 3. Weighted percentage of Canadians with a CVD event history vaccinated against influenza, from 2009 to 2018, across various provinces
See this image and copyright information in PMC

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