Influenza Vaccination in Adults in the United States with COPD before and after the COVID-19 Pandemic (2017–2022): A Multi-Year Cross-Sectional Study
Abstract
:1. Introduction
- Are US adults with an HCOPD more likely to receive seasonal influenza vaccination than adults without an HCOPD?
- Has this relationship changed over time, and was it impacted by the COVID-19 pandemic?
- Are there any effect modifiers of this association?
2. Methods
2.1. Dataset
2.2. Exposure of Interest: History of COPD
2.3. Outcome of Interest: Receipt of Annual Influenza Vaccination
2.4. Confounders of Interest
2.5. Final Study Sample
2.6. Statistical Analyses
3. Results
3.1. Characteristics of the Final Study Sample
3.2. Weighted and Adjusted Logistic Regression Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Liu, Y.; Carlson, S.A.; Watson, K.B.; Xu, F.; Greenlund, K.J. Trends in the Prevalence of Chronic Obstructive Pulmonary Disease Among Adults Aged ≥18 Years—United States, 2011–2021. MMWR Morb. Mortal. Wkly. Rep. 2023, 72, 1250–1256. [Google Scholar] [CrossRef]
- Jacobs, D.M.; Noyes, K.; Zhao, J.; Gibson, W.; Murphy, T.F.; Sethi, S.; Ochs-Balcom, H.M. Early Hospital Readmissions after an Acute Exacerbation of Chronic Obstructive Pulmonary Disease in the Nationwide Readmissions Database. Ann. Am. Thorac. Soc. 2018, 15, 837–845. [Google Scholar] [CrossRef]
- Soler-Cataluña, J.J.; Martínez-García, M.Á.; Román Sánchez, P.; Salcedo, E.; Navarro, M.; Ochando, R. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax 2005, 60, 925–931. [Google Scholar] [CrossRef] [PubMed]
- Wedzicha, J.A.; Seemungal, T.A.R. COPD exacerbations: Defining their cause and prevention. Lancet 2007, 370, 786–796. [Google Scholar] [CrossRef]
- Cummings, C.N.; O’Halloran, A.C.; Azenkot, T.; Reingold, A.; Alden, N.B.; Meek, J.I.; Garg, S. Hospital-acquired influenza in the United States, FluSurv-NET, 2011–2012 through 2018–2019. Infect. Control Hosp. Epidemiol. 2022, 43, 1447–1453. [Google Scholar] [CrossRef] [PubMed]
- Bahadori, K.; FitzGerald, J.M. Risk factors of hospitalization and readmission of patients with COPD exacerbation–systematic review. Int. J. Chronic Obstr. Pulm. Dis. 2007, 2, 241–251. [Google Scholar]
- Awatade, N.; Wark, P.; Chan, A.; Al Mamun, A.; Mohd Esa, N.Y.; Matsunaga, K.; Rhee, C.K.; Hansbro, P.; Singh Sohal, S. The complex association between COPD and COVID-19. J. Clin. Med. 2023, 12, 3791. [Google Scholar] [CrossRef]
- Sethi, S.; Murphy, T.F. Infection in the Pathogenesis and Course of Chronic Obstructive Pulmonary Disease. N. Engl. J. Med. 2008, 359, 2355–2365. [Google Scholar] [CrossRef]
- Bouquet, J.; Tabor, D.E.; Silver, J.S.; Nair, V.; Tovchigrechko, A.; Griffin, M.P.; Jin, H. Microbial burden and viral exacerbations in a longitudinal multicenter COPD cohort. Respir. Res. 2020, 21, 77. [Google Scholar] [CrossRef]
