Prevalence and predictors of influenza vaccination among frail, community-living elderly patients: an international observational study.

The annual winter outbreak of influenza is one of the major cause of morbidity and mortality among frail elderly people. The aim of the present study was to identify prevalence and predictors of influenza vaccination in a large European population of frail and old people living in community. This was an observational study conducted in 11 European countries. We enrolled 3878 people 65 years and older already receiving home care services within the urban areas. All participants were assessed with the Minimum Data Set-Home Care (MDS-HC) instrument containing over 300 items, including socio-demographic, physical and cognitive characteristics of patients as well as medical diagnoses and medications received. A single question about the influenza vaccination status was used. The rate of influenza vaccination was around 59% of the studied sample. Significant geographical variations were evident in the prevalence of vaccination ranging from 31% of Prague (Czech Republic) to 88% of Rotterdam (The Netherlands). Overall, persons living alone were less likely to receive influenza vaccine as compared with those living with an informal caregiver (OR, 0.78; 95% CI 0.67-0.90). Similarly, cognitive impairment and presence of economic problems were associated with a lower likelihood of being vaccinated (OR: 0.69, 95% CI 0.59-0.80 and OR, 0.58; 95% CI 0.45-0.74, respectively). On the other hand, old age and comorbidity were associated with an higher probability of being vaccinated. In conclusion, more than 40% of subjects in this sample of home care patients in Europe did not receive influenza vaccination. Recommendations for influenza vaccination have not been adequately implemented.