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Benedict Kpozehouen E, Macintyre CR, Tan TC. Determinants of uptake of influenza, zoster and pneumococcal vaccines in patients with cardiovascular diseases. Vaccine 2024; 42:3404-3409. [PMID: 38704255 DOI: 10.1016/j.vaccine.2024.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 02/13/2024] [Accepted: 04/09/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Globally, cardiovascular disease (CVD) is the leading cause of death and illness. Vaccine-preventable infections may increase acute coronary vascular disease events and the risk of complications. Low vaccine coverage has been reported among adults at high risk of complications from vaccine-preventable infections. There is a gap in research evidence around determinants of uptake of vaccines among adults with CVD. This study examined the uptake of influenza, pneumococcal and zoster vaccines and the determinants of uptake of the vaccines among cardiac patients. METHOD A prospective cross-sectional study was carried out among hospitalised cardiac patients through an interviewer-administered questionnaire. Descriptive statistics were used to investigate self-reported uptake of influenza, pneumococcal and zoster vaccines. Univariate and multivariate analyses of participants' social demographic and clinical characteristics were conducted to identify factors for receiving influenza vaccine. RESULTS Low vaccination rates among 104 participants were found for influenza (45.2%), pneumococcal (13.5%) and zoster (5.8%) vaccines. The most common reason for not receiving influenza vaccine was concern about side effects. Lack of awareness about the pneumococcal and zoster vaccines was the main reason for the poor uptake of these vaccines. Australia-born participants were more likely to receive influenza vaccine than overseas-born participants. Working-age participants and, interestingly, people living with a current smoker were less likely to receive influenza vaccine. CONCLUSION Influenza, pneumococcal and zoster vaccine uptake among cardiac patients was low. Encouraging physician recommendations for vaccination for cardiac patients under 65 years of age and addressing vaccination challenges among people from culturally and linguistically diverse backgrounds and pharmacy, workplace, and hospital vaccination may help increase vaccination uptake among cardiac patients.
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Affiliation(s)
| | | | - Timothy C Tan
- Department of Cardiology, Blacktown Hospital, NSW 2148, Australia; Western Sydney University, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Australia
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Binte Hossain F, Muscatello D, Jayasinghe S, Jonnagaddala J, Liu B. Uptake of pneumococcal vaccines in older Australian adults before and after universal public funding of PCV13. Vaccine 2024; 42:3084-3090. [PMID: 38584056 DOI: 10.1016/j.vaccine.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 03/25/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND In 2020 Australia changed the funded universal older adult pneumococcal vaccination program from use of the 23-valent pneumococcal polysaccharide vaccine (PPV23) at age 65 to the 13-valent pneumococcal conjugate vaccine (PCV13) at age 70 years. We investigated uptake of both PCV13 and PPV23 in older adults before and after the program change. METHODS We analysed a national dataset of records of patients attending general practices (GPs). We included regular attendees aged 65 or above in 2020. Cumulative uptake of PCV13 and monthly uptake of PPV23 was compared for the two periods before (January 2019 to June 2020) and after (July 2020 to May 2021) the program change on 1 July 2020, by age groups and presence of comorbid conditions. RESULTS Our study included data from 192,508 patients (mean age in 2020: 75.1 years, 54.2 % female, 46.1 % with at least one comorbidity). Before July 2020, for all adults regardless of underlying comorbidities, the cumulative uptake of PCV13 was < 1 % but by May 2021, eleven months after the program changes, cumulative uptake of PCV13 had increased among those aged 70-79 years (without comorbidity: 16.3 %; with comorbidity: 21.1 %) and 80 + years (without comorbidity: 13.5 %; with comorbidity: 17.7 %), but not among those aged 65-69 years (without comorbidity: 1.3 %; with comorbidity: 3 %). Monthly uptake of PPV23 dropped following the program change across all age groups. CONCLUSIONS Changes in uptake of PCV13 and PPV23 among those aged 70 + years were consistent with program changes. However, PCV13 uptake was still substantially lower in individuals aged 65-69 years overall and in those with comorbidities.
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Affiliation(s)
- Fariha Binte Hossain
- School of Population Health, UNSW, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW 2033, Australia.
| | - David Muscatello
- School of Population Health, UNSW, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW 2033, Australia
| | - Sanjay Jayasinghe
- National Centre for Immunisation Research and Surveillance (NCIRS), Kids Research, Sydney Children's Hospitals Network, Cnr Hawkesbury Rd & Hainsworth St, Westmead, NSW 2145, Australia; Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney 2145, Australia
| | - Jitendra Jonnagaddala
- School of Population Health, UNSW, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW 2033, Australia
| | - Bette Liu
- School of Population Health, UNSW, Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW 2033, Australia; National Centre for Immunisation Research and Surveillance (NCIRS), Kids Research, Sydney Children's Hospitals Network, Cnr Hawkesbury Rd & Hainsworth St, Westmead, NSW 2145, Australia
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Mastrovito B, Lardon A, Dubromel A, Nave V, Beny K, Dussart C. Understanding the gap between guidelines and influenza vaccination coverage in people with diabetes: a scoping review. Front Public Health 2024; 12:1360556. [PMID: 38706547 PMCID: PMC11066301 DOI: 10.3389/fpubh.2024.1360556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/09/2024] [Indexed: 05/07/2024] Open
Abstract
Background Diabetes affects millions of people worldwide, making them more vulnerable to infections, including seasonal influenza. It is therefore particularly important for those suffering from diabetes to be vaccinated against influenza each year. However, influenza vaccination coverage remains low in this population. This review primarily aims to identify the determinants of influenza vaccination in people with diabetes (T1D or T2D). Secondly, it aims to assess main recommendations for influenza vaccination, vaccine effectiveness, vaccination coverage, and how education and pharmacists can encourage uptake of the vaccine in the diabetic population. Methods A scoping review was conducted in January 2022 to systematically review evidence on influenza vaccination in people with diabetes using data from PubMed, Science Direct, and EM Premium with terms such as "Diabetes mellitus," "Immunization Programs," "Vaccination," and "Influenza Vaccines." Quality assessment and data extraction were independently conducted by two authors. Disagreements between the authors were resolved through discussion and consensus, and if necessary, by consulting a third author. Results Of the 333 records identified, 55 studies met the eligibility criteria for inclusion in this review. Influenza vaccination was recommended for people ≥6 months. Despite effectiveness evidence showing a reduction in mortality and hospitalizations in people with diabetes vaccinated vs. non-vaccinated ones, very few studies reported a coverage rate ≥ 75%, which is WHO's target objective. Determinants such as advanced age, presence of comorbidities and healthcare givers' advice were associated with increased vaccination uptake. On the contrary, fear of adverse reactions and concerns about vaccine effectiveness were significant barriers. Finally, education and pharmacists' intervention played a key role in promoting vaccination and increasing vaccination uptake. Conclusion Influenza vaccination coverage in people with diabetes remains low despite recommendations and evidence on vaccine effectiveness. Motivators and barriers as well as several socio-demographic and clinical factors have been identified to explain this trend. Efforts are now needed to increase the number of diabetics vaccinated against influenza, mainly through education and the involvement of healthcare givers.
