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Alqifari SF, Esmail AK, Alarifi DM, Alsuliman GY, Alhati MM, Mutlaq MR, Aldhaeefi M, Alshuaibi SA, Amirthalingam P, Abdallah A, Wasel AS, Hamad HR, Alamin S, Atia TH, Alqahtani T. Adherence to Advisory Committee on Immunization Practices in diabetes mellitus patients in Saudi Arabia: A multicenter retrospective study. World J Diabetes 2024; 15:440-454. [PMID: 38591075 PMCID: PMC10999047 DOI: 10.4239/wjd.v15.i3.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/03/2024] [Accepted: 02/18/2024] [Indexed: 03/15/2024] Open
Abstract
BACKGROUND Patients with diabetes mellitus (DM) are predisposed to an increased risk of infection signifying the importance of vaccination to protect against its potentially severe complications. The Centers for Disease Control and Prevention/Advisory Committee on Immunization Practices (CDC/ACIP) issued immunization re-commendations to protect this patient population. AIM To assess the adherence of patients with DM to the CDC/ACIP immunization recommendations in Saudi Arabia and to identify the factors associated with the vaccine adherence rate. METHODS An observational retrospective study conducted in 2023 was used to collect data on the vaccination records from 13 diabetes care centers in Saudi Arabia with 1000 eligible patients in phase I with data collected through chart review and 709 patients in phase II through online survey. RESULTS Among participants, 10.01% (n = 71) had never received any vaccine, while 85.89% (n = 609) received at least one dose of the coronavirus disease 2019 (COVID-19) vaccine, and 34.83% (n = 247) had received the annual influenza vaccine. Only 2.96% (n = 21), 2.11% (n = 15), and 1.12% (n = 8) received herpes zoster, tetanus, diphtheria, and pertussis (Tdap), and human papillomavirus (HPV) vaccines, respectively. For patients with DM in Saudi Arabia, the rate of vaccination for annual influenza and COVID-19 vaccines was higher compared to other vaccinations such as herpes zoster, Tdap, pneumococcal, and HPV. Factors such as vaccine recommendations provided by family physicians or specialists, site of care, income level, DM-related hospitalization history, residency site, hemoglobin A1c (HbA1c) level, and health sector type can significantly influence the vaccination rate in patients with DM. Among non-vaccinated patients with DM, the most reported barriers were lack of knowledge and fear of side effects. This signifies the need for large-scale research in this area to identify additional factors that might facilitate adherence to CDC/ACIP vaccine recommendations in patients with DM. CONCLUSION In Saudi Arabia, patients with DM showed higher vaccination rates for annual influenza and COVID-19 vaccines compared to other vaccinations such as herpes zoster, Tdap, pneumococcal, and HPV. Factors such as vaccine recommendations provided by family physicians or specialists, the site of care, income level, DM-related hospitalization history, residency site, HbA1c level, and health sector type can significantly influence the vaccination rate in patients with DM.
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Affiliation(s)
| | - Aya K Esmail
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Dalal M Alarifi
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Ghalya Y Alsuliman
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Maram M Alhati
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - May R Mutlaq
- Department of Family Medicine, International Medical Center, Jeddah 23214, Saudi Arabia
| | - Mohammed Aldhaeefi
- Clinical and Administrative Pharmacy Sciences, College of Pharmacy, Howard University, Washington, DC 20059, United States
| | - Shaden A Alshuaibi
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | | | - Abrar Abdallah
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Afaf S Wasel
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Heba R Hamad
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Shoroq Alamin
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Tasneem H Atia
- Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
| | - Tariq Alqahtani
- Department of Pharmacology, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
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Lee DH, Yang B, Gu S, Kim EG, Kim Y, Kang HK, Choe YH, Jeon HJ, Park S, Lee H. Influenza vaccination trend and related factors among patients with diabetes in Korea: Analysis using a nationwide database. Front Endocrinol (Lausanne) 2023; 14:1077846. [PMID: 36817596 PMCID: PMC9935563 DOI: 10.3389/fendo.2023.1077846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/20/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Subjects with diabetes are at higher risk of serious influenza-related complications. We aimed to investigate the yearly trend of influenza vaccination and factors associated with being unvaccinated for influenza in subjects with diabetes using a nationwide observational study performed within the recent decade. METHODS Among 105,732 subjects from the Korea National Health and Nutrition Examination Survey between 2007 and 2019, 8,632 with diabetes were included. We investigated the yearly trend of influenza vaccination and factors associated with being unvaccinated for influenza. RESULTS During the study period, the prevalence of influenza vaccination in subjects with diabetes showed a tendency to increase every year, reaching almost 60% in 2019, which was higher than the rate in subjects without diabetes. Younger age (adjusted hazard ratio (aHR) [95% CI] 11.29 [8.63-14.75] for < 50 years; 6.16 [5.21-7.29] for 50-65 years), male (aHR 1.67 [1.52-1.87]), current smoker (aHR 1.31 [1.00-1.72], lower-income status (aHR 1.46 [1.17, 1.84]), and high education level (aHR 1.30 [1.01-1.67]) were associated with being unvaccinated. Also, a poorer glycemic control with HbA1c ≥ 9% was found to be correlated with unvaccinated status (aHR 1.48 [1.15-1.90]). CONCLUSION The influenza vaccination rate is still unsatisfactory in subjects with diabetes. Young age, males, low-income level, high education level, and poor glycemic control were associated with unvaccinated status. Considering the risk-benefits of influenza vaccination in patients with diabetes, physicians should make an effort to increase vaccination rates, especially in low vaccination rate groups.
