Background: An estimated 50,000 adults in the United States (U.S.) die each year from one of 10 vaccine preventable diseases. For those who survive vaccine preventable infections, health care costs and loss of income become more significant. While children in the U.S. aged 0-2 exhibit vaccine prevalence rates of almost 90%, some adult vaccine prevalence rates in the U.S. population are reported to be nearly 30-40% less than the goals set forth by Healthy People 2010. The purpose of this study was to examine the associations between socio-demographic characteristics of U.S. adults and adult vaccination prevalence for pneumococcal, hepatitis A, hepatitis B, tetanus, and pertussis. Methods: Data from the 2008 National Health Interview Survey were assessed examining various health indicators and characteristics of non-institutionalized adults and children. The sample was restricted to adults ≥18 years of age. Odds ratios were calculated and multivariate logistic regression was also conducted. P-values of Results: There were 21781 total observations; 19.3% received the pneumococcal vaccine, 9.4% received the hepatitis A vaccine, 27.2% received the hepatitis B vaccine, 55.1% received the tetanus vaccine, and 15.2% received the pertussis vaccine. Of the socio-demographic characteristics examined, age, health insurance, marital status, and education were significant for either all five or at least four of the vaccines included in this study. As one might expect those who reported health insurance and those who had a higher level of education usually had a higher likelihood of vaccine receipt as compared to those without health insurance and those with less than a high school education. Age associations varied due to age-related recommendations for certain vaccines such as pneumococcal (recommended for adults ≥65). Compared to the married population (referent), marital status results varied, but for reasons unclear. Whites, the referent group, were the most likely to be vaccinated as compared to Blacks, Hispanics/Latinos, and Asians. Hispanics/Latinos typically had the lowest likelihood of vaccination in this examination. Conclusions: This study further explores the impact of socio-demographic disparities on vaccination status and adds new information to the literature regarding adult vaccination rates for preventable diseases. While research exists related to strengthening interventions such as patient reminder systems, those who do not see the same health care providers on a regular basis remain at risk for lower vaccination prevalence. It is important to better understand the role of social determinants of health, specifically in terms of vaccinations. Future research is needed to further characterize the association of socio-demographic factors with receipt of optional vaccines in adults.

JESSICA MASTRODOMENICO An Examination of the Socio-Demographic Characteristics Associated with Adult Vaccination Prevalence for Preventable Diseases in the United States Background: An estimated 50,000 adults in the United States (U.S.) die each year from one of 10 vaccine preventable diseases. For those who survive vaccine preventable infections, health care costs and loss of income become more significant. While children in the U.S. aged 0-2 exhibit vaccine prevalence rates of almost 90%, some adult vaccine prevalence rates in the U.S. population are reported to be nearly 30-40% less than the goals set forth by Healthy People 2010. The purpose of this study was to examine the associations between socio-demographic characteristics of U.S. adults and adult vaccination prevalence for pneumococcal, hepatitis A, hepatitis B, tetanus, and pertussis. Methods: Data from the 2008 National Health Interview Survey were assessed examining various health indicators and characteristics of non-institutionalized adults and children. The sample was restricted to adults ≥18 years of age. Odds ratios were calculated and multivariate logistic regression was also conducted. P-values of <0.05 and 95% confidence intervals were used to determine statistical significance. Results: There were 21781 total observations; 19.3% received the pneumococcal vaccine, 9.4% received the hepatitis A vaccine, 27.2% received the hepatitis B vaccine, 55.1% received the tetanus vaccine, and 15.2% received the pertussis vaccine. Of the socio-demographic characteristics examined, age, health insurance, marital status, and education were significant for either all five or at least four of the vaccines included in this study. As one might expect those who reported health insurance and those who had a higher level of education usually had a higher likelihood of vaccine receipt as compared to those without health insurance and those with less than a high school education. Age associations varied due to age-related recommendations for certain vaccines such as pneumococcal (recommended for adults ≥65). Compared to the married population (referent), marital status results varied, but for reasons unclear. Whites, the referent group, were the most likely to be vaccinated as compared to Blacks, Hispanics/Latinos, and Asians. Hispanics/Latinos typically had the lowest likelihood of vaccination in this examination. Conclusions: This study further explores the impact of socio-demographic disparities on vaccination status and adds new information to the literature regarding adult vaccination rates for preventable diseases. While research exists related to strengthening interventions such as patient reminder systems, those who do not see the same health care providers on a regular basis remain at risk for lower vaccination prevalence. It is important to better understand the role of social determinants of health, specifically in terms of vaccinations. Future research is needed to further characterize the association of socio-demographic factors with receipt of optional vaccines in adults.