Open Access Research article

Influenza vaccine uptake among community-dwelling Italian elderly: results from a large cross-sectional study

Carlos Chiatti12*, Pamela Barbadoro1, Giovanni Lamura2, Lucia Pennacchietti1, Francesco Di Stanislao1, Marcello M D'Errico1 and Emilia Prospero1

Author Affiliations

1 Department of Biomedical Sciences, Section of Hygiene and Public Health, Polytechnic University of the Marche Region, via Tronto, 10/a, Torrette di Ancona, 60020, Italy

2 Department of Gerontological Research, Italian National Research Centre on Ageing - I.N.R.C.A., Via Santa Margherita 5, Ancona, 60100, Italy

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BMC Public Health 2011, 11:207  doi:10.1186/1471-2458-11-207

Published: 1 April 2011



Flu vaccination significantly reduces the risk of serious complications like hospitalization and death among community-dwelling older people, therefore vaccination programmes targeting this population group represent a common policy in developed Countries. Among the determinants of vaccine uptake in older age, a growing literature suggests that social relations can play a major role.


Drawing on the socio-behavioral model of Andersen-Newman - which distinguishes predictors of health care use in predisposing characteristics, enabling resources and need factors - we analyzed through multilevel regressions the determinants of influenza immunization in a sample of 25,183 elderly reached by a nationally representative Italian survey.


Being over 85-year old (OR = 1.99; 95% CI 1.77 - 2.21) and suffering from a severe chronic disease (OR = 2.06; 95% CI 1.90 - 2.24) are the strongest determinants of vaccine uptake. Being unmarried (OR = 0.81; 95% CI 0.74 - 0.87) and living in larger households (OR = 0.83; 95% CI 0.74 - 0.87) are risk factors for lower immunization rates. Conversely, relying on neighbors' support (OR = 1.09; 95% CI 1.02 - 1.16) or on privately paid home help (OR = 1.19; 95% CI 1.08 - 1.30) is associated with a higher likelihood of vaccine uptake.


Even after adjusting for socio-demographic characteristics and need factors, social support, measured as the availability of assistance from partners, neighbors and home helpers, significantly increases the odds of influenza vaccine use among older Italians.

influenza vaccine; older people; Italy