Influenza vaccination coverages among children, adults, health care workers and immigrants in Spain: Related factors and trends, 2003-2006

Objectives: This study sought to: describe influenza vaccination coverage among Spanish children, adults, health care workers (HCWs), and immigrants according to the 2006 Spanish National Health Survey (NHS); and analyze the time trend for the period 2003-2006. Methods: We analyzed 38,329 questionnaires drawn from the 2006 NHS, covering subjects aged 6 months and over. As the dependent variable, we took the answer to the question, "Did you (or your child) have a 'flu shot in the last campaign?". Independent variables were age group, gender, nationality, occupation (HCWs), and coexistence of chronic conditions. Results: In 2006, vaccination coverage for the Spanish population was: 22.2% overall; 6.8% for all children; and 19.1% for children with a chronic medical condition. Coverages were: 66.8% among subjects aged >= 65 years; 26.6% among high-risk subjects aged <65 years; and 24.2% among HCWs. A significantly Lower proportion of immigrants reported vaccination than did indigenous subjects. After controlling for possible confounders, the likelihood of having been vaccinated in 2006 was lower than in 2003 for the entire population (adjusted OR 92, 95%CI 0.86-0.97). In specific target groups, however, coverage underwent a significant reduction from 2003 to 2006 among high-risk subjects aged 16-64 years, and immigrants. Significant improvements were found among subjects aged over 64 years, and children. Conclusions: Available data show unacceptably low levels of influenza vaccination coverage among high-risk subjects aged under 65 years, children with chronic medical conditions, and HCWs. A special effort is thus called for to implement strategies that have demonstrated their effectiveness in enhancing vaccination coverages. (C) 2008 The British Infection Society. Published by Elsevier Ltd. All rights reserved.