Analysis of influenza vaccination coverage among the elderly living in Rome, based on a deprivation index, 2009-13


Influenza vaccination
Vaccine coverage



Elderly people are more likely to develop influenza-related complications, but despite the recommendations, the optimal vaccination coverage is not reached. The use of deprivation indices can help identifying subgroups with lower vaccine uptake. We analyzed vaccination coverage of elderly living in the city of Rome based on their socioeconomic characteristics using a local deprivation index.


We focused on population ≥65 years living in the city of Rome from 2009 to 2013. Information about vaccination coverage was collected from general practitioners. A combination of multivariate techniques, including multiple linear regression, factor and cluster analysis, was used to construct a composite area-based deprivation index. The index was calculated for each census tract, based on data from the 2001 Italian census.


The majority of elderly living in the city of Rome belonged to the medium (40.4%) and medium-high (24%) deprivation groups, and only 4.5% of the population was in the low deprivation group. An inverse relationship was found between influenza vaccination coverage and deprivation index: elderly from low deprivation group had lower coverage (55.45%) in respect to high deprivation group (57.59%). In particular, vaccination coverage decreased with the increase of replacement index, employment rate and the percentage of: singles, divorced; graduates and higher school graduates; employed, entrepreneurs and freelancers, family assistants, students; foreigners and stateless persons residing in Italy; families of one person.


Our results show an inverse relationship between deprivation and vaccination coverage and may help identifying subgroups that could benefit from targeted initiatives to increase vaccination coverage.