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Journal of Public Health Advance Access originally published online on October 5, 2005
Journal of Public Health 2005 27(4):371-377; doi:10.1093/pubmed/fdi054
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© The Author 2005, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.

Influenza vaccine uptake and distribution in England and Wales using data from the General Practice Research Database, 1989/90–2003/04



Carol Joseph

Nichola Goddard

David Gelb
Carol Joseph, Consultant Clinical Scientist, Nichola Goddard, Senior Scientist, David Gelb, Senior Statistician, Respiratory Diseases Department, Health Protection Agency Centre for Infections, 61 Colindale Avenue, London NW9 5EQ, UK

Address correspondence to Carol Joseph. Email: carol.joseph{at}hpa.org.uk

Background Routinely collected data from patients registered with general practices participating in the General Practice Research Database (GPRD) were used to analyse influenza vaccine uptake and distribution in England and Wales between 1989/90 and 1996/97. Major changes to influenza immunization policy were introduced in 1998 and 2000 when immunization of the elderly became age related rather than risk related. This new study examines trends in vaccine uptake for high- and low-risk patients and the impact of the policy changes on uptake in the elderly.

Methods Between 0.5 and 2.7 million patients registered with practices participating in the GPRD from 1989 to 2004 were included. Data were examined by age group, medical risk group and evidence of vaccination per study year.

Results Vaccine uptake among high-risk persons aged 65 or more increased from 36.7 per cent in 1989/90 to 72.1 per cent in 2003/04. For the same period, uptake rates for high-risk persons under 65 years increased from 10.8 to 24.3 per cent. For those at high risk, uptake by females was higher in all age groups up to 65 years. Of those that were vaccinated, a higher proportion of the 65 and over were vaccinated in October each year compared with the high risk under 65 (p < 0.001).

Conclusions Coverage among high-risk patients in younger age groups continues to fall well below satisfactory levels, especially among the youngest groups. Government policy should now focus on ways to improve uptake in these patients.

Keywords: immunization, influenza, risk groups, vaccine uptake


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