- Martin-Loeches, I.; van Someren Greve, F.; Schultz, M. Bacterial pneumonia as an influenza complication. Curr. Opin. Inf. Dis. 2017, 30, 201–207. [Google Scholar] [CrossRef]
- Liao, K.M.; Chen, Y.J.; Shen, C.W.; Ou, S.K.; Chen, C.Y. The Influence of Influenza Virus Infections in Patients with Chronic Obstructive Pulmonary Disease. Int. J. Chron. Obstruct Pulmon Dis. 2022, 17, 2253–2261. [Google Scholar] [CrossRef]
- Kopsaftis, Z.; Wood-Baker, R.; Poole, P. Influenza vaccine for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst. Rev. 2018, 6, CD002733. [Google Scholar] [CrossRef] [PubMed]
- Mulpuru, S.; Li, L.; Ye, L.; Hatchette, T.; Andrew, M.K.; Ambrose, A.; Taylor, G. Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD. Chest 2019, 155, 69–78. [Google Scholar] [CrossRef]
- Martínez-Baz, I.; Casado, I.; Navascués, A.; Portillo, M.E.; Guevara, M.; Ezpeleta, C.; Castilla, J. Chronic obstructive pulmonary disease and influenza vaccination effect in preventing outpatient and inpatient influenza cases. Sci. Rep. 2022, 12, 4862. [Google Scholar] [CrossRef] [PubMed]
- Bekkat-Berkani, R.; Wilkinson, T.; Buchy, P.; Dos Santos, G.; Stefanidis, D.; Devaster, J.M.; Meyer, N. Seasonal influenza vaccination in patients with COPD: A systematic literature review. BMC Pulm. Med. 2017, 17, 79. [Google Scholar] [CrossRef] [PubMed]
- Fridman, A.; Gershon, R.; Gneezy, A. COVID-19 and vaccine hesitancy: A longitudinal study. PLoS ONE 2021, 16, e0250123. [Google Scholar] [CrossRef]
- Altman, J.D.; Miner, D.S.; Lee, A.A.; Asay, A.E.; Nielson, B.U.; Rose, A.M.; Poole, B.D. Factors affecting vaccine attitudes influenced by the COVID-19 pandemic. Vaccines 2023, 11, 516. [Google Scholar] [CrossRef]
- CDC. Behavioral Risk Factor Surveillance System. 2023. Available online: https://www.cdc.gov/brfss/ (accessed on 15 March 2024).
- Akinbami, L.J.; Liu, X. Chronic Obstructive Pulmonary Disease among Adults Aged 18 and Over in the United States, 1998–2009. NCHS Data Brief No. 63. 2011. Available online: https://www.cdc.gov/nchs/products/databriefs/db63.htm#:~:text=COPD%20prevalence%20was%20highest%20among,75%E2%80%9384%20(11.2%25) (accessed on 15 March 2024).
- Chen, J.Y.; Fox, S.A.; Cantrell, C.H.; Stockdale, S.E.; Kagawa-Singer, M. Health Disparities and Prevention: Racial/ethnic Barriers To Flu Vaccinations. J. Community Health 2007, 32, 5–20. [Google Scholar] [CrossRef]
- La, E.M.; Trantham, L.; Kurosky, S.K.; Odom, D.; Aris, E.; Hogea, C. An analysis of factors associated with influenza, pneumoccocal, Tdap, and herpes zoster vaccine uptake in the US adult population and corresponding inter-state variability. Hum. Vaccin. Immunother. 2018, 14, 430–441. [Google Scholar] [CrossRef]
