Newswise — Only one in two U.S. adults with arthritis received seasonal flu vaccinations in 2007, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Philadelphia, Pa.
Seasonal flu immunization is recommended for, among others, people age 50 years old and up and for those with disease- or drug-induced immunosuppression because of the strong likelihood that they will experience more-than-average complications due to the flu. Many arthritis patients are in this target group, but little is known about their level of compliance with recommendations.
Researchers from the Centers for Disease Control and Prevention recently looked at data from the 2007 Behavioral Risk Factor Surveillance System—an annual, randomly-dialed, phone survey of U.S. adults conducted in all 50 states and D.C. to estimate the prevalence and related characteristics of influenza immunization (commonly called the flu vaccine) among U.S. adults with arthritis.
The survey asked standardized questions about the presence of various chronic diseases and other questions to determine if participants had received the flu vaccination by injection or nasal spray within the previous 12 months. Using these types of questions, researchers determined that the flu immunization prevalence for people with arthritis was 52.3 percent, which was significantly higher than adults without arthritis (31.4 percent). Based on this prevalence data, they calculated that adults with arthritis were arthritis were 1.4 times more likely to get a flu vaccination than adults without arthritis. Still, given that adults with arthritis are generally an at-risk population for developing the flu, higher rates of vaccination are necessary to protect these individuals from flu infection and associated complications.
“The good news is that adults with arthritis get their seasonal flu vaccination more often than adults without arthritis, but the bad news is that almost half still don’t get their flu shot every year,” explains Jennifer Hootman, PhD; an epidemiologist with the Centers for Disease Control and Prevention’s National Center for Chronic Disease Prevention and Health Promotion in Atlanta, Ga., and lead investigator in the study. “We need more research to identify the reasons why adults with chronic disease do not get recommended flu vaccinations,” she says.
Further breaking down the results obtained from the survey among those with arthritis, researchers determined that flu vaccinations were less common among African Americans, Hispanics and multi-racial participants, as well as those with less than a high school education, current smokers, obese participants, those with no health insurance, and those with no personal health care provider. However, participants over the age of 45 and those with diabetes, heart disease or a disability, in addition to having arthritis, received the vaccination at significantly higher rates.
Dr. Hootman explains that, for some people, the flu can be serious. Over 200,000 people are hospitalized and 36,000 die from seasonal influenza each year, and Dr. Hootman stresses that getting a flu shot every year is the best way to prevent the flu.
“The seasonal flu vaccination is the best way to prevent the flu and is highly recommended for young children, those over age 50, and adults with chronic health conditions,” says Dr. Hootman. “All health care providers should recommend seasonal influenza vaccination for those patients at high risk of complications from the flu. Persons with reduced immune capacity due to inflammatory rheumatic diseases such as rheumatoid arthritis or lupus should also get a 2009 H1N1 influenza vaccination.”
The ACR is an organization of and for physicians, health professionals, and scientists that advances rheumatology through programs of education, research, advocacy and practice support that foster excellence in the care of people with or at risk for arthritis and rheumatic and musculoskeletal diseases. For more information on the ACR’s annual meeting, see www.rheumatology.org/annual.
Editor’s Notes: Dr. Hootman will present this study during the ACR Annual Scientific Meeting at the Pennsylvania Convention from 9:00 – 11:00 AM ON Monday, October 19 in Hall D.
Presentation Number: 723
Influenza Immunization Status Among US Adults with Arthritis, 2007
Jennifer M. Hootman, ATC, PhD , Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA Charles G. Helmick, MD , Centers for Disease Control and Prevention, Atlanta, GA
Purpose: : In April 2009 an outbreak of a novel H1N1 influenza virus was documented in the US and has since spread worldwide. Annual flu immunization is recommended for people age ≥50 years and for those with disease- or drug-induced immunosuppression, who do poorly with an influenza infection. Most arthritis patients are in this target group but little is known about their level of compliance with recommendations. The purpose of this study was to estimate the prevalence and related characteristics of influenza immunization (FLU-IM) among US adults with arthritis.
Method: Data are from the 2007 (n = 430,912) Behavioral Risk Factor Surveillance System, an annual, random-digit dialed national phone survey of US adults conducted in all 50 states and D.C. Arthritis was defined as a ‘yes’ response to “Have you ever been told by a doctor or other health care professional that you have arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?” FLU-IM status was defined as having received a flu shot or flu nasal spray in the past 12 months. Estimates (95% confidence intervals, CI) of FLU-IM by arthritis status were calculated using statistical weights to account for the complex sample design. Multivariate logistic regression (adjusted odds ratios and 95% CI) was used to identify factors that might be significantly (p<0.05) related to FLU-IM status, including demographics (age, sex, race/ethnicity, education level), general health indicators (obesity, self-rated health, current smoker, presence of diabetes, heart disease or a disability), and health care factors (have health insurance, have a usual health care provider).
Results: The unadjusted FLU-IM prevalence was 52.3% (CI 51.8 – 52.8; 1.2% received nasal spray, 52.0% received injection) among adults with arthritis, significantly higher than among adults without arthritis (31.4%, CI 31.0-31.7), and in multivariate analyses adults with arthritis were 1.4 (CI 1.4 – 1.5) times more likely to receive FLU-IM. Among adults with arthritis who had seen a health care provider in the past 12 months, FLU-IM was significantly lower among non-Hispanic Blacks (0.7, CI 0.6-0.7), Hispanics (0.6, CI 0.5-0.7), non-Hispanic Other/Multiracial (0.8, CI 0.7-0.9), those with less than a high school education (0.7, CI 0.7-0.8), current smokers (0.7, CI 0.7-0.8), the obese (0.9, CI 0.8-0.9), those with no health insurance (0.7, CI 0.6-0.8), and those with no personal health care provider (0.7, CI 0.6-0.9). FLU-IM was significantly higher among older adults (age 45-64 = 1.6, CI 1.5-1.8; age 65+ = 4.5, CI 4.1-4.9) and persons with diabetes (1.7, CI 1.6-1.8), heart disease (1.3, CI 1.2-1.4), or a disability (1.2, CI 1.1-1.3).
Conclusion: Only 1 in 2 US adults with arthritis received FLU-IM in 2007. Among people with arthritis, race/ethnic minorities, smokers, obese persons, and those with low education are higher risk groups and should be targeted for FLU-IMM, although the live attenuated nasal spray vaccine is not recommended for people with immunosuppression.
Disclosure: J. M. Hootman, None; C. G. Helmick, None.
RSS