Impact of health insurance coverage on seasonal influenza vaccination rates across age groups

Background: In the United States, influenza is associated with substantial medical costs, hospitalizations, lost productivity, and thousands of deaths annually. Individuals without health insurance coverage have less access to healthcare and are likely to forgo preventative measures. The seasonal influenza vaccination is one such preventative measure which greatly reduces influenza morbidity and complications that arise from influenza infection.

Objective: To examine the differences between seasonal influenza vaccination rates among individuals with and without health insurance coverage.

Methods: We included data from persons 18 years and older living in the United States contributing to the Behavioral Risk Factor Surveillance System in 2008-2010(n=1,298,191). Using multivariable logistic regression accounting for the complex sampling design, we modeled the association between self-reported receipt of influenza vaccination and health insurance coverage adjusting for potential confounders including sociodemographics and comorbid conditions. Stratification across age groups examined differences across the life span.

Results: Forty-seven percent reported receiving a flu shot and 10.5% reported no insurance coverage. Overall, persons with health insurance were twice as likely report having received a flu shot relative to those without health insurance (adjusted odds ratio (aOR) 2.31;95% Confidence Interval(CI):2.23 to 2.39). This association was highest for those aged 35 to 44 years (aOR 2.99; 95% CI:2.79 to 3.21) and lowest for those aged 18 to 24 years (aOR 1.81; 95% CI:1.64 to 2.00).

Conclusion: Determining how to overcome the barriers that hamper the optimal uptake of influenza vaccines is important. This research demonstrates that access to healthcare is essential across the life span.