Correlates of seasonal flu vaccination among U.S. home health aides: Findings from the National Home Health Aide Survey

Introduction: During an influenza pandemic, vulnerable and sick populations (i.e. elderly with chronic diseases, permanent disability, or terminal illness) are often rendered various home medical services by health aides (HAs). Given that these paraprofessionals receive limited training and reach many older patient populations highly susceptible to influenza virus, we sought to examine socio-demographic correlates of seasonal flu vaccination receipt among HAs.

Methods: We used data from the 2007 U.S. National Home Health Aide Survey, the first nationally representative sample of HAs that reported on their occupational status, job and demographic characteristics and receipt of seasonal flu vaccine (n= 3,377). Predictors for receipt of seasonal flu vaccine were assessed using logistic regression with adjustment for sample design.

Results: Variation in seasonal flu vaccine receipt was noted among all HAs, including: home health (41%), home care (43%), personal care attendants (46%), hospice (49%), and other types of HAs (68%). HAs who did not receive flu vaccination were significantly more likely to be younger age, Black non-Hispanic, never married, with family income less than $20,000, and be employed as a hospice aide when compared to those who received vaccination (p<0.001). After adjustment for socio-demographic indicators (i.e. age and gender), home health, home care, hospice and personal care attendants were significantly less likely to report receiving seasonal flu vaccine as compared to other types of HAs (Adjusted odds ratio, AOR = 0.35, 95% CI [0.17–0.71]); 0.37,[0.16-0.87]; 0.48,[0.24-0.96], and 0.44,[0.21-0.89], respectively). Conclusion: Targeted effective vaccination campaigns are needed to improve vaccination rates among HAs.