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Prev Med . Differences in influenza vaccination by gender identity and state-level gender equity policies: Behavioral risk factor surveillance syst

tetano

Editor, Senior Moderator
Prev Med


. 2023 Mar 30;107485.
doi: 10.1016/j.ypmed.2023.107485. Online ahead of print.
Differences in influenza vaccination by gender identity and state-level gender equity policies: Behavioral risk factor surveillance system, 2015-2019


Sarah N Cox[SUP] 1 [/SUP], Mark A Fajans[SUP] 2 [/SUP], Collrane J Frivold[SUP] 3 [/SUP], Alyson J Littman[SUP] 4 [/SUP], Jennifer E Balkus[SUP] 5 [/SUP]



Affiliations

Abstract

Background: It is estimated that there are 1.4 million transgender and over 700,000 non-binary people in the United States, many of whom face barriers to health care access that contribute to health disparities Although previous studies have reported greater vaccine uptake in cisgender women compared to men, national-level estimates of influenza vaccine uptake among transgender and non-binary people are unknown. This analysis characterizes lack of influenza vaccine uptake by gender identity and examines associations between vaccination status and state-level gender equity policies.
Methods: We used cross-sectional data from adults participating in the 2015-2019 United States Behavioral Risk Factors Surveillance System surveys. Weighted prevalence differences per 100 (PDs) and confidence intervals (CIs) of being unvaccinated against influenza by self-reported gender identity (cisgender woman, cisgender man, transgender women, transgender man, gender non-conforming) were estimated using generalized linear regression models.
Results: Compared to cisgender women (unvaccinated prevalence = 57.3%), the prevalence of being unvaccinated was higher among cisgender men (64.4%; PD = 7.0 95% CI: 6.7-7.4), transgender women (65.4%; PD = 8.1, 95% CI 4.0-12.2), transgender men (64.6%; PD = 7.3, 95% CI: 2.7-11.8), and gender non-conforming individuals (64.6%; PD = 7.2, 95% CI: 1.3-13.2). This pattern was similar among individuals living in states with protective versus restrictive gender equity policies.
Conclusions: Our results identified a disparity in influenza vaccine uptake by gender identity. Future research should explore barriers to and facilitators of vaccine uptake among transgender and non-binary populations, which could inform policies and health promotion interventions co-designed and implemented with the transgender and non-binary communities.

Keywords: Gender; Health equity; Health policy; Immunization; Influenza; Non-binary; Transgender; Vaccination; Vaccine uptake.
 
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