Singleton James A, Wortley Pascale, Lu Peng-Jun
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Tex Heart Inst J. 2004;31(1):22-7.
People who have cardiovascular disease are at increased risk of hospitalization or death associated with influenza infection, and are included among the high-risk groups for whom annual influenza vaccination is recommended. To measure the progress toward the national year 2000 and 2010 objectives of a 60% annual influenza vaccination of adults with high-risk conditions aged 18 to 64 years, we analyzed data from the 1997 to 2001 National Health Interview Surveys (NHIS) regarding persons with cardiovascular disease. The NHIS is an annual, cross-sectional survey representative of the U.S., noninstitutionalized, civilian population. Estimated percentages of persons with heart disease reporting influenza vaccination were relatively stable during the 1996-97