Manas K Akmatov, Claudia Kohring, Jakob Holstiege, Doreen Müller
{"title":"[Utilization of the influenza vaccination among individuals over 60 years: spatial variations and regional risk factors].","authors":"Manas K Akmatov, Claudia Kohring, Jakob Holstiege, Doreen Müller","doi":"10.1007/s00103-025-04103-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The aims of the study were to determine the influenza vaccination coverage among individuals aged 60 and older, examine spatial variations, and identify spatial clusters as well as regional risk factors for low vaccination coverage.</p><p><strong>Methods: </strong>The study was based on nationwide outpatient claims data from 2022 and 2023. The study population consisted of 22,303,411 individuals with statutory health insurance aged 60 and older. The influenza vaccination coverage was calculated as the proportion of vaccinated individuals during the 2022/23 season among all persons with Statutory Health Insurance (SHI) who had contact with SHI-authorized physicians in 2022. Global spatial autocorrelation, local spatial clusters, and regional risk factors for low vaccination coverage were examined using global and local Moran's I as well as geographically weighted regression.</p><p><strong>Results: </strong>The nationwide influenza vaccination coverage was 37%, with district-level variations ranging from 10% to 61%. The global autocorrelation was 0.87 (global Moran's I, p < 0.0001). Two strongly pronounced local clusters were identified. A large spatial cluster with relatively high vaccination coverage spanned across all eastern federal states as well as districts in southeastern Lower Saxony, Schleswig-Holstein, and Hamburg. Another cluster with relatively low vaccination coverage encompassed almost all districts in southern Germany. The risk factors for low vaccination coverage included residence in western Germany and in sparsely populated rural districts. The density of general practitioners showed a positive correlation with vaccination coverage. The relationships between vaccination coverage and explanatory variables varied regionally.</p><p><strong>Discussion: </strong>The identification of spatial clusters and regional risk factors for low vaccination coverage can serve as a basis for regionally tailored intervention measures to improve vaccine uptake.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1138-1146"},"PeriodicalIF":1.5000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460560/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00103-025-04103-8","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/18 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The aims of the study were to determine the influenza vaccination coverage among individuals aged 60 and older, examine spatial variations, and identify spatial clusters as well as regional risk factors for low vaccination coverage.
Methods: The study was based on nationwide outpatient claims data from 2022 and 2023. The study population consisted of 22,303,411 individuals with statutory health insurance aged 60 and older. The influenza vaccination coverage was calculated as the proportion of vaccinated individuals during the 2022/23 season among all persons with Statutory Health Insurance (SHI) who had contact with SHI-authorized physicians in 2022. Global spatial autocorrelation, local spatial clusters, and regional risk factors for low vaccination coverage were examined using global and local Moran's I as well as geographically weighted regression.
Results: The nationwide influenza vaccination coverage was 37%, with district-level variations ranging from 10% to 61%. The global autocorrelation was 0.87 (global Moran's I, p < 0.0001). Two strongly pronounced local clusters were identified. A large spatial cluster with relatively high vaccination coverage spanned across all eastern federal states as well as districts in southeastern Lower Saxony, Schleswig-Holstein, and Hamburg. Another cluster with relatively low vaccination coverage encompassed almost all districts in southern Germany. The risk factors for low vaccination coverage included residence in western Germany and in sparsely populated rural districts. The density of general practitioners showed a positive correlation with vaccination coverage. The relationships between vaccination coverage and explanatory variables varied regionally.
Discussion: The identification of spatial clusters and regional risk factors for low vaccination coverage can serve as a basis for regionally tailored intervention measures to improve vaccine uptake.
背景：本研究的目的是确定60岁及以上人群的流感疫苗接种覆盖率，检查空间变化，确定低疫苗接种覆盖率的空间聚集性和区域危险因素。方法：研究基于2022年和2023年全国门诊索赔数据。研究人群包括22303411名60岁及以上拥有法定健康保险的个人。流感疫苗接种覆盖率计算为2022/23年接种疫苗的个人在2022年与法定健康保险（SHI）授权医生接触的所有人中的比例。利用全球和局部Moran's I以及地理加权回归分析了低疫苗接种率的全球空间自相关、局部空间聚类和区域危险因素。结果：全国流感疫苗接种率为37%，地区差异在10% ~ 61%之间。全球自相关系数为0.87（全球Moran’s I, p ）。讨论：确定低疫苗接种率的空间集群和区域危险因素可以作为区域定制干预措施的基础，以提高疫苗接种率。
期刊介绍：
Die Monatszeitschrift Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - umfasst alle Fragestellungen und Bereiche, mit denen sich das öffentliche Gesundheitswesen und die staatliche Gesundheitspolitik auseinandersetzen.
Ziel ist es, zum einen über wesentliche Entwicklungen in der biologisch-medizinischen Grundlagenforschung auf dem Laufenden zu halten und zum anderen über konkrete Maßnahmen zum Gesundheitsschutz, über Konzepte der Prävention, Risikoabwehr und Gesundheitsförderung zu informieren. Wichtige Themengebiete sind die Epidemiologie übertragbarer und nicht übertragbarer Krankheiten, der umweltbezogene Gesundheitsschutz sowie gesundheitsökonomische, medizinethische und -rechtliche Fragestellungen.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