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2017-03-16T21:44:40Z No. of bitstreams: 1 DISSERTA??O FERNANDA VERS?O CAPA DURA.pdf: 4333883 bytes, checksum: db37432e4c72154490e1dd23a9328846 (MD5) / Made available in DSpace on 2017-03-16T21:44:40Z (GMT). No. of bitstreams: 1 DISSERTA??O FERNANDA VERS?O CAPA DURA.pdf: 4333883 bytes, checksum: db37432e4c72154490e1dd23a9328846 (MD5) Previous issue date: 2015-12-14 / Funda??o de Amparo ? Pesquisa do Estado da Bahia - FAPEB / Brazil has for forty years with the national immunization program, which provides free vaccinations for the population in all cycles of life. Among the adult population, we highlight the vaccination in you work in the health sector, which have increased risk of getting sick from infectious diseases, within the work, but also outside of it. The aim of this study was to determine the vaccination status of health workers as well as the factors that determine the complete vaccination for adult calendar health ministry. for this, it was built four articles: 1 - vaccination profile of workers in the health sector of Bahia; 2 - Factors associated with vaccination among workers of primary care and medium complexity in Bahia; 3 Immunization status against hepatitis B workers of primary care and medium complexity of Bahia, Brazil; 4 - Vaccination against hepatitis B and Anti-HBs among health workers. It is considered the study of the determination of vaccination among specific groups such as health workers, a chance to build service strategies to maintain its protected population of diseases that have specific immunizations. This study sought to simplify a complex outcome. This was a pioneering study, to investigate the vaccination status and its completeness for all vaccines provided by the health ministry for adults through a methodology that could provide subsidies for triggering preventive actions to SUS workers not only to local reality, but above all national. This study allowed the analysis of information from various realities of working conditions in Bahia related to the vaccination process. Research like this certify that the knowledge produced can be used in public administration. Given the situation of low immunization when investigated the completion of the immunization schedule adults, suggest the workshops with workers linked to the health sector, focused on reducing barriers to access to vaccination strategies to improve the acceptance of immunizations and the perception of the subjects regarding their health. / O Brasil conta h? quarenta anos com o programa nacional de imuniza??o, que garante vacina??o gratuita para a popula??o em todos ciclos da vida. Entre a popula??o adulta, destacamos a vacina??o nos trabalhares do setor sa?de, que possuem risco acrescido de adoecer por doen?as infecciosas, dentro do trabalho, mas tamb?m fora de dele. O objetivo deste estudo foi reconhecer a situa??o vacinal dos trabalhadores da sa?de, bem como os fatores que determinam a vacina??o completa para o calend?rio do adulto do minist?rio da sa?de. para isso, foram constru?dos quatro artigos: 1 - Perfil vacinal dos trabalhadores do setor sa?de da Bahia; 2 - Fatores associados ? vacina??o entre trabalhadores da aten??o prim?ria e m?dia complexidade na Bahia; 3- Situa??o vacinal contra hepatite b em trabalhadores da aten??o prim?ria e m?dia complexidade da Bahia, Brasil; 4 ? Vacina??o contra hepatite B e Anti-HBs entre trabalhadores da sa?de. Considera-se o estudo da determina??o da vacina??o entre grupos espec?ficos, como os trabalhadores da sa?de, uma possibilidade para constru??o de estrat?gias do servi?o para manter sua popula??o protegida de doen?as que possuem imunizantes espec?ficos. Esse trabalho buscou simplificar um desfecho complexo. Tratou-se de um estudo pioneiro, por investigar o estado vacinal e sua completude para todas as vacinas previstas pelo minist?rio da sa?de para adultos atrav?s de uma proposta metodol?gica que pudesse oferecer subs?dios para o desencadeamento de a??es de car?ter preventivo para trabalhadores do SUS n?o apenas para realidade local, mas, sobretudo, nacional. Este estudo possibilitou a an?lise de informa??es de v?rias realidades de condi??es de trabalho na Bahia relacionadas ao processo de vacina??o. Pesquisas como esta certificam que o conhecimento produzido pode ser utilizado na gest?o p?blica. Diante da situa??o de baixa imuniza??o, quando investigada a completude do calend?rio vacinal do adulto, sugere-se a realiza??o de oficinas com os trabalhadores vinculados ao setor sa?de, focadas na redu??o das barreiras de acesso ? vacina??o, em estrat?gias para melhorar a aceita??o de imuniza??es e sobre a percep??o dos sujeitos com rela??o ? sua sa?de.