- Nowak, G.J.; Cacciatore, M.A.; Len-Ríos, M.E. Understanding and increasing influenza vaccination acceptance: Insights from a 2016 National Survey of U.S. Adults. Int. J. Environ. Res. Public Health 2018, 15, 711. [Google Scholar] [CrossRef]
- Takayama, M.; Wetmore, C.M.; Mokdad, A.H. Characteristics associated with the uptake of influenza vaccination among adults in the United States. Prev. Med. 2012, 54, 358–362. [Google Scholar] [CrossRef] [PubMed]
- Lu, P.-J.; O’Halloran, A.; Williams, W.W.; Lindley, M.C.; Farrall, S.; Bridges, C.B. Racial and ethnic disparities in vaccination coverage among adult populations in the U.S. Am. J. Prev. Med. 2015, 49, S412–S425. [Google Scholar] [CrossRef] [PubMed]
- Kumbhare, S.D.; Beiko, T.; Wilcox, S.R.; Strange, C. Characteristics of COPD Patients Using United States Emergency Care or Hospitalization. Chronic Obs. Pulm. Dis. 2016, 3, 539–548. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Lochner, K.A.; Wynne, M. Flu shots and the characteristics of unvaccinated elderly Medicare beneficiaries. Medicare Medicaid Res. Rev. 2011, 1, 1–11. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Lucyk, K.; Simmonds, K.A.; Lorenzetti, D.L.; Drews, S.J.; Svenson, L.W.; Russell, M.L. The association between influenza vaccination and socioeconomic status in high income countries varies by the measure used: A systematic review. BMC Med. Res. Methodol. 2019, 19, 153. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Brewer, L.I.; Ommerborn, M.J.; Nguyen, A.L.; Clark, C.R. Structural inequities in seasonal influenza vaccination rates. BMC Public Health 2021, 21, 1166. [Google Scholar] [CrossRef]
- Chen, Y.; Yi, Q.-L.; Wu, J.; Li, F. Chronic disease status, self-perceived health and hospital admissions are important predictors for having a flu shot in Canada. Vaccine 2007, 25, 7436–7440. [Google Scholar] [CrossRef] [PubMed]
- Watson, I.; Oancea, S.C. Does self-rated health status influence receipt of an annual flu vaccination? Prev. Med. 2020, 131, 105949. [Google Scholar] [CrossRef]
- Wheaton, A.G.; Liu, Y.; Croft, J.B.; VanFrank, B.; Croxton, T.L.; Punturieri, A.; Postow, L.; Greenlund, K.J. Chronic Obstructive Pulmonary Disease and Smoking Status—United States, 2017. MMWR Morb. Mortal. Wkly. Rep. 2019, 68, 533–538. [Google Scholar] [CrossRef]
- Shahrabani, S.; Benzion, U. The effects of socioeconomic factors on the decision to be vaccinated: The case of flu shot vaccination. Isr. Med. Assoc. J. 2006, 8, 630–634. [Google Scholar]
- Talbot, L.; Maclennan, K. Physiology of pregnancy. Anaesth. Intensive Care Med. 2016, 17, 341–345. [Google Scholar] [CrossRef]
- Boehmer, L.M.; Waqar, S.N.; Govindan, R. Influenza Vaccination in Patients with Cancer: An Overview. Oncology 2010, 24, 1167–1170. [Google Scholar] [PubMed]
