Observational studyBMJ open2018
Influenza-associated hospitalisation, vaccine uptake and socioeconomic deprivation in an English city region: an ecological study.
Observational study in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Association of socio-economic and clinical factors with influenza vaccination uptake in high-risk individuals: an Italian retrospective cohort study, 2019-2023.International journal of health geographics · 2025Article
- Navigating the crossroads of health and wealth: socioeconomic inequality in flu vaccination uptake among the elderly in Iran.BMC geriatrics · 2025Article
- A thematic analysis of flu vaccine hesitance in ethnically minoritised communities in Liverpool.PloS one · 2025Article
- Article
- Social health gradient and risk factors among patients hospitalized for COVID-19 and pre-pandemic respiratory infections. A linked national individual case-control study in Belgium.Frontiers in public health · 2024Article
- Evaluating socioeconomic inequalities in influenza vaccine uptake during the COVID-19 pandemic: A cohort study in Greater Manchester, England.PLoS medicine · 2023Article
- Neighborhood disadvantage and immune-related illnesses among residents living in the US Gulf States.Annals of epidemiology · 2023Article
- Impact of social deprivation on clinical outcomes of adults hospitalised with community-acquired pneumonia in England: a retrospective cohort study.BMJ open respiratory research · 2022Article
- Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review.Vaccines · 2022Review
- COVID-19-What Price Do Children Pay? An Analysis of Economic and Social Policy Factors.International journal of environmental research and public health · 2022Review
- Influenza vaccine uptake among at-risk adults (aged 16-64 years) in the UK: a retrospective database analysis.BMC public health · 2021Article
- Article
- Risk factors associated with outbreaks of seasonal infectious disease in school settings, England, UK.Epidemiology and infection · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesEvery year, influenza poses a significant burden on the National Health Service in England. Influenza vaccination is an effective measure to prevent severe disease, hence, maximising vaccine coverage in the most vulnerable is a priority. We aimed to identify the extent to which socioeconomic status is associated with influenza-associated illness (IAI) and influenza vaccine coverage.
designRetrospective observational study using hospital episode statistics.
settingMerseyside, North-West of England, including the city of Liverpool.
participantsResidents of Merseyside hospitalised with IAI between April 2004 and March 2016, and Merseyside general practice registered patients eligible for influenza vaccination in 2014/2015 and 2015/2016 influenza seasons. EXPOSURES: Socioeconomic deprivation based on lower super output area English Indices of Deprivation scores. PRIMARY AND SECONDARY OUTCOME MEASURES: Incidence and risk of IAI hospitalisation, and vaccine uptake.
resultsThere were 89 058 hospitalisations related to IAI among Merseyside residents (mean yearly rate=4.9 per 1000 population). Hospitalisations for IAI were more frequent in the most socioeconomically deprived areas compared with the least deprived in adults aged 15-39 years (incidence rate ratio (IRR) 2.08;95% CI 1.76 to 2.45; p<0.001), 60-64 years (IRR 2.65; 95% CI 2.35 to 2.99; p<0.001) and 65+ years (IRR 1.90; 95% CI 1.73 to 2.10; p<0.001), whereas rates in children were more homogeneous across deprivation strata. Vaccine uptake was lower than the nationally set targets in most neighbourhoods. The odds of vaccine uptake were 30% lower (OR 0.70; 95% CI 0.66 to 0.74; p<0.001) and 10% lower (OR 0.90; 95% CI 0.88 to 0.92; p<0.001) in the most socioeconomically deprived quintile compared with the least deprived, among children aged 24-59 months and 65+ years, respectively.
conclusionsHigher rates of IAI hospitalisations and lower vaccine uptake in the most socioeconomically deprived populations suggest that health promotion policies and interventions that target these populations should be a priority.
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