Health Disparities
Uptake of the influenza and pneumococcal vaccines among immigrant and non-immigrant older adults in Canada: a cross-sectional analysis of data from the Canadian Longitudinal Study on Aging (CLSA) Ji Yoon Kim* Ji Yoon Kim Giorgia Sulis Alton Russell Seungmi Yang Jesse Papenburg Ananya Banerjee Patricia Li
Background: In Canada, influenza and pneumococcal vaccination rates in older adults fall below the national target of 80%. Immigrant status may be associated with lower uptake of both vaccines, but limited efforts have been made to explore such disparities. Therefore, we examined the association between immigrant status and uptake of influenza and pneumococcal vaccines among older adults as well as the relative importance of immigrant status in predicting uptake of both vaccines.
Methods: We conducted a cross-sectional secondary analysis of the Canadian Longitudinal Study on Aging data. We descriptively analyzed uptake of the vaccines by immigrant status and used Poisson regression models with robust standard errors to estimate the associations of immigrant status and other key equity stratifiers with vaccination. Importance of key determinants, including immigrant status, in predicting both vaccinations were assessed using random forest algorithms.
Results: Immigrant participants reported lower uptake of influenza vaccine in the past 12 months (63.8% [95% CI: 60.9-66.7%] vs. 66.9% [95% CI: 65.5-68.3%]) and pneumococcal vaccine ever (48.7% [95% CI: 45.6-51.8%] vs. 55.8% [95% CI: 54.3-57.3%]). Prevalence of influenza and pneumococcal vaccinations were both lower among immigrant participants compared to non-immigrant participants. Immigrant status was among the 10 most important predictors of pneumococcal vaccination, but among the less important predictors of influenza vaccination.
Conclusions: Overall, we found disparities in influenza and pneumococcal vaccination by immigrant status among older adults in Canada. Further studies on vaccine uptake and decision-making among marginalized communities, including immigrants, are warranted to equitably improve vaccine uptake.