- Kamboj, M.; Bohlke, K.; Baptiste, D.M.; Dunleavy, K.; Fueger, A.; Jones, L.; Kohn, E.C. Vaccination of Adults with Cancer: ASCO Guideline. J. Clin. Oncol. 2024, 42, 1699–1721. [Google Scholar] [CrossRef] [PubMed]
- Mallia, P.; Johnston, S.L. Influenza infection and COPD. Int. J. Chronic Obstr. Pulm. Dis. 2007, 2, 55–64. [Google Scholar] [CrossRef]
- Mohan, A.; Chandra, S.; Agarwal, D.; Guleria, R.; Broor, S.; Guar, B.; Pandey, R.M. Prevalence of viral infection detected by PCR and RT-PCR in patients with acute exacerbation of COPD: A systematic review. Respirology 2010, 15, 536–542. [Google Scholar] [CrossRef]
- Alsharawy, A.; Spoon, R.; Smith, A.; Ball, S. Gender Differences in Fear and Risk Perception During the COVID-19 Pandemic. Front. Psychol. 2021, 12, 689467. [Google Scholar] [CrossRef]
- Vander Weg, M.; Howren, M.B.; Cai, X. Use of Routine Clinical Preventive Services Among Daily Smokers, Non-daily Smokers, Former Smokers, and Never-smokers. Nicotine Tob. Res. 2012, 14, 123–130. [Google Scholar] [CrossRef] [PubMed]
- Vosoris, N.T.; Lougheed, M.D. Influenza vaccination among Canadians with chronic respiratory disease. Resp. Med. 2009, 103, 50–58. [Google Scholar] [CrossRef]
- Ciblak, M.A. Grip Platformu Influenza vaccination in Turkey: Prevalence of risk groups, current vaccination status, factors influencing vaccine uptake and steps taken to increase vaccination rate. Vaccine 2013, 31, 518–523. [Google Scholar] [CrossRef]
- Cimen, P.; Unlu, M.; Kirakli, C.; Katgi, N.; Ucsular, F.D.; Ayranci, A.; Guclu, S.Z. Should patients with COPD be vaccinated? Respir. Care 2015, 60, 239–243. [Google Scholar] [CrossRef] [PubMed]
- Williams, L.; Deakin, K.; Gallant, A.; Rasmussen, S.; Young, D.; Cogan, N. A mixed methods study of seasonal influenza vaccine hesitancy in adults with chronic respiratory conditions. Influenza Other Respir. Viruses 2021, 15, 625–633. [Google Scholar] [CrossRef] [PubMed]
- Ford, E.S.; Mannino, D.M.; Wheaton, A.G.; Giles, W.H.; Presley-Cantrell, L.; Croft, J.B. Trends in the Prevalence of Obstructive and Restrictive Lung Function Among Adults in the United States: Findings from the National Health and Nutrition Examination Surveys from 1988–1994 to 2007–2010. Chest 2013, 143, 1395–1406. [Google Scholar] [CrossRef] [PubMed]
- Pierannunzi, C.; Hu, S.S.; Balluz, L. A systematic review of publications assessing reliability and validity of the Behavioral Risk Factor Surveillance System (BRFSS), 2004–2011. BMC Med. Res. Methodol. 2013, 13, 49. [Google Scholar] [CrossRef]
Overall (N = 822,783) | Received SIV Past 12 Months | p Value | ||||||
---|---|---|---|---|---|---|---|---|
Yes (N = 431,990) | No (N = 390,793) | |||||||
Unweighted Counts | Weighted | Weighted | Weighted | |||||
Median | IQR | Median | IQR | Median | IQR | |||
