Patterns of influenza vaccination coverage in the United States from 2009 to 2015

Alice P.Y. Chiu, Jonathan Dushoff, Duo Yu, Daihai He

Research output: Journal article publicationJournal articleAcademic researchpeer-review

19 Citations (Scopus)


Influenza vaccination has shown substantial protective effectiveness in the United States. Methods We investigated state-level patterns of coverage rates of seasonal and pandemic influenza vaccination, among the overall population (six months or older) in the U.S. and specifically among children (aged between 6 months and 17 years) and the elderly (aged 65 years or older), from 2009/10 to 2014/15, and associations with ecological factors. We obtained state-level influenza vaccination rates from national surveys, and state-level socio-demographic and health data from a variety of sources. We employed a retrospective ecological study design, and used both linear models and linear mixed-effect models to determine the levels of ecological association of the state-level vaccinations rates with these factors, both with and without region as a factor for the three populations. Results and Conclusions Health-care access has a robust, positive association with state-level vaccination rates across all populations and models. This highlights a potential population-level advantage of expanding health-care access. We also found that prevalence of asthma in adults is negatively associated with mean influenza vaccination rates in the elderly populations.
Original languageEnglish
Pages (from-to)122-127
Number of pages6
JournalInternational Journal of Infectious Diseases
Publication statusPublished - 1 Dec 2017


  • Ecological study
  • Influenza
  • Mixed model
  • Vaccination coverage

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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