, Volume 41, Issue 2, pp 465-471
Date: 12 Feb 2013

Adherence and factors associated with influenza vaccination among subjects with asthma in Spain

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Influenza has a high morbidity and mortality rate and an increased risk of complications in vulnerable individuals. Children and adults with asthma have a high risk of complications, hospitalisation and even death. The objectives of this study were as follows: to compare influenza vaccination coverage in Spain in a population of asthmatics aged ≥16 years with an equivalent population of non-asthmatics; to identify the factors that influence vaccination coverage among patients with asthma; and to compare coverage during the period 2006/2007 with that of 2009/2010.


We used data from the 2009 European Health Survey (EHS), which included a population of 22,188 individuals (≥16 years of age), of whom 1,669 [7.5 %; 95 % confidence interval (CI), 7.13–7.98] had asthma. The dependent variable was the answer (yes/no) to a question asking whether or not the interviewed person had been vaccinated against seasonal (not pandemic) influenza in the previous season. As independent variables, we analysed socio-demographic characteristics, health-related variables and the use of health care services.


Vaccination coverage was 35.2 % (95 % CI, 32.5–37.9) among asthmatics and 22.1 % (95 % CI, 21.4–22.7) among non-asthmatics (p < 0.001). The probability of being vaccinated is almost twice as high for asthmatics as it is for non-asthmatics [odds ratio (OR), 1.92; 95 % CI, 1.69–2.17]. Among asthmatics, vaccination coverage increased with age, worse self-rated health status and not smoking. No significant change in coverage was observed between the study periods.


Seasonal influenza vaccination coverage among Spanish asthmatics is lower than desired and has not improved in recent years. Urgent strategies are necessary in order to increase vaccination coverage among asthmatics.