Age at survey | 822,783 | 60.25 | 54.36–66.89 | 62.16 | 55.86–68.84 | 58.62 | 53.40–64.55 | <0.0001 |
Overall (N = 822,783) | Received SIV past 12 months | p value | ||||||
Yes (N = 431,990) | No (N = 390,793) | |||||||
Unweighted counts | Weighted | Weighted | Weighted | |||||
Percent | 95% CI for percent | Percent | 95% CI for percent | Percent | 95% CI for percent | |||
Ever Diagnosed with COPD | ||||||||
Yes | 80,710 | 9.44 | 9.30–9.58 | 54.80 | 54.04–55.56 | 45.20 | 44.44–45.96 | <0.0001 |
No | 742,073 | 90.56 | 90.42–90.70 | 48.79 | 48.53–49.05 | 52.21 | 50.95–51.47 | |
Healthcare Coverage | ||||||||
Yes | 783,275 | 93.70 | 93.56–93.84 | 51.24 | 50.99–51.50 | 48.76 | 48.50–49.01 | <0.0001 |
No | 39,508 | 6.30 | 6.16–6.44 | 21.32 | 20.47–22.17 | 78.68 | 77.83–79.53 | |
Sex | ||||||||
Male | 379,462 | 50.64 | 50.39–50.89 | 46.70 | 46.35–47.05 | 53.30 | 52.95–53.65 | <0.0001 |
Female | 443,321 | 49.36 | 49.12–49.61 | 51.95 | 51.60–52.29 | 48.05 | 47.71–48.40 | |
Race | ||||||||
White, non-Hispanic | 682,856 | 76.56 | 76.31–76.80 | 50.52 | 50.27–50.79 | 49.47 | 49.21–49.73 | <0.0001 |
Black, non-Hispanic | 71,355 | 12.88 | 12.70–13.06 | 44.29 | 43.55–45.04 | 55.71 | 54.96–56.45 | |
American Indian/Alaska Native, non-Hispanic | 16,629 | 1.58 | 1.52–1.64 | 42.61 | 40.84–44.38 | 57.39 | 55.62–59.16 | |
Asian, non-Hispanic | 15,357 | 4.26 | 4.09–4.43 | 55.38 | 53.31–57.46 | 44.62 | 42.54–46.69 | |
Other races | 34,607 | 4.73 | 4.61–4.85 | 41.16 | 39.85–42.46 | 58.84 | 57.54–60.15 | |
Income | ||||||||
<$15,000 | 70,276 | 9.39 | 9.24–9.54 | 41.56 | 40.72–42.41 | 58.44 | 57.60–59.28 | <0.0001 |
$15,000 to <$25,000 | 111,307 | 13.50 | 13.32–13.67 | 44.64 | 43.96–45.31 | 55.37 | 54.70–56.04 | |
$25,000 to <$35,000 | 86,396 | 10.06 | 9.91–10.21 | 46.85 | 46.07–47.63 | 53.15 | 52.37–53.93 | |
$35,000 to <$50,000 | 113,246 | 12.59 | 12.43–12.75 | 48.89 | 48.21–49.58 | 51.11 | 50.42–51.79 | |
$50,000 or more | 441,567 | 54.46 | 54.21–54.71 | 52.44 | 52.11–52.78 | 47.56 | 47.22–47.89 | |
Employment Status | ||||||||
Employed for wages/self-employed | 389,833 | 50.71 | 50.46–50.96 | 41.43 | 40.50–42.35 | 58.56 | 57.65–59.50 | <0.0001 |
Homemaker/student/retired | 334,089 | 35.45 | 35.22–35.68 | 44.28 | 43.82–44.74 | 55.72 | 55.26–56.18 | |
Out of work | 30,263 | 4.56 | 4.44–4.67 | 48.35 | 47.89–48.81 | 51.65 | 51.19–52.11 | |
Unable to work | 68,598 | 9.29 | 9.14–9.43 | 57.79 | 57.41–58.17 | 42.21 | 41.83–42.59 | |
Education | ||||||||
Less than high school | 46,057 | 11.32 | 11.12–11.51 | 70.25 | 69.64–70.87 | 29.75 | 29.13–30.36 | <0.0001 |
High school graduate | 212,952 | 26.89 | 26.68–27.11 | 32.53 | 32.22–32.85 | 67.47 | 67.15–67.78 | |
Some college/technical school | 231,936 | 31.23 | 31.00–31.47 | 37.83 | 37.53–38.14 | 62.17 | 61.86–62.48 | |
College graduate or more | 331,838 | 30.56 | 30.35–30.77 | 49.81 | 49.56–50.07 | 50.19 | 49.93–50.44 | |
