Does Sex Influence Immunization Status for Influenza and Pneumonia in Older Veterans?

Authors

  • Bevanne Bean-Mayberry MD, MHS,

    1. From the *Veterans Affairs Greater Los Angeles Health Services Research and Development Center of Excellence, Center for the Study of Health Care Provider Behavior, Sepulveda, CaliforniaDepartment of Medicine, School of Medicine and Department of Health Services, School of Public Health, University of California at Los Angeles, Los Angeles, California§Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PennsylvaniaDepartment of Sociology, University of Pittsburgh, Pittsburgh, Pennsylvania#Veterans Affairs Palo Alto Healthcare System, Palo Alto, California; and **Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Elizabeth M. Yano PhD, MSPH,

    1. From the *Veterans Affairs Greater Los Angeles Health Services Research and Development Center of Excellence, Center for the Study of Health Care Provider Behavior, Sepulveda, CaliforniaDepartment of Medicine, School of Medicine and Department of Health Services, School of Public Health, University of California at Los Angeles, Los Angeles, California§Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PennsylvaniaDepartment of Sociology, University of Pittsburgh, Pittsburgh, Pennsylvania#Veterans Affairs Palo Alto Healthcare System, Palo Alto, California; and **Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Maria K. Mor PhD,

    1. From the *Veterans Affairs Greater Los Angeles Health Services Research and Development Center of Excellence, Center for the Study of Health Care Provider Behavior, Sepulveda, CaliforniaDepartment of Medicine, School of Medicine and Department of Health Services, School of Public Health, University of California at Los Angeles, Los Angeles, California§Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PennsylvaniaDepartment of Sociology, University of Pittsburgh, Pittsburgh, Pennsylvania#Veterans Affairs Palo Alto Healthcare System, Palo Alto, California; and **Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Nichole K. Bayliss BA, MA,

    1. From the *Veterans Affairs Greater Los Angeles Health Services Research and Development Center of Excellence, Center for the Study of Health Care Provider Behavior, Sepulveda, CaliforniaDepartment of Medicine, School of Medicine and Department of Health Services, School of Public Health, University of California at Los Angeles, Los Angeles, California§Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PennsylvaniaDepartment of Sociology, University of Pittsburgh, Pittsburgh, Pennsylvania#Veterans Affairs Palo Alto Healthcare System, Palo Alto, California; and **Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Xiangyan Xu MPH,

    1. From the *Veterans Affairs Greater Los Angeles Health Services Research and Development Center of Excellence, Center for the Study of Health Care Provider Behavior, Sepulveda, CaliforniaDepartment of Medicine, School of Medicine and Department of Health Services, School of Public Health, University of California at Los Angeles, Los Angeles, California§Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PennsylvaniaDepartment of Sociology, University of Pittsburgh, Pittsburgh, Pennsylvania#Veterans Affairs Palo Alto Healthcare System, Palo Alto, California; and **Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Michael J. Fine MD, MSc

    1. From the *Veterans Affairs Greater Los Angeles Health Services Research and Development Center of Excellence, Center for the Study of Health Care Provider Behavior, Sepulveda, CaliforniaDepartment of Medicine, School of Medicine and Department of Health Services, School of Public Health, University of California at Los Angeles, Los Angeles, California§Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PennsylvaniaDepartment of Sociology, University of Pittsburgh, Pittsburgh, Pennsylvania#Veterans Affairs Palo Alto Healthcare System, Palo Alto, California; and **Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
    Search for more papers by this author

  • The views in this article do not necessarily represent the views of the Department of Veterans Affairs.

Address correspondence to Bevanne Bean-Mayberry, VA Greater Los Angeles HSR&D Center of Excellence, Sepulveda Ambulatory Care Center and Nursing Home, 16111 Plummer Street, Sepulveda, CA 91343. E-mail: bevanne.bean-mayberry@va.gov

Abstract

OBJECTIVES: To compare the prevalence of influenza and pneumococcal immunization rates according to sex in a national sample of older veterans in the Department of Veterans Affairs (VA) healthcare system.

DESIGN: Retrospective, cross-sectional.

SETTING: VA healthcare system.

PARTICIPANTS: Current VA healthcare system users aged 65 and older eligible for immunization in fiscal years 2001 to 2003 (N=48,424 patient records).

MEASUREMENTS: Generalized estimating equations were performed to analyze combined chart review and administrative data to determine effect of sex on receipt of influenza and pneumococcal immunizations.

RESULTS: Unadjusted immunization rates were higher for men than women for influenza (73% vs 69%) and pneumococcal (87% vs 83%) vaccine. Adjusting for demographics, clinical comorbidities, use, and region, women had significantly lower odds of influenza (odds ratio (OR)=0.85, 95% confidence interval (CI=0.79–0.92) and pneumococcal (OR=0.77, 95% CI=0.71–0.84) immunization.

CONCLUSION: Older female veterans have lower rates of immunization than older male veterans in VA settings. Although VA remains above community levels for immunization, older female veterans will benefit from targeted efforts to increase immunization prevalence.

Ancillary