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Affiliation(s)
- Dong-Hwa Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungbuk National University College of Medicine and Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Bumhee Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Seonhye Gu
- Department of Epidemiology and Health Informatics, Korea University, Seoul, Republic of Korea
| | - Eung-Gook Kim
- Department of Biochemistry, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Youlim Kim
- Division of Pulmonary and Allergy, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hyung Koo Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Yeong Hun Choe
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Internal Medicine, Chonbuk National University Hospital-Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Hyun Jeong Jeon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungbuk National University College of Medicine and Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Seungyong Park
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Internal Medicine, Chonbuk National University Hospital-Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
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Burbage SC, Parikh MA, Campbell PJ, Ramachandran S, Gatwood J, Ozawa S, Urick BY. Associations between pharmacy choice and influenza vaccination: Mail order vs community pharmacy users. J Manag Care Spec Pharm 2022; 28:1379-1391. [PMID: 36427345 PMCID: PMC10373029 DOI: 10.18553/jmcp.2022.28.12.1379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND: Despite the effectiveness of vaccines, US adult vaccination rates remain low. This is especially true for the influenza vaccine, which is recommended annually and widely available. The accessibility of community pharmacies as convenient places to receive influenza vaccines has been shown to increase uptake. However, use of mail order pharmacies may reduce in-person pharmacist encounters and reduce the likelihood that users receive annual influenza vaccines. OBJECTIVE: To determine the association between the type of pharmacy a patient uses and their likelihood of receiving an influenza vaccine. METHODS: This cross-sectional cohort study used the 2018 Medical Expenditure Panel Survey to observe noninstitutionalized US adult pharmacy users. Pharmacy type was dichotomized into community use only vs any mail order pharmacy use. Multivariable weighted logistic regression was used to identify associations between the type of pharmacy used and influenza vaccination, adjusting for sociodemographic, health status, and health care access and utilization confounders. All analyses were stratified by age (< 65 and ≥ 65 years). RESULTS: The aged younger than 65 years and aged 65 years and older samples had 8,074 and 4,037 respondents who represented 95,930,349 and 40,163,276 weighted observations, respectively. Compared with community pharmacy users, mail order users were more likely to be aged 65 and older, be White, have high income, and have a usual source of care (P < 0.0001). Adjusted odds ratios (AORs) for influenza vaccination were significantly lower among community pharmacy users than mail order users among individuals aged younger than 65 years (AOR=0.71; 95% CI = 0.580.87) but was not significant among those aged 65 years and older (AOR = 0.87; 95% CI = 0.69-1.09). CONCLUSIONS: Community pharmacy users aged younger than 65 years are less likely to receive the influenza vaccine than their mail order pharmacy user counterparts. These counterintuitive results could be caused by residual confounding due to differences in factors that influence pharmacy use type and vaccination likelihood. Further exploration is needed to account for differences between these populations that independently drive vaccination choice. DISCLOSURES: Dr Burbage was a fellow in the Real World Evidence, Population Health and Quality Research Postdoctoral Fellowship Program in collaboration with University of North Carolina Eshelman School of Pharmacy and Pharmacy Quality Alliance, and supported by Janssen Scientific Affairs at the time of this study. She is now employed by Janssen Scientific Affairs. Dr Parikh is an employee of Pharmacy Quality Alliance. Dr Campbell was employed by Pharmacy Quality Alliance at the time of the study. He is now employed by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. Dr Ramachandran has received an unrelated research contract with Pharmacy Quality Alliance. Dr Gatwood has received vaccine-related research grants from Merck & Co. and GlaxoSmithKline unrelated to this project and consulting fees for a vaccine-related expert panel with Merck & Co. unrelated to this manuscript and is an advisory board member with Janssen Scientific Affairs. Dr. Urick was employed by the UNC Eshelman School of Pharmacy at the time of this writing and is currently employed by Prime Therapeutics. He has received community pharmacy-related consulting fees from Cardinal Health and Pharmacy Quality Solutions unrelated to this work. Dr Ozawa has a research grant from Merck & Co. unrelated to this project. This project did not receive funding from any agency in the public, commercial, or not-for-profit sectors.