Marital Status | ||||||||
Married/unmarried couple | 493,189 | 63.52 | 63.28–63.75 | 51.23 | 50.92–51.55 | 48.77 | 48.45–49.08 | <0.0001 |
Never married | 74,175 | 8.62 | 8.48–8.76 | 44.74 | 43.90–45.58 | 55.26 | 54.42–56.10 | |
Separated/divorced/widowed | 255,419 | 27.87 | 27.65–28.09 | 46.51 | 46.06–46.95 | 53.49 | 53.05–53.94 | |
Self-Reported Health Status | ||||||||
Excellent | 132,067 | 15.97 | 15.79–16.15 | 46.58 | 45.96–47.20 | 53.42 | 52.80–54.04 | <0.0001 |
Very good | 281,139 | 32.06 | 31.83–32.29 | 50.57 | 50.15–50.99 | 49.43 | 49.01–49.85 | |
Good | 257,381 | 31.91 | 31.67–32.14 | 49.50 | 49.05–49.95 | 50.50 | 50.05–50.95 | |
Fair | 112,983 | 14.95 | 14.77–15.13 | 49.29 | 48.62–49.95 | 50.72 | 50.05–51.38 | |
Poor | 39,213 | 5.11 | 5.00–5.22 | 49.76 | 48.67–50.85 | 50.24 | 49.15–51.33 | |
Angina/Coronary Heart Disease | ||||||||
Yes | 57,055 | 6.50 | 6.39–6.62 | 58.56 | 57.67–59.45 | 41.44 | 40.55–42.33 | <0.0001 |
No | 765,728 | 93.50 | 93.38–93.61 | 48.72 | 48.46–48.98 | 51.28 | 51.03–51.54 | |
Diabetes | ||||||||
Yes | 148,547 | 18.66 | 18.46–18.86 | 57.70 | 57.12–58.29 | 42.30 | 41.71–42.88 | <0.0001 |
No | 674,236 | 81.34 | 81.15–81.54 | 47.44 | 47.17–47.72 | 52.56 | 52.28–52.83 | |
Smoking Status | ||||||||
Current smoker | 116,438 | 14.89 | 14.71–15.05 | 37.42 | 36.84–38.01 | 62.58 | 61.99–63.16 | <0.0001 |
Former smoker | 255,735 | 30.22 | 30.00–30.45 | 53.28 | 52.85–53.71 | 46.72 | 46.29–47.15 | |
Never smoker | 450,610 | 54.89 | 54.65–55.14 | 50.43 | 50.09–50.78 | 49.57 | 49.22–49.91 |
Total Unweighted n | Unweighted n with Outcome (Flu Shot) (Unweighted Count, Weighted Prevalence) | Weighted/Unadjusted | Weighted/Adjusted | |||
---|---|---|---|---|---|---|
# | # | WUOR | 95% CI | WAOR | 95% CI | |
Overall | 822,783 | 431,990 (49.36%) | 1.27 | 1.23, 1.32 **** | 1.23 | 1.19, 1.28 **** |
Current Smoker | 116,438 | 46,979 (37.42%) | 1.63 | 1.54, 1.73 **** | 1.36 | 1.28, 1.45 **** |
Male | 56,059 | 20,593 (33.57%) | 1.69 | 1.55, 1.84 **** | 1.35 | 1.23, 1.48 **** |
2017 | 10,310 | 3,653 (33.29%) | 1.33 | 1.09, 1.62 ** | ||
2018 | 10,628 | 3,111 (27.22%) | 1.19 | 0.98, 1.45 + | ||
2019 | 9,035 | 3,312 (32.63%) | 1.55 | 1.27, 1.88 **** | ||
2020 | 8,890 | 3,473 (35.39%) | 1.52 | 1.22, 1.88 *** | ||
2021 | 8,764 | 3,573 (37.27%) | 1.24 | 0.96, 1.60 + | ||
2022 | 8,432 | 3,471 (37.09%) | 1.30 | 1.07, 1.58 *** | ||
Female | 60,379 | 26,386 (41.69%) | 1.49 | 1.38, 1.61 **** | 1.31 | 1.20, 1.43 **** |
2017 | 11,603 | 4,897 (39.36%) | 1.26 | 1.04, 1.52 * | ||
2018 | 11,137 | 3,732 (32.60%) | 1.23 | 1.03, 1.48 * | ||
2019 | 9,975 | 4,468 (42.33%) | 1.42 | 1.19, 1.70 **** | ||
2020 | 9,410 | 4,517 (46.16%) | 1.28 | 1.01, 1.64 * | ||
2021 | 9,479 | 4,554 (45.60%) | 1.25 | 1.02, 1.53 * | ||