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Affiliation(s)
- Brice Mastrovito
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Alexia Lardon
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Amelie Dubromel
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Viviane Nave
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Karen Beny
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Claude Dussart
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
- EA 4129 P2S Parcours Santé Systémique, Claude Bernard University Lyon 1, Lyon, France
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Chen H, Li Q, Zhang M, Gu Z, Zhou X, Cao H, Wu F, Liang M, Zheng L, Xian J, Chen Q, Lin Q. Factors associated with influenza vaccination coverage and willingness in the elderly with chronic diseases in Shenzhen, China. Hum Vaccin Immunother 2022; 18:2133912. [PMID: 36269145 DOI: 10.1080/21645515.2022.2133912] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Elderly individuals with chronic illnesses are more prone to get influenza. We aimed to investigate the factors associated with influenza coverage and willingness in chronic disease patients aged ≥60 years in Longhua district, Shenzhen City of southern China. Data collected in October 2020 were used in this work. The immunization status of older persons with chronic conditions and their willingness to receive the vaccine were assessed. Multivariable logistic regression was employed to determine the respective independent factors related to vaccination coverage and willingness for influenza. Only 4.8% of 5045 people were immunized against influenza, whereas 92.7% of the individuals agreed to receive the vaccine. Individuals between the ages of 70 and 79 (adjusted OR [aOR] 1.47, P = .012), those with higher education levels (aOR 1.53, P = .005 for high school; aOR 2.44, P < .001 for college or above), those who use of a family doctor (aOR 2.91, P < .001), those who frequently have physical examinations once a year (aOR 2.52, P < .001), and those who have never smoked (aOR 1.62, P = .018) were positively associated with the influenza vaccination. Meanwhile, older age was adversely linked with influenza vaccination willingness (aOR 0.68 for 70-79 years, P = .003; aOR 0.55 for≥80 years, P = .025) in contrast to those aged 60-69. High willingness to get vaccinated was more frequent in people with a high school diploma (aOR 1.33, P = .037). In this work, we observed that the coverage is poor but the immunization desire is high regarding influenza vaccination. Interestingly, older age was associated with higher coverage and lower willingness. These suggest that raising immunization rates among older people with chronic conditions and strengthening health education for caregivers should be the primary concerns.
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Affiliation(s)
- Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Qiushuang Li
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Minyi Zhang
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Zihao Gu
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Xiaofeng Zhou
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - He Cao
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Fei Wu
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Minyi Liang
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Liting Zheng
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Juxian Xian
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, Guangdong, China
| | - Qihui Lin
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, Guangdong, China
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Trent MJ, Salmon DA, MacIntyre CR. Predictors of pneumococcal vaccination among Australian adults at high risk of pneumococcal disease. Vaccine 2022; 40:1152-1161. [DOI: 10.1016/j.vaccine.2022.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/04/2022] [Accepted: 01/08/2022] [Indexed: 01/31/2023]
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Eilat-Tsanani S, Vashitz-Giwnewer A. Uptake of pneumococcal vaccination in older people in northern Israel. Prev Med Rep 2021; 24:101553. [PMID: 34976622 PMCID: PMC8683891 DOI: 10.1016/j.pmedr.2021.101553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/06/2021] [Accepted: 09/04/2021] [Indexed: 11/18/2022] Open
Abstract
A database research presents uptake of pneumococcal vaccine in people older than 65. A databased retrospective research following 20,591 people older than 65 years for uptake of pneumococcal vaccine during 5 years. The research was conducted in a large HMO that provided the vaccine free of charge. Uptake of the vaccine was associated with other health promotion activities. Uptake of the vaccine was not associated with visits to family health clinics.
The 23-valent pneumococcal vaccine is recommended for people aged 65 years and over, to prevent pneumonia, a leading cause of infectious morbidity in older people. This study assessed pneumococcal vaccination in people aged 65–74 years living in northern Israel who were eligible for the pneumococcal vaccine since introduction free of charge. This retrospective study used the database of Clalit Health Services, the largest health maintenance organization in Israel. We fitted a Cox regression model to assess associations of vaccine uptake with sociodemographic and clinical characteristics, and a Wilcoxon rank-sum test and Chi-square test to assess associations of vaccine uptake with the performance of other health-related activities. The analysis included 20,591 people. People aged 65–70 were more likely to take the vaccine than people aged 71–74 [HR = 1.8; CI: 1.6–1.9]. Jews were more likely to take it than Arabs [HR = 1.1; CI: 1.0–1.2], and men were more likely to take it than women [HR = 1.1; CI: 1.0–1.2]. In women who took the vaccine, the rate of performance of mammography was higher (61.9 % ± 45.3 vs 50.3% ± 44.5, p < 0.0001). A similar trend was found for men and women with respect to occult blood tests (36.3% ± 31.5 vs 31.7% ± 30, p < 0.0001). Frequency of visits to family medicine clinics was negatively associated with vaccination. Uptake of the pneumococcal vaccine was associated with some parameters indicative of self-care but not with the level of exposure to the primary health care staff. After-hours health promotion activities by trained personnel may be an effective way to cope with the gap in performance.
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Affiliation(s)
- Sophia Eilat-Tsanani
- The Department of Family Medicine, Clalit Health Services, Northern Region, POB 685, Nof Hagalil 17106 Israel
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
- Corresponding author at: Afula region office, Emek Medical Center, 101 Rabin av., Afula, Israel.
| | - Ayelet Vashitz-Giwnewer
- The Department of Family Medicine, Clalit Health Services, Northern Region, POB 685, Nof Hagalil 17106 Israel
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Gibney KB, MacLachlan J, Coutts R, Higgins N, Strachan J. Incidence of Invasive Pneumococcal Disease Higher Among People Notified With Markers of Hepatitis C Virus Infection: Population-based Surveillance in Victoria, Australia, 2001-2017. Clin Infect Dis 2021; 72:e319-e325. [PMID: 32750118 DOI: 10.1093/cid/ciaa1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Worse outcomes from invasive pneumococcal disease (IPD) have been reported among those coinfected with hepatitis C. We aimed to establish if IPD notification rates are higher among people notified with markers of hepatitis C virus infection than the general population. METHODS IPD cases notified in Victoria, Australia, from July 2001-December 2017 were linked with hepatitis C cases (diagnosed by serology or PCR testing) notified from January 1991-December 2017. IPD incidence was calculated using population data and the estimated number of Victorians with hepatitis C. RESULTS From July 2001-December 2017, 6407 IPD cases were notified. Hepatitis C infection was notified in 342 (5.3%) of IPD cases overall, and 24.4% among IPD cases aged 45-49 years. Among IPD cases also notified with hepatitis C, 55.3% were infected with 13-valent pneumococcal conjugate vaccine serotypes and 82.8% with 23-valent pneumococcal polysaccharide vaccine serotypes. Compared with IPD cases without hepatitis C, IPD cases also notified with hepatitis C were younger (mean age, 45.7 vs 49.4 years; P = .011) and more often male (65.5% vs 55.5%, P < .001). Annual IPD notification incidence was 6.8/100 000 among people without hepatitis C and 39.4/100 000 among people with hepatitis C (IRR, 5.8; 95% CI, 5.2-6.4; P < .001). CONCLUSIONS IPD notification incidence was 5 times higher among people notified with markers of hepatitis C than the general population. Pneumococcal vaccination should be offered to people with markers of hepatitis C virus infection. To facilitate appropriate treatment, young and middle-aged adults with IPD should be tested for hepatitis C.
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Affiliation(s)
- Katherine B Gibney
- Health Protection Branch, Victorian Department of Health and Human Services, Melbourne, Australia.,The Peter Doherty Institute of Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | - Jennifer MacLachlan
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Rachel Coutts
- Health Protection Branch, Victorian Department of Health and Human Services, Melbourne, Australia
| | - Nasra Higgins
- Health Protection Branch, Victorian Department of Health and Human Services, Melbourne, Australia
| | - Janet Strachan
- Health Protection Branch, Victorian Department of Health and Human Services, Melbourne, Australia
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Almasri L, Holtzclaw BJ. Assessing Vaccine Protection for Older Adults with Diabetes: A Systematic Review. West J Nurs Res 2021; 44:582-597. [PMID: 33845695 DOI: 10.1177/01939459211005710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Immunosenescence and comorbidities increase the susceptibility of older adults with diabetes mellitus (DM) to vaccine-preventable diseases, hospitalization, disability, or death. This systematic review synthesizes research on protecting older adults with DM during pandemics, exploring vaccine safety, tolerance, and vaccination uptake by older adults in anticipation of seasonal influenza outbreaks during the current COVID-19 threat. Addressed were: (a) age-related factors influencing the effectiveness of vaccines against infectious disease in older adults; (b) vaccine safety, tolerance, effectiveness for older persons with DM; and (c) issues affecting older adults accepting immunization recommendations. Medline and CINAHL databases yielded 214 studies with 43 meeting inclusion criteria (32 descriptive and 11 controlled trials). Findings show altered glycemic control stimulates proinflammatory mediators, increasing infection risk, vaccines, and annual revaccinations safely reduce hospitalization rates, mortality outcomes, without affecting glycemic control. However, vaccines fail to evoke optimal antibody responses in older adults. Unawareness, fear of side effects, tend to lower vaccination participation.
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Affiliation(s)
- Leena Almasri
- Donald W. Reynolds Center of Geriatric Nursing Excellence, Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Barbara J Holtzclaw
- Donald W. Reynolds Center of Geriatric Nursing Excellence, Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Pneumococcal Vaccine in Adult Asthma Patients. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1289:55-62. [PMID: 32696445 DOI: 10.1007/5584_2020_562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Streptococcus pneumoniae is the most frequent source of community-acquired bacterial pneumonia in adults. Respiratory tract infections are the foremost reasons for asthma exacerbations. The World Health Organization and the Centers for Disease Control and Prevention consider asthma a clear indication for pneumococcal vaccination. The aim of this study was to determine the extent to which adult patients with asthma in Poland adhere to a schedule of recommended pneumococcal vaccinations. In addition, the study attempted to assess the source of the patient knowledge on vaccination and the plausible determents for vaccination. The study was conducted among patients at specialist outpatient clinics in the form of an anonymous survey that contained questions about asthma, vaccines, and the knowledge and motivations. A total of 214 patients (149 females and 65 males) of the mean age of 52 ± 17 years were interviewed. A staggering 93% of patients did not receive pneumococcal vaccination, and only 24% of patients were aware of the need for this vaccine. Age, gender, and education did not affect whether patients chose to receive the vaccine. The most often quoted reason for not receiving the vaccine was lack of information, followed by lack of faith in vaccine efficacy, and the fear of adverse effects. From the standpoint of health hazard stemming from prophylaxis avoidance, it appears paramount to educate asthmatic patients on the benefits of receiving pneumococcal vaccination.
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Knowledge, Attitudes and Practices of Flu Vaccination in Hemodialysis Patients. Vaccines (Basel) 2021; 9:vaccines9020077. [PMID: 33498996 PMCID: PMC7912544 DOI: 10.3390/vaccines9020077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/04/2021] [Accepted: 01/19/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Hemodialysis (HD) patients have an increased risk of morbidity and mortality due to infections. Despite the positive effect of vaccinations, the implementation of this method of prophylaxis is low. OBJECTIVES This study aimed to explore the knowledge, attitudes and practices of flu vaccination among HD patients of two different dialysis centers. METHODS A total of 193 patients (mean age 63.6 years), who voluntarily agreed to participate in an anonymous survey related to influenza vaccination, were enrolled in this cross-sectional study. RESULTS A total of 45% of patients declared that they took regular, annual flu vaccination. In this group, 87.4% believed that vaccinations were effective. This opinion strongly correlated with the frequency of regular vaccinations (r = 0.56, p < 0.01). Multivariate logistic regression revealed that this opinion is an independent predictor of regular vaccinations with adjusted OR 9.86 (95% CI 4.36, 22.33). Groups of patients who had been irregularly or never vaccinated reject vaccinations for the following reasons: fear of adverse events-29.2%, conviction that vaccination was ineffective-26.4%, and lack of information about vaccination-22.6%. CONCLUSION Knowledge among HD patients about the benefits of vaccinations is poor. Therefore, educational activities are required. Active vaccination promotion and education of patients rejecting this method of prevention play a key role in improving standards of care for HD patients.
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Arsenović S, Gazibara T. Factors associated with seasonal influenza immunization in people with chronic diseases. MEDICINSKI PODMLADAK 2021. [DOI: 10.5937/mp72-31846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Annually, at a global level, 3 to 5 million people present severe clinical forms of seasonal influenza and up to 650 000 people die of influenza-related complications. People with chronic diseases, such as cardiovascular, pulmonary, renal, hepatic, neurologic, hematologic and metabolic diseases or those reciveing immunosuppressive therapy, constitute a high-risk population group for the development of influenza-related complications, more severe clinical course and poorer health-related outcomes. Due to all of the above, people with chronic diseases are of high priority to receive the influenza vaccine. Immunization represents the key strategy to prevent influenza both in terms of effectiveness and health care costs. Based on the World Health Organization (WHO) recommendations, adequate seasonal influenza immunization coverage among people with chronic diseases is set at 75%. However, few countries achieve this threshold. Understanding predictive factors of vaccination, at different levels of health care delivery (such as individuals, service providers, health policy), is essential to secure acceptance of influenza immunization and achieve the recommended level of vaccination coverage. In this mini review, all the available evidence regarding seasonal influenza vaccination coverage is summarized, alongside factors associated with vaccine uptake in people with chronic diseases as a whole, as well as according to specific diseases such as: cardiovascular and pulmonary disorders, diabetes and cancer. Based on the reviewed empirical evidence, a wide spectrum of factors associated with immunization against influneza was found in people who have chronic diseases. Although diverse, these factors can be systematized into 4 distinctive groups: socio-demographic characteristics, individual attitudes and beliefs, health promoting behaviors and factors related to the health care system. Further efforts are needed to improve the seasonal influenza vaccination coverage. The immunization strategy needs to include the health care system and the community to support people with chronic diseases to continously accept the influenza vaccine.
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Bigaj J, Czaicki N, Zielonka TM. Factors Affecting Influenza Vaccination Rate in Adults with Asthma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1279:101-111. [PMID: 32424493 DOI: 10.1007/5584_2020_519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Asthma is considered one of the most common noncommunicable diseases worldwide, with an incidence of 5.4% in the Polish, adult population. Symptoms of the disease can be triggered or worsened by a variety of factors including viral infection such as influenza, affirming the necessity for prophylactic vaccination. However, there is concern among the general population of the possibility of anaphylactic response to vaccination, which can deter patients with allergic asthma for fear of triggering exacerbation of their condition. The objective of the study was to determine the extent to which patients with asthma adhere to a schedule of recommended vaccinations in Poland. Two hundred fourteen patients were recruited from specialist outpatient clinics in Warsaw to complete voluntarily an anonymous questionnaire created for the purpose of this study. Within the past year, 82% stated having at least one respiratory infection, and 72% of patients were aware of the recommendation for annual vaccination against the flu. Forty-three percent of patients reported receiving the flu vaccine at least once, and only 20% followed through with annual vaccination. The most common sources of information about the importance of annual flu vaccination were from their doctors (47%) and the media (26%). Relatively few asthmatic patients in Warsaw get annual flu vaccinations despite the recommendations. These results were mainly sourced due to uncorrected fears and a lack of information about the importance of prophylaxis in asthma. It is essential to create effective strategies to inform patients with asthma of the importance of annual vaccinations.
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Affiliation(s)
- Jeremy Bigaj
- Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, North Wales, UK
| | - Natalie Czaicki
- Ipswich Hospital, East Suffolk and North Essex NHS Foundation Trust, Colchester, UK
| | - Tadeusz M Zielonka
- Department of Family Medicine, Medical University of Warsaw, Warsaw, Poland.
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13
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Perceptions of influenza and pneumococcal vaccine uptake by older persons in Australia. Vaccine 2019; 37:4454-4459. [DOI: 10.1016/j.vaccine.2019.06.079] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 01/21/2023]
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Bertoldo G, Pesce A, Pepe A, Pelullo CP, Di Giuseppe G. Seasonal influenza: Knowledge, attitude and vaccine uptake among adults with chronic conditions in Italy. PLoS One 2019; 14:e0215978. [PMID: 31042752 PMCID: PMC6493755 DOI: 10.1371/journal.pone.0215978] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 04/11/2019] [Indexed: 11/19/2022] Open
Abstract
This cross-sectional study aimed at evaluating the knowledge and attitudes concerning influenza vaccination in Southern Italy, and investigating the potential determinants of vaccine uptake. The sample consisted of 700 adults (mean age 58.7y) with chronic diseases attending four public specialty clinics in Italy. Overall, 64.7% of the participants were aware that influenza can be prevented with vaccines and that patients with chronic diseases are at higher risk of developing severe complications. Less than half of the sample (42.1%) received influenza vaccine in the last season, and 46.9% declared the will to receive influenza vaccination in the next season. The level of awareness was significantly lower among the elderly (> = 65y) and those with a higher self-reported health. A significantly higher likelihood of vaccination was observed among the elderly, the subjects with a higher knowledge about vaccine utility and safety, the participants with chronic respiratory diseases, and those who had taken more drugs. Future education programs and communication strategies are strongly needed in adults with chronic diseases to improve influenza vaccination knowledge and uptake.
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Affiliation(s)
- Gaia Bertoldo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples (Italy)
| | - Annalisa Pesce
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples (Italy)
| | - Angela Pepe
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples (Italy)
| | - Concetta Paola Pelullo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples (Italy)
| | - Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples (Italy)
- * E-mail:
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Shono A, Hoshi SL, Kondo M. The impact on vaccination coverage following introduction of a routine pneumococcal vaccination programme for the elderly in Japan. Vaccine 2018; 36:5886-5890. [PMID: 30143271 DOI: 10.1016/j.vaccine.2018.08.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 06/07/2018] [Accepted: 08/09/2018] [Indexed: 01/05/2023]
Abstract
In October 2014, a routine pneumococcal vaccination programme in the elderly aged 65-100 years old was initiated in Japan. Currently, this programme is within a transitional period. Eligibility for subsidy under the programme is granted for target ages in 5-year increments, over a 5-year roll-out period. We assessed the impact of the routine vaccination programme on vaccination coverage and explored the factors relating to pneumococcal vaccine uptake. We conducted a cross-sectional web-based survey in 2015 for respondents aged 65-79 years. A total of 3889 respondents answered the survey. The vaccination coverage in this study was estimated as 33.5%. Of the total respondents, 3327 were not vaccinated at initiation of the routine vaccination programme. The uptake of vaccination after implementation of the programme among them was 22.3%. There was a significant relationship between vaccination and eligibility for subsidy under the routine vaccination programme (adjusted odds ratio: 16.7). While there are some limitations to this study, introduction of the routine vaccination programme might affect pneumococcal vaccination coverage in the elderly.
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Affiliation(s)
- Aiko Shono
- Department of Public Health and Epidemiology, Faculty of Pharmaceutical Sciences, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo 204-8588, Japan.
| | - Shu-Ling Hoshi
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8577, Japan
| | - Masahide Kondo
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8577, Japan
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Schwarze J, Openshaw P, Jha A, Giacco SR, Firinu D, Tsilochristou O, Roberts G, Selby A, Akdis C, Agache I, Custovic A, Heffler E, Pinna G, Khaitov M, Nikonova A, Papadopoulos N, Akhlaq A, Nurmatov U, Renz H, Sheikh A, Skevaki C. Influenza burden, prevention, and treatment in asthma-A scoping review by the EAACI Influenza in asthma task force. Allergy 2018; 73:1151-1181. [PMID: 29105786 DOI: 10.1111/all.13333] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2017] [Indexed: 12/19/2022]
Abstract
To address uncertainties in the prevention and management of influenza in people with asthma, we performed a scoping review of the published literature on influenza burden; current vaccine recommendations; vaccination coverage; immunogenicity, efficacy, effectiveness, and safety of influenza vaccines; and the benefits of antiviral drugs in people with asthma. We found significant variation in the reported rates of influenza detection in individuals with acute asthma exacerbations making it unclear to what degree influenza causes exacerbations of underlying asthma. The strongest evidence of an association was seen in studies of children. Countries in the European Union currently recommend influenza vaccination of adults with asthma; however, coverage varied between regions. Coverage was lower among children with asthma. Limited data suggest that good seroprotection and seroconversion can be achieved in both children and adults with asthma and that vaccination confers a degree of protection against influenza illness and asthma-related morbidity to children with asthma. There were insufficient data to determine efficacy in adults. Overall, influenza vaccines appeared to be safe for people with asthma. We identify knowledge gaps and make recommendations on future research needs in relation to influenza in patients with asthma.
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Affiliation(s)
- J. Schwarze
- Centre for Inflammation Research The Queens Medical Research Institute University of Edinburgh Edinburgh UK
| | - P. Openshaw
- Respiratory Sciences National Heart and Lung Institute Imperial College London London UK
| | - A. Jha
- Respiratory Sciences National Heart and Lung Institute Imperial College London London UK
| | - S. R. Giacco
- Department of Medical Sciences and Public Health “M. Aresu” University of Cagliari Cagliari Italy
| | - D. Firinu
- Department of Medical Sciences and Public Health “M. Aresu” University of Cagliari Cagliari Italy
| | | | - G. Roberts
- Faculty of Medicine Southampton and David Hide Asthma and Allergy Centre St Mary's Hospital University of Southampton Newport Isle of Wight UK
| | - A. Selby
- Faculty of Medicine Southampton and David Hide Asthma and Allergy Centre St Mary's Hospital University of Southampton Newport Isle of Wight UK
| | - C. Akdis
- Swiss Institute of Allergy and Asthma Research University of Zurich Davos Switzerland
| | - I. Agache
- Department of Allergy and Clinical Immunology Faculty of Medicine Transylvania University Brasov Brasov Romania
| | - A. Custovic
- Department of Paediatrics Imperial College London London UK
| | - E. Heffler
- Personalized Medicine Asthma and Allergy Clinic Department of Biomedical Sciences Humanitas University Milan Italy
| | - G. Pinna
- Department of Medical Microbiology National Kapodistrian University of Athens Athens Greece
| | - M. Khaitov
- National Research Center Institute of Immunology of Federal Medicobiological Agency Moscow Russia
| | - A. Nikonova
- National Research Center Institute of Immunology of Federal Medicobiological Agency Moscow Russia
| | - N. Papadopoulos
- Division of Infection, Inflammation & Respiratory Medicine The University of Manchester Manchester UK
- Allergy Department 2nd Paediatric Clinic National Kapodistrian University of Athens Athens Greece
| | - A. Akhlaq
- Department of Health and Hospital Management Institute of Business Management Korangi Creek Karachi 75190 Pakistan
| | - U. Nurmatov
- Division of Population Medicine School of Medicine Cardiff University the National Centre for Population Health and Wellbeing Research Wales UK
| | - H. Renz
- Institute of Laboratory Medicine and Pathobiochemistry Molecular Diagnostics Philipps University Marburg University Hospital Giessen & Marburg Marburg Germany
| | - A. Sheikh
- Asthma UK Centre for Applied Research Usher Institute of Population Health Sciences and Informatics The University of Edinburgh Edinburgh UK
| | - C. Skevaki
- Institute of Laboratory Medicine and Pathobiochemistry Molecular Diagnostics Philipps University Marburg University Hospital Giessen & Marburg Marburg Germany
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Davis TME, Kauhanen J, Davis WA. Pneumococcal vaccination and incident hospitalisation for pneumonia in type 2 diabetes: the Fremantle Diabetes Study Phase
II. Intern Med J 2017; 47:1206-1210. [DOI: 10.1111/imj.13569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/28/2017] [Accepted: 04/03/2017] [Indexed: 01/13/2023]
Affiliation(s)
- Timothy M. E. Davis
- School of Medicine and Pharmacology University of Western Australia, Fremantle Hospital Fremantle Western Australia Australia
| | - Jane Kauhanen
- Department of Endocrinology and Diabetes Fremantle Hospital Fremantle Western Australia Australia
| | - Wendy A. Davis
- School of Medicine and Pharmacology University of Western Australia, Fremantle Hospital Fremantle Western Australia Australia
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Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of Influenza Vaccination Intention and Behavior - A Systematic Review of Influenza Vaccine Hesitancy, 2005 - 2016. PLoS One 2017; 12:e0170550. [PMID: 28125629 PMCID: PMC5268454 DOI: 10.1371/journal.pone.0170550] [Citation(s) in RCA: 713] [Impact Index Per Article: 101.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 01/06/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Influenza vaccine hesitancy is a significant threat to global efforts to reduce the burden of seasonal and pandemic influenza. Potential barriers of influenza vaccination need to be identified to inform interventions to raise awareness, influenza vaccine acceptance and uptake. OBJECTIVE This review aims to (1) identify relevant studies and extract individual barriers of seasonal and pandemic influenza vaccination for risk groups and the general public; and (2) map knowledge gaps in understanding influenza vaccine hesitancy to derive directions for further research and inform interventions in this area. METHODS Thirteen databases covering the areas of Medicine, Bioscience, Psychology, Sociology and Public Health were searched for peer-reviewed articles published between the years 2005 and 2016. Following the PRISMA approach, 470 articles were selected and analyzed for significant barriers to influenza vaccine uptake or intention. The barriers for different risk groups and flu types were clustered according to a conceptual framework based on the Theory of Planned Behavior and discussed using the 4C model of reasons for non-vaccination. RESULTS Most studies were conducted in the American and European region. Health care personnel (HCP) and the general public were the most studied populations, while parental decisions for children at high risk were under-represented. This study also identifies understudied concepts. A lack of confidence, inconvenience, calculation and complacency were identified to different extents as barriers to influenza vaccine uptake in risk groups. CONCLUSION Many different psychological, contextual, sociodemographic and physical barriers that are specific to certain risk groups were identified. While most sociodemographic and physical variables may be significantly related to influenza vaccine hesitancy, they cannot be used to explain its emergence or intensity. Psychological determinants were meaningfully related to uptake and should therefore be measured in a valid and comparable way. A compendium of measurements for future use is suggested as supporting information.
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Affiliation(s)
- Philipp Schmid
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Dorothee Rauber
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Cornelia Betsch
- Center for Empirical Research in Economics and Behavioral Sciences, University of Erfurt, Erfurt, Germany
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Gianni Lidolt
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
| | - Marie-Luisa Denker
- Department of Media and Communication Sciences, University of Erfurt, Erfurt, Germany
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Influenza Vaccination Coverage Among Polish Patients with Chronic Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 968:19-34. [PMID: 28315129 DOI: 10.1007/5584_2016_193] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Patients at a high-risk of severe influenza, because of their underlying health disorders, are recommended to receive a seasonal influenza vaccination. In Poland, influenza coverage rate in the general population is very low (3.4 %). However, there is little known about the coverage rate among high-risk patients. The aim of this study was to describe a general knowledge, perception, and influenza vaccination coverage rate among Polish patients with enhanced risk for influenza. We conducted a self-reported survey among 500 patients with chronic disorders: 120 pulmonary, 80 hemodialyzed, 100 thyroid cancer, and 200 cardiovascular patients. We found the following influenza vaccination coverage in the respective groups of patients: 58 % in pulmonary, 34 % in hemodialyzed, 32 % in cardiovascular, and 9 % in thyroid cancer patients. The difference between the coverage rate in pulmonary patients compared with the other risk groups was significant (p < 0.05). In pulmonary patients, the most important barrier for influenza vaccination was a lack of recommendations from healthcare workers, while a high awareness of influenza was the most powerful driver for vaccination (p < 0.05). We conclude that although the influenza vaccination coverage in Polish patients with chronic diseases is higher than that reported in the general population, this rate remains much below the recommended level and should be improved.
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Dyda A, Karki S, Hayen A, MacIntyre CR, Menzies R, Banks E, Kaldor JM, Liu B. Influenza and pneumococcal vaccination in Australian adults: a systematic review of coverage and factors associated with uptake. BMC Infect Dis 2016; 16:515. [PMID: 27670446 PMCID: PMC5037616 DOI: 10.1186/s12879-016-1820-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 09/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the absence of an adult vaccination register, coverage estimates for influenza and pneumococcal vaccination come from surveys and other data sources. METHODS Systematic review and meta-analysis of studies examining vaccination coverage in Australian adults from 1990 to 2015, focusing on groups funded under the National Immunisation Program, and intervals prior to and following the introduction of universal funding. RESULTS Twenty-two studies met the inclusion criteria; 18 used self-report to determine vaccination status. There were 130 unique estimates of coverage extracted. Among adults aged ≥65y, during the period of universal funding (1999-onwards), the summary estimate of annual influenza vaccination coverage from 27 point estimates was 74.8 % (95 % CI 73.4-76.2 %; range 63.9-82.4 %); prior to this period (1992-1998) from 10 point estimates it was 61.3 % (95 % CI 58.0-64.6 %; range 44.3-71.3 %). For the period of universal funding for pneumococcal vaccination (2005-onwards) the summary estimate for coverage was 56.0 % (95 % CI 53.2-58.8 %; range 51.2-72.8 %, 10 point estimates); prior to 2005 it was 35.4 % (95 % CI 18.8-52.0 %; range 15.4-45.2 %). Coverage for both vaccines was significantly higher following the introduction of universal funding. Influenza vaccination coverage in those aged 18-65 years with a medical indication was lower but data were not combined. Seven studies reported on Aboriginal Australians with three studies reporting five coverage estimates for influenza vaccination in adults ≥65 years (range 71 % - 89 %). CONCLUSIONS Adult influenza and pneumococcal vaccination coverage has increased since the introduction of universal funding, but remains sub-optimal, with pneumococcal coverage lower than influenza. IMPLICATIONS This review highlights the need for more coverage data overall and in high risk groups, to support public health programs to improve coverage.
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Affiliation(s)
- Amalie Dyda
- School of Public Health and Community Medicine, University of New South Wales (UNSW), Sydney, New South Wales (NSW), Australia.
| | - Surendra Karki
- School of Public Health and Community Medicine, University of New South Wales (UNSW), Sydney, New South Wales (NSW), Australia
| | - Andrew Hayen
- School of Public Health and Community Medicine, University of New South Wales (UNSW), Sydney, New South Wales (NSW), Australia
| | - C Raina MacIntyre
- School of Public Health and Community Medicine, University of New South Wales (UNSW), Sydney, New South Wales (NSW), Australia
| | - Robert Menzies
- School of Public Health and Community Medicine, University of New South Wales (UNSW), Sydney, New South Wales (NSW), Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, Australian Capital Territory, Australia
| | | | - Bette Liu
- School of Public Health and Community Medicine, University of New South Wales (UNSW), Sydney, New South Wales (NSW), Australia
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Domínguez A, Soldevila N, Toledo D, Godoy P, Torner N, Force L, Castilla J, Mayoral JM, Tamames S, Martín V, Egurrola M, Sanz F, Astray J, Project PI12/02079 Working Group. Factors associated with pneumococcal polysaccharide vaccination of the elderly in Spain: A cross-sectional study. Hum Vaccin Immunother 2016; 12:1891-9. [PMID: 27064311 PMCID: PMC4964813 DOI: 10.1080/21645515.2016.1149661] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 01/15/2016] [Accepted: 01/29/2016] [Indexed: 09/30/2022] Open
Abstract
Vaccination of the elderly is an important factor in limiting the impact of pneumonia in the community. The aim of this study was to investigate the factors associated with pneumococcal polysaccharide vaccination in patients aged ≥ 65 years hospitalized for causes unrelated to pneumonia, acute respiratory disease, or influenza-like illness in Spain. We made a cross-sectional study during 2013-2014. A bivariate analysis was performed comparing vaccinated and unvaccinated patients, taking into account sociodemographic variables and risk medical conditions. A multivariate analysis was performed using multilevel regression models. 921 patients were included; 403 (43.8%) had received the pneumococcal vaccine (394 received the polysaccharide vaccine). Visiting the general practitioner ≥ 3 times during the last year (OR = 1.79; 95% CI 1.25-2.57); having received the influenza vaccination in the 2013-14 season (OR = 2.57; 95% CI 1.72-3.84) or in any of the 3 previous seasons (OR = 11.70; 95% CI 7.42-18.45) were associated with receiving the pneumococcal polysaccharide vaccine. Pneumococcal vaccination coverage of hospitalized elderly people is low. The elderly need to be targeted about pneumococcal vaccination and activities that encourage healthcare workers to proactively propose vaccination might be useful. Educational campaigns aimed at the elderly could also help to increase vaccination coverages and reduce the burden of pneumococcal disease in the community.
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Affiliation(s)
- Angela Domínguez
- Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Núria Soldevila
- Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Diana Toledo
- Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pere Godoy
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Catalunya, Barcelona, Spain
- Institut de Recerca Biomèdica de Lleida, Universitat de Lleida, Lleida, Spain
| | - Núria Torner
- Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Luis Force
- Unidad de Enfermedades Infecciosas, Hospital de Mataró, Mataró, Spain
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Salud Pública, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | | | - Sonia Tamames
- Dirección General de Salud Pública, Investigación, Desarrollo e Innovación, Junta de Castilla y León, León, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Área de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Mikel Egurrola
- Servicio de Neumología, Hospital de Galdakao-Usansolo, Vizcaya, Spain
| | - Francisco Sanz
- Servicio de Neumología, Consorci Hospital General Universitari de Valencia, Valencia, Spain
| | - Jenaro Astray
- Área de Epidemiología, Consejería de Sanidad de Madrid, Madrid, Spain
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Lu PJ, O'Halloran A, Ding H, Srivastav A, Williams WW. Uptake of Influenza Vaccination and Missed Opportunities Among Adults with High-Risk Conditions, United States, 2013. Am J Med 2016; 129:636.e1-636.e11. [PMID: 26551981 PMCID: PMC5831078 DOI: 10.1016/j.amjmed.2015.10.031] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 10/15/2015] [Accepted: 10/15/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Since 1960, the Advisory Committee on Immunization Practices has recommended influenza vaccination for adults with certain high-risk conditions because of increased risk for complications from influenza infection. We assessed national influenza vaccination among persons ages 18-64 years with high-risk conditions. METHODS We analyzed data from the 2012 and 2013 National Health Interview Survey. The Kaplan-Meier survival analysis procedure was used to estimate the cumulative proportion of influenza vaccination among adults ages 18-64 years with high-risk conditions. Potential missed opportunities for influenza vaccination were also evaluated. Multivariable logistic regression and predictive marginal analyses were conducted to identify factors independently associated with vaccination. RESULTS Overall, 39.9 million adults ages 18-64 years (18.9%) had at least one high-risk condition. For adults ages 18-64 years with high-risk conditions, overall influenza vaccination coverage was 49.5%. Coverage among adults 50-64 years of age was significantly higher compared with those ages 18-49 years (59.3% vs 39.0%; P <.05). Among adults ages 18-64 years, coverage was 46.2% for those with chronic lung diseases, 50.5% for those with heart disease, 58.0% for those with diabetes, 62.5% for those with renal disease, and 56.4% for those with cancer. Overall, 90.1% reported at least one visit to a health care setting where vaccination could have been provided. Among adults ages 18-64 years with high-risk conditions, older age, being female, Hispanic ethnicity or Asian race, having one or more physician visits, a regular physician for health care, health insurance, and having ever received pneumococcal vaccination were independently associated with a higher likelihood of influenza vaccination. Being widowed/divorced/separated or never married and not being employed were independently associated with a lower likelihood of influenza vaccination. CONCLUSIONS Influenza vaccination coverage varies substantially by age and high-risk conditions but remains low. Approximately 50% of those with high-risk conditions remain unvaccinated. Health care providers should ensure they routinely assess influenza vaccination status, and recommend and offer vaccines to those with high-risk conditions.
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Affiliation(s)
- Peng-Jun Lu
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Ga.
| | - Alissa O'Halloran
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Ga; Leidos Inc, Atlanta, Ga
| | - Helen Ding
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Ga; Eagle Medical Services LLC, San Antonio, Tex
| | - Anup Srivastav
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Ga; Leidos Inc, Atlanta, Ga
| | - Walter W Williams
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Ga
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Cha SH, Paik JH, Lee MR, Yang H, Park SG, Jeon YJ, Yoo S. Influenza Vaccination Coverage Rate according to the Pulmonary Function of Korean Adults Aged 40 Years and Over: Analysis of the Fifth Korean National Health and Nutrition Examination Survey. J Korean Med Sci 2016; 31:709-14. [PMID: 27134491 PMCID: PMC4835595 DOI: 10.3346/jkms.2016.31.5.709] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 02/16/2016] [Indexed: 11/20/2022] Open
Abstract
Influenza vaccination is an effective strategy to reduce morbidity and mortality, particularly for those who have decreased lung functions. This study was to identify the factors that affect vaccination coverage according to the results of pulmonary function tests depending on the age. In this cross-sectional study, data were obtained from 3,224 adults over the age of 40 who participated in the fifth National Health and Nutrition Examination Survey and underwent pulmonary function testing in 2012. To identify the factors that affect vaccination rate, logistic regression analysis was conducted after dividing the subjects into two groups based on the age of 65. Influenza vaccination coverage of the entire subjects was 45.2%, and 76.8% for those aged 65 and over. The group with abnormal pulmonary function had a higher vaccination rate than the normal group, but any pulmonary dysfunction or history of COPD did not affect the vaccination coverage in the multivariate analysis. The subjects who were 40-64 years-old had higher vaccination coverage when they were less educated or with restricted activity level, received health screenings, and had chronic diseases. Those aged 65 and over had significantly higher vaccination coverage only when they received regular health screenings. Any pulmonary dysfunction or having COPD showed no significant correlation with the vaccination coverage in the Korean adult population.
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Affiliation(s)
- Seung-Hyun Cha
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Jeong-Hun Paik
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Mi-Ra Lee
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Huiho Yang
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Seung-Guk Park
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Young-Jee Jeon
- Department of Family Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Sunmi Yoo
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
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24
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Yang TU, Song JY, Noh JY, Cheong HJ, Kim WJ. Influenza and Pneumococcal Vaccine Coverage Rates among Patients Admitted to a Teaching Hospital in South Korea. Infect Chemother 2015; 47:41-8. [PMID: 25844262 PMCID: PMC4384449 DOI: 10.3947/ic.2015.47.1.41] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 03/08/2015] [Accepted: 03/08/2015] [Indexed: 12/19/2022] Open
Abstract
Background Influenza and pneumococcal vaccinations can reduce morbidity and mortality especially in the elderly and patients with chronic medical disease. The purpose of this study was to estimate vaccination coverage of these populations in a hospital setting. Materials and Methods We conducted a cross-sectional, descriptive study involving adult patients admitted to a 1,000-bed teaching hospital on April 15, 2013. We ascertained the information on whether the patient had received influenza vaccination within a year prior to admission or pneumococcal vaccination by interviewing each patient. Results A total of 491 eligible patients aged ≥50 years or with chronic medical illnesses were analyzed. The overall vaccination rate for influenza was 57.2%, and that of pneumococcus was 17.6% among the vaccine-eligible subjects. Influenza/pneumococcal vaccination rates of patients by disease were 62.8%/17.2% for diabetes, 53.3%/15.6% for malignancy, 67.6%/23.5% for chronic pulmonary disease, 66.7%/15.3% for chronic cardiovascular disease, 68.7%/26.9% for chronic renal disease, and 51.2%/18.6% for chronic hepatic disease. Young adult patients with chronic medical conditions were consistently less likely to receive influenza and pneumococcal vaccines irrespective of the underlying disease. Conclusion The influenza and pneumococcal vaccine coverage rates among hospitalized patients were low in South Korea. This was especially the case for young adult patients with chronic medical illnesses.
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Affiliation(s)
- Tae Un Yang
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Goren A, Roberts C, Victor TW. Comorbid risk, respondent characteristics and likelihood of pneumococcal vaccination versus no vaccination among older adults in Brazil. Expert Rev Vaccines 2013; 13:175-84. [PMID: 24308584 DOI: 10.1586/14760584.2014.863714] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study investigated predictors of pneumococcal polysaccharide vaccine (PPV) use among older adults in Brazil. Respondents aged ≥50 from 2011 National Health and Wellness Survey in Brazil who had ever (vs never) received PPV were compared on comorbid risk, sociodemographics and vaccination behaviors. Logistic regression and decision tree analyses predicted PPV receipt as a function of the measures. Among 3195 respondents, 8.7% reported ever receiving PPV (10.4% among those at risk). Adjusting for covariates, adults classified as high or moderate risk had significantly greater odds of pneumococcal vaccination (odds ratios [ORs]: 2.42 or 1.36, respectively), as were those who received flu vaccinations (OR: 2.21) or were parents/guardians of a vaccinated child (OR: 6.48). In Brazil, child vaccination appears to be the dominant predictor of adult PPV uptake, followed by influenza vaccination. Higher disease risk was a significant predictor, but most older at-risk adults (89.6%) did not receive PPV.
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Affiliation(s)
- Amir Goren
- Health Outcomes Practice, Kantar Health, 11 Madison Ave, Fl 12, New York, NY 10010, USA
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Satman I, Akalin S, Cakir B, Altinel S. The effect of physicians' awareness on influenza and pneumococcal vaccination rates and correlates of vaccination in patients with diabetes in Turkey: an epidemiological Study "diaVAX". Hum Vaccin Immunother 2013; 9:2618-26. [PMID: 23887188 PMCID: PMC4162054 DOI: 10.4161/hv.25826] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
We aimed to examine the effect of increased physician awareness on the rate and determinants of influenza and pneumococcal vaccinations in diabetic patients. Diabetic patients (n = 5682, mean [SD] age: 57.3 [11.6] years, 57% female) were enrolled by 44 physicians between Sept 2010 and Jan 2011. The physicians were initially questioned regarding vaccination practices, and then, they attended a training program. During the last five years, the physicians recommended influenza and pneumococcal vaccinations to 87.9% and 83.4% of the patients, respectively; however; only 27% of the patients received the influenza and 9.8% received the pneumococcal vaccines. One year after the training, the vaccination rates increased to 63.3% and 40.7%, respectively. The logistic regression models revealed that variables which increased the likelihood of having been vaccinated against influenza were: longer duration of diabetes, presence of hyperlipidemia and more use of concomitant medications whereas more use of anti-hyperglycemic medications was associated with increased odds of vaccination. On the other hand, older age, longer duration of diabetes and presence of a cardiovascular disease were variables which decreased the likelihood of having been vaccinated against pneumococcal disease during the past five years. However, during the study period, variables which decreased the odds of having been vaccinated included: older age and anti-hyperglycemic medications for influenza, and presence of hyperlipidemia and a family history of hypertension for pneumococcal disease. While variables which increased the likelihood of vaccination in the same period were: increased number of co-morbidities for influenza, and family history of diabetes for pneumococcal disease. We conclude that increased awareness of physicians may help improve vaccination rates against influenza and pneumococcal disease. However, diabetic patients with more severe health conditions are less likely to having been vaccinated. More structural/systematic vaccination programs are needed to increase the vaccination rates in patients with diabetes.
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Affiliation(s)
- Ilhan Satman
- Istanbul University; Istanbul Faculty of Medicine; Istanbul, Turkey
| | - Sema Akalin
- Marmara University; Medical Foundation; Istanbul, Turkey
| | - Bekir Cakir
- Yildirim Bayezit University; Ataturk Training and Research Hospital; Ankara, Turkey
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Prevalence of seasonal influenza vaccination and associated factors in people with chronic diseases in Hong Kong. Epidemiol Infect 2012; 141:377-89. [PMID: 22717154 DOI: 10.1017/s0950268812000672] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Chronic disease patients are at high risk of developing serious influenza-related complications. This study investigated the prevalence of seasonal influenza vaccination (IV) and associated factors in such patients. A random sample of 704 Chinese adults with chronic disease was anonymously interviewed by telephone; 35·8% of them had ever taken up IV and 22·7% did so during the last flu season. The most frequently mentioned facilitator was recommendation made by a healthcare worker (HCW). Knowledge that IV is required annually, perceived severe health impacts of influenza, and recommendation made by a HCW were positively associated with previous IV and intention to take up IV in the next year, while perceived side-effects was inversely associated with previous IV and intention to take up IV. The coverage of IV in this study population was low. HCWs should clarify IV-related health beliefs in chronic disease patients and actively advise them to take up IV.
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Kee SY, Cheong HJ, Chun BC, Kim WJ. Influenza Vaccination Coverage Rate and Factors Associated with Vaccination in People with Chronic Disease. Infect Chemother 2011. [DOI: 10.3947/ic.2011.43.5.406] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Sae Yoon Kee
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Hee Jin Cheong
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Byung Chul Chun
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Woo Joo Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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