ArticlePharmacoEconomics - open2021
State-Level Variations and Factors Associated with Adult Vaccination Coverage: A Multilevel Modeling Approach.
Article in PharmacoEconomics - open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Impact of Vaccines Across the Lifespan: A New Perspective in Public Health-Conclusions of an Expert Panel-Part 1.Vaccines · 2026Review
- Tetanus Control in the United States and Global Disaster Settings: Public Health Disparities and Prevention Strategies.Medicina (Kaunas, Lithuania) · 2026Review
- Adult vaccination coverage in the United States: A database analysis and literature review of improvement strategies.Human vaccines & immunotherapeutics · 2024Review
- State and territory immunization program activities and their association with human papillomavirus vaccine initiation in the United States of America: A multilevel approach.PLOS global public health · 2024Article
- State policies increase vaccination by shaping social norms.Scientific reports · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdult vaccination rates in the USA are generally low and fall short of public health goals.
objectivesOur aim was to evaluate the effect of state-level characteristics on adult vaccination coverage in the USA.
methodsThis study was a cross-sectional, retrospective analysis of 2015-2017 Behavioral Risk Factor Surveillance System data, conducted from March to October 2019 and including seasonal influenza; pneumococcal; tetanus, diphtheria, and acellular pertussis (Tdap); and herpes zoster (HZ) vaccines. Multilevel logistic regression models examined interstate vaccination coverage variability and assessed the impact of state-level characteristics, with model-adjusted coverage estimated.
resultsModel-adjusted vaccination coverage varied by state, with 35.1-48.1% coverage for influenza (2017), 68.2-80.8% for pneumococcal (2017), 21.9-46.5% for Tdap (2016), and 30.5-50.9% for HZ (2017). Characteristics associated with vaccination included state-level insurance coverage, pharmacists' vaccination authority, vaccination exemptions, and adult immunization information systems participation, as well as individual-level measures of income and education. After adjusting for these factors, substantial interstate heterogeneity remained.
conclusionsModel-adjusted coverage was generally low and varied by state. A small number of state-level characteristics partially explained interstate coverage variability. This and future research assessing additional state characteristics may help determine policies most likely to increase adult vaccination.
Identifiers
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Registered trials
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