Academic journal article Canadian Journal of Public Health

Consultation with Health Care Professionals and Influenza Immunization among Women in Contact with Young Children

Academic journal article Canadian Journal of Public Health

Consultation with Health Care Professionals and Influenza Immunization among Women in Contact with Young Children

Article excerpt

ABSTRACT

Objective: Primary health providers serve an important role in providing and promoting annual influenza immunization to high-risk groups and their close contacts. The purpose of this analysis was to determine whether consultation with a medical professional increases the likelihood of receiving a flu shot among women who have given birth in the past five years and to determine whether this association differs by type of medical professional.

Methods: Data were obtained from the Canadian Community Health Survey (2005), Cycle 3.1. Logistic regression was used to examine the association between receiving a flu shot in the past 12 months and consulting with family doctors, specialists, nurses, chiropractors, or homeopaths/naturopaths.

Results: Among the 6,925 women included in our sample, 1,847 (28.4%) reported receiving a flu shot in the past 12 months. After adjustment for socio-demographic characteristics and province of residence, women who received flu shots in the past 12 months were significantly more likely to consult with a family doctor (AOR 1.56, 95% CI 1.34-1.83) and significantly less likely to consult with a chiropractor (AOR 0.76, 95% CI 0.64-0.90) or a homeopath/naturopath (AOR 0.72, 95% CI 0.54-0.97) over the same time period.

Conclusion: Consultation with family doctors was found to have the strongest association with annual flu shots among women in contact with young children, whereas consultation with alternative care providers was found to have an independent inverse association. Given the influenza-associated health risks for young children, medical professionals should promote immunization at the time of consultation for household contacts of young children, including pregnant women.

Key words: Influenza; human; immunization; women; health care; utilization

La traduction du résumé se trouve à la fin de l'article. Can J Public Health 2010;101(1):15-19.

Mots clés : grippe; humain; immunisation; femmes; utilisation des soins de santé

Annual influenza immunization, more commonly known as the "flu shot", can prevent serious complications and mortality associated with infection, especially among individuals at high risk for these outcomes. One particular high-risk group is children 6 to 23 months of age.1,2 The influenza-attributed hospitalization rate among this age group was estimated at 200 per 100,000 per year for the 3 most severe influenza seasons between 1996/1997 and 1999/2000.3 During the 2005/2006 influenza season, 20.7% of laboratory-confirmed influenza cases occurred in children <5 years old.4 Pregnant women also represent a high-risk group. In Canada, the annual influenza-associated hospitalization rate is 104 per 100,000 for healthy pregnant women compared to 6 per 100,000 for non-pregnant women.5

During the 2004/2005 influenza season, the National Advisory Committee on Immunization (NACI) in Canada introduced recommendations for immunization of children aged 6 to 23 months.6-8 Annual influenza immunization is also recommended for individuals considered capable of transmitting influenza to those at high risk of influenza-related complications, for example household contacts of children less than 23 months and pregnant women.2,6 NACI extended its recommendation to include immunization for all pregnant women in 2007.2,5,9 Despite the benefits, seasonal vaccination rates among pregnant women remain low, ranging between 0% and 20%.9-13 Recent investigations into the H1N1 pandemic suggest an increased risk for influenza-associated complications in pregnant women and support improved vaccination coverage among this high-risk group.14

Primary health providers offer an important mechanism through which high-risk groups access the health care system and receive recommendations regarding annual flu shots.15-17 Our analysis aims to determine whether consultation with a medical professional increases the likelihood of having a flu shot among women in contact with young children, controlling for covariates and potential confounders, and to determine whether this association differs by type of medical professional. …

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