2022 | 8,775 | 4,218 (45.40%) | 1.33 | 1.10, 1.61 ** | ||
Former Smoker | 255,735 | 185,716 (53.28%) | 1.50 | 1.43, 1.58 **** | 1.35 | 1.27, 1.43 **** |
Male | 132,033 | 71,828 (51.78%) | 1.70 | 1.58, 1.83 **** | 1.45 | 1.33, 1.58 **** |
2017 | 24,367 | 12,577 (50.62%) | 1.25 | 1.01, 1.54 * | ||
2018 | 24,464 | 10,993 (42.66%) | 1.24 | 1.04, 1.47 * | ||
2019 | 21,414 | 11,921 (52.31%) | 1.70 | 1.41, 2.07 **** | ||
2020 | 20,000 | 11,692 (54.56%) | 1.91 | 1.47, 2.49 **** | ||
2021 | 21,037 | 12,349 (56.44%) | 1.11 | 0.93, 1.32 | ||
2022 | 10,751 | 12,296 (55.83%) | 1.74 | 1.44, 2.11 **** | ||
Female | 123,702 | 71,391 (55.13%) | 1.31 | 1.22, 1.40 **** | 1.24 | 1.15, 1.35 **** |
2017 | 23,640 | 12,752 (51.71%) | 1.55 | 1.31, 1.84 **** | ||
2018 | 22,875 | 10,662 (44.68%) | 1.34 | 1.10, 1.63 ** | ||
2019 | 19,852 | 11,685 (56.51%) | 1.23 | 1.04, 1.47 * | ||
2020 | 18,744 | 11,825 (60.83%) | 1.15 | 0.94, 1.41 | ||
2021 | 19,210 | 12,175 (59.45%) | 1.06 | 0.87, 1.30 | ||
2022 | 19,381 | 12,292 (58.83%) | 1.14 | 0.94, 1.38 | ||
Never Smoker | 450,610 | 241,792 (50.43%) | 1.26 | 1.17, 1.36 **** | 1.18 | 1.09, 1.27 **** |
Male | 191,370 | 96,015 (47.42%) | 1.38 | 1.19, 1.60 **** | 1.23 | 1.05, 1.44 **** |
2017 | 32,024 | 15,216 (43.71%) | 1.45 | 1.07, 1.97 * | ||
2018 | 32,953 | 13,687 (39.00%) | 1.39 | 1.03, 1.89* | ||
2019 | 30,571 | 15,388 (47.18%) | 1.30 | 0.95, 1.78 | ||
2020 | 30,076 | 16,271 (51.06%) | 1.14 | 0.65, 1.99 | ||
2021 | 32,479 | 18,012 (51.83%) | 1.16 | 0.87, 1.53 | ||
2022 | 33,267 | 18,441 (51.47%) | 0.99 | 0.74, 1.33 | ||
Female | 259,240 | 144,777 (52.93%) | 1.16 | 1.07, 1.25 *** | 1.13 | 1.04, 1.23 ** |
2017 | 47,906 | 25,055 (48.91%) | 1.22 | 1.01, 1.48* | ||
2018 | 46,405 | 21,253 (43.50%) | 1.10 | 0.91, 1.34 | ||
2019 | 41,911 | 23,504 (51.73%) | 1.04 | 0.86, 1.26 | ||
2020 | 40,420 | 24,539 (57.35%) | 1.03 | 0.82, 1.31 | ||
2021 | 41,569 | 25,365 (58.05%) | 1.18 | 0.95, 1.46 | ||
2022 | 41,029 | 25,061 (58.40%) | 1.24 | 0.99, 1.54 + |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Wold, M.; Oancea, S.C. Influenza Vaccination in Adults in the United States with COPD before and after the COVID-19 Pandemic (2017–2022): A Multi-Year Cross-Sectional Study. Vaccines 2024, 12, 931. https://doi.org/10.3390/vaccines12080931
Wold M, Oancea SC. Influenza Vaccination in Adults in the United States with COPD before and after the COVID-19 Pandemic (2017–2022): A Multi-Year Cross-Sectional Study. Vaccines. 2024; 12(8):931. https://doi.org/10.3390/vaccines12080931
Chicago/Turabian StyleWold, Marissa, and Sanda Cristina Oancea. 2024. "Influenza Vaccination in Adults in the United States with COPD before and after the COVID-19 Pandemic (2017–2022): A Multi-Year Cross-Sectional Study" Vaccines 12, no. 8: 931. https://doi.org/10.3390/vaccines12080931