County-Level Factors Associated With Influenza and COVID-19 Vaccination in Indiana, 2020‒2022.

Publication date: Feb 22, 2024

Objectives. To assess COVID-19 and influenza vaccination rates across Indiana’s 92 counties and identify county-level factors associated with vaccination. Methods. We analyzed county-level data on adult COVID-19 vaccination from the Indiana vaccine registry and 2021 adult influenza vaccination from the Centers for Disease Control and Prevention. We used multiple linear regression (MLR) to determine county-level predictors of vaccinations. Results. COVID-19 vaccination ranged from 31. 2% to 87. 6% (mean = 58. 0%); influenza vaccination ranged from 33. 7% to 53. 1% (mean = 42. 9%). In MLR, COVID-19 vaccination was significantly associated with primary care providers per capita (b = 0. 04; 95% confidence interval [CI] = 0. 02, 0. 05), median household income (b = 0. 23; 95% CI = 0. 12, 0. 34), percentage Medicare enrollees with a mammogram (b = 0. 29; 95% CI = 0. 08, 0. 51), percentage uninsured (b = -1. 22; 95% CI = -1. 57, -0. 87), percentage African American (b = 0. 31; 95% CI = 0. 19, 0. 42), percentage female (b = -0. 97; 95% CI = -1. 79, ‒0. 15), and percentage who smoke (b = -0. 75; 95% CI = -1. 26, -0. 23). Influenza vaccination was significantly associated with percentage uninsured (b = 0. 71; 95% CI = 0. 22, 1. 21), percentage African American (b = -0. 07; 95% CI = -0. 13, -0. 01), percentage Hispanic (b = -0. 28; 95% CI = -0. 40, -0. 17), percentage who smoke (b = -0. 85; 95% CI = -1. 06, -0. 64), and percentage who completed high school (b = 0. 54; 95% CI = 0. 21, 0. 87). The MLR models explained 86. 7% (COVID-19) and 70. 2% (influenza) of the variance. Conclusions. Factors associated with COVID-19 and influenza vaccinations varied. Variables reflecting access to care (e. g., insurance) and higher risk of severe disease (e. g., smoking) are notable. Programs to improve access and target high-risk populations may improve vaccination rates. (Am J Public Health. Published online ahead of print February 29, 2024:e1-e9. https://doi. org/10. 2105/AJPH. 2023. 307553).

Concepts Keywords
Hispanic B=
Indiana B=0
Influenza Ci=
Vaccinations Ci=0
County
Covid
Factors
Indiana
Influenza
Level
Mlr
Percentage
Rates
Vaccination
Vaccinations

Semantics

Type Source Name
disease MESH Influenza
disease MESH COVID-19
disease VO vaccination
disease VO vaccine

Original Article

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