Influenza vaccine uptake among older adults in Brazil: Socioeconomic equality and the role of preventive policies and public services

Background: Influenza is a significant cause of morbidity and mortality worldwide. Since 1999, influenzavaccine is provided free-of-charge to adults aged 60 years or more in Brazil. Although vaccination coverageis high, previous studies have shown that socioeconomic and lifestyle factors play an essential role inpredicting vaccine uptake. This study aimed to investigate whether previous knowledge of factors thatconstrain influenza vaccine uptake among older adults contributed to increasing the access to vaccinationin 2015-16. Methods: This cross-sectional study assessed data from the baseline of the Brazilian Longitudinal Studyof Aging. This national representative sample encompassed individuals aged 60 and older (n = 5221). Vaccination status was the outcome variable; covariates included socio-demographic and behavioralcharacteristics, health status, and access to healthcare. Logistic regression fitted the association betweenvaccine uptake and covariates. Results: The coverage of influenza vaccination was 73.0% (95% confidence interval: 70.6-75.2); rankinglower than the goal of 80% set up by the national health authority. The most frequent reasons to justify theoption of skipping vaccination were cultural beliefs about the lack of efficacy and possible side effects ofthe vaccine. The coverage of vaccination did not differ by socioeconomic characteristics. Older individuals, never smokers, having two or more chronic diseases, and being registered in the Family Health Programwere positively associated with influenza vaccine uptake. Conclusions: Absent socioeconomic inequalities point out changes in the barriers to vaccination. Thesefindings provide insights into tailoring public health strategies, targeting professional recommendationsand public perceptions of the vaccine. (c) 2019 The Authors. Published by Elsevier Limited on behalf of King Saud Bin Abdulaziz Universityfor Health Sciences. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).