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Affiliation(s)
- Sabree C Burbage
- University of North Carolina at Chapel Hill Eshelman School of Pharmacy
- Janssen Scientific Affairs
| | | | - Patrick J Campbell
- Pharmacy Quality Alliance, Alexandria, VA
- Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ
| | | | - Justin Gatwood
- University of Tennessee Health Science Center College of Pharmacy, Nashville
| | - Sachiko Ozawa
- University of North Carolina at Chapel Hill Eshelman School of Pharmacy
| | - Benjamin Y Urick
- University of North Carolina at Chapel Hill Eshelman School of Pharmacy
- Prime Therapeutics
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Kianoush S, Rifai MA, Patel J, Michos ED, Alam M, Samad Z, Sohail R, Cader FA, Sayed A, Zhu D, Virani SS. Racial disparity in flu vaccine uptake among Asian American Individuals: A National Health Interview Survey Study. Curr Probl Cardiol 2022; 47:101391. [PMID: 36100094 DOI: 10.1016/j.cpcardiol.2022.101391] [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: 08/30/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022]
Abstract
Vaccination coverage rates across Asian American subpopulations with atherosclerotic cardiovascular disease (ASCVD) and diabetes mellitus is not well-studied. We used data from the National Health Interview Survey (NHIS) from 2006-2018 and included participants with a history of ASCVD or diabetes. Vaccination coverage in White were compared with Chinese, Asian Indian, Filipino, and 'other Asian' (Japanese, Korean, and Vietnamese) adults using univariable and multivariable logistic regression models. We included 50,839 participants, mean age 62.7±0.1 years, 46.3% women, 89.1% US-born. Filipino (59%) and Asian Indian (56%) adults were less likely to receive influenza vaccine than 'other Asians' (66%), Chinese (65%), and White (60%) participants (P<0.001). In multivariable adjusted models, Chinese (OR=1.66, 1.02-2.69), Asian Indian (OR=1.50, 1.07-2.10), and 'other Asian' ethnicity (OR=1.81, 1.38-2.36) were associated with higher odds of receiving influenza vaccination compared with White. Influenza vaccine coverage remains suboptimal across all studied races/ethnicities.
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Affiliation(s)
- Sina Kianoush
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Mahmoud Al Rifai
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Jaideep Patel
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine
| | - Mahboob Alam
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Zainab Samad
- Department of Medicine, Aga Khan University, Karachi, Pakistan Aga Khan University, Karachi, Pakistan
| | - Rizwan Sohail
- Section of Infectious Disease, Department of Medicine, Baylor College of Medicine, Houston, TX
| | - F Aaysha Cader
- Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh
| | | | - Dongshan Zhu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Salim S Virani
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX; Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX; DeBakey Heart and Vascular Institute, Houston Methodist, Houston, TX.
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County Social Vulnerability and Influenza Vaccine Rates: National and Local Estimates for Medicare Recipients. Am J Prev Med 2022; 62:e1-e9. [PMID: 34548222 DOI: 10.1016/j.amepre.2021.06.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Seasonal influenza vaccination among older adults is well below the recommendation of Healthy People 2020. Although geographic disparities in influenza vaccination are well documented, it remains unclear how community attributes correlate with influenza vaccination rates. Social vulnerability measures play an important role in interventions addressing vaccine equity; however, social vulnerability dimensions as corollaries of vaccination are poorly understood. To inform vaccine equity interventions, this analysis investigates spatially varying associations between county social vulnerability and influenza vaccination rate among Medicare recipients. METHODS County-level 2018 data (N=3,105) from the Centers for Disease Control and Prevention's Social Vulnerability Index were merged with the percentage of Medicare recipients vaccinated against influenza. Multilevel linear regression and geographically weighted regression generated global and local estimates, adjusted for potential confounders. Analyses were conducted in November 2020-April 2021. RESULTS A 10-percentile point increase in the overall Social Vulnerability Index was associated with an 0.87-point decrease in percentage vaccinated (p<0.001) with substantial variation by Social Vulnerability Index theme and geography. A 10-percentile point increase in socioeconomic vulnerability was associated with a 1.6-point decrease in vaccination (p<0.001) with stronger associations in higher Social Vulnerability Index quartiles and in parts of the Midwest, South, and coastal Northeast. Other Social Vulnerability Index themes had smaller associations with mixed directions: household composition and disability estimates were negative, whereas estimates for minority status and language and housing and transportation were positive. CONCLUSIONS Medicare recipients in socioeconomically vulnerable counties have low influenza vaccination rates, particularly in select regions of the country. Best practices to improve vaccine access and uptake should be targeted and should explicitly consider local socioeconomic vulnerability.
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