| Popis: |
Despite the implementation of incentive policies to promote seasonal flu vaccination for more than 20 years in France, the coverage of high-risk individuals remains largely insufficient. While there is extensive literature on the determinants of vaccination in a given year, it rarely considers the specificity of flu vaccination, which must be repeated every autumn to remain effective. We aim to fill this gap by focusing on the flu vaccination behavior of high-risk individuals (65 years and older, chronic diseases) over a 15-year period. Based on data from 87,820 women in the French E3N cohort, we used sequence analysis methods (localized Optimal Matching) to identify typical seasonal flu vaccination profiles based on individual trajectories from 2004 to 2018. Then, using a multinomial model, we studied the individual determinants associated with the different patterns of vaccination use identified. Sequence analysis resulted in a partition of 8 clusters, which can be summarized into 4 typical behaviors: almost half of the women get vaccinated against flu each year (43%); conversely, another important share never get vaccinated against flu (32%); some do not get vaccinated for several years and then get vaccinated every year (20%); and finally, a minor share discontinued vaccination (5%). Thus, once women start getting vaccinated they generally continue every year. Nonetheless, this is a double-edged sword, as an important share of women considered at risk refrain from being vaccinated for more than a decade. Determinants associated with regular vaccination are being more at risk (age, weight, and chronic diseases), being in contact with physicians, being more educated, being in couple, having children, not smoking, and undergoing breast cancer screening. |
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