Determinants of Receiving the Pandemic (H1N1) 2009 Vaccine and Intention to Receive the Seasonal Influenza Vaccine in Taiwan

<div><p>Objectives</p><p>The paper examines the factors associated with both receiving pandemic (H1N1) 2009 vaccines and individuals’ intentions to get the next seasonal influenza vaccine in Taiwan.</p><p>Methods</p><p>We conducted a representative nationwide survey with in-person household interviews during April–July 2010. Multivariate logistic regression incorporated socio-demographic background, household characteristics, health status, behaviors, and perceptions of influenza and vaccination.</p><p>Results</p><p>We completed interviews with 1,954 respondents. Among those, 548 (28.0%) received the pandemic (H1N1) 2009 vaccination, and 469 (24.0%) intended to get the next seasonal influenza vaccine. Receipt of the H1N1 vaccine was more prevalent among schoolchildren, the elderly, those who had contact with more people in their daily lives, and those who had received influenza vaccinations in previous years. In comparison, the intention to receive the next seasonal influenza vaccine tended to be stronger among children, the elderly, and those who reported less healthy status or lived with children, who received a seasonal influenza vaccination before, and who worried more about a possible new pandemic.</p><p>Conclusions</p><p>Children, the elderly, and those who had gotten seasonal flu shots before in Taiwan were more likely to both receive a pandemic H1N1 vaccination and intend to receive a seasonal influenza vaccine.</p></div

Selected variables associated with intention to get seasonal influenza vaccines.

<p>IQR interquartile range (25th percentile–75th percentile).</p

Multivariate logistic regression for covariates of intention to get seasonal influenza vaccines.

<p>Multivariate logistic regression for covariates of intention to get seasonal influenza vaccines.</p

Selected variables associated with receipt of pandemic (H1N1) 2009 vaccination.

<p>IQR interquartile range (25th percentile–75th percentile).</p

Priorities for the influenza vaccination plan in Taiwan during the 2009–2010 influenza season.

<p>Priorities for the influenza vaccination plan in Taiwan during the 2009–2010 influenza season.</p

Survival percentages of out-of-hospital cardiac arrests (OHCA) by district in areas with high (> = 5,000 persons/km²) and low (< 5,000 persons/km²) population densities of Kaohsiung City, 2011–2013.

<p>Survival percentages of out-of-hospital cardiac arrests (OHCA) by district in areas with high (> = 5,000 persons/km²) and low (< 5,000 persons/km²) population densities of Kaohsiung City, 2011–2013.</p

The residual maps after geographically weighted regression.

<p>(A) Male (B) Female.</p

Geographic Disparity in Chronic Obstructive Pulmonary Disease (COPD) Mortality Rates among the Taiwan Population

<div><p>Chronic obstructive pulmonary disease (COPD) causes a high disease burden among the elderly worldwide. In Taiwan, the long-term temporal trend of COPD mortality is declining, but the geographical disparity of the disease is not yet known. Nationwide COPD age-adjusted mortality at the township level during 1999–2007 is used for elucidating the geographical distribution of the disease. With an ordinary least squares (OLS) model and geographically weighted regression (GWR), the ecologic risk factors such as smoking rate, area deprivation index, tuberculosis exposure, percentage of aborigines, density of health care facilities, air pollution and altitude are all considered in both models to evaluate their effects on mortality. Global and local Moran’s I are used for examining their spatial autocorrelation and identifying clusters. During the study period, the COPD age-adjusted mortality rates in males declined from 26.83 to 19.67 per 100,000 population, and those in females declined from 8.98 to 5.70 per 100,000 population. Overall, males’ COPD mortality rate was around three times higher than females’. In the results of GWR, the median coefficients of smoking rate, the percentage of aborigines, PM₁₀ and the altitude are positively correlated with COPD mortality in males and females. The median value of density of health care facilities is negatively correlated with COPD mortality. The overall adjusted R-squares are about 20% higher in the GWR model than in the OLS model. The local Moran’s I of the GWR’s residuals reflected the consistent high-high cluster in southern Taiwan. The findings indicate that geographical disparities in COPD mortality exist. Future epidemiological investigation is required to understand the specific risk factors within the clustering areas.</p></div

Interpolation of the interval from the call to hospital admission by using the Kriging method.

<p>Areas marked with red indicate a prolonged interval of an out-of-hospital cardiac arrest (OHCA) case from the call to hospital admission, while areas marked with green show a short interval (<30 min). Uncolored areas are locations without sufficient interpolation information (sparse OHCA event points).</p

Flow chart of the study design.

<p>Abbreviations: CPR: cardiopulmonary resuscitation; AED: automated external defibrillator; LMA: laryngeal mask airway.</p