Association of social-economic development with influenza vaccination among older residents in Guizhou province: a spatial autocorrelation analysis

  Objective   To analyze region-specific correlation of social-economic condition with influenza vaccination among residents aged ≥ 65 years for providing evidences to developing strategies on influenza vaccination in the elderly.

  Methods  The information on all ≥ 65 years old residents vaccinated with influenza vaccine during an influenza epidemic season (September 1, 2020 – April 30, 2021) in Guizhou province were collected from Guizhou Province Planned Immunization Infor-mation System; county/district specific data on demographics and social-economic development of the same period were extracted from statistics yearbooks of Guizhou province simultaneously. Geographical visualization analyses were performed on the data collected; correlation coefficient and spatial autocorrelation were adopted to assess the relationships between social-economic indicators and the elderly′s influenza vaccination.

  Results  The overall influenza vaccination rate for the ≥ 65 year old population in the province was 2.15% (84 155/3 905 500) and the highest county/district specific rate was 15.84% (16 418/103 630). Pearson correlation analysis showed that gross domestic production (GDP), regional GDP per capita, and regional disposable income per permanent resident were positively correlated with influenza vaccination rate, with the highest correlation coefficient of 0.73 for the correlation between the disposable income per permanent resident and the influenza vaccination rate (P < 0.01). The results of global spatial autocorrelation analysis revealed a non-random distribution of influenza vaccination prevalence and a spatial autocorrelation of the vaccination rate (Moran′s I = 0.5718, Z = 9.4449, P < 0.001). Further two variable spatial autocorrelation analysis indicated joint spatial autocorrelation of the county/district specific influenza vaccination rate and GDP (Moran′s I = 0.3743, Z = 7.2968, P < 0.001), GDP per capita (Moran′s I = 0.3914, Z = 7.4309, P < 0.001), and disposable income per permanent resident (Moran′s I = 0.5224, Z = 8.9407, P < 0.001).

  Conclusion  From a spatial perspective, there is a positive correlation between regional influenza vaccination rate in ≥ 65 years old population and social-economic condition, suggesting that special attention should be paid to influenza vaccination among elderly people in regions with underdeveloped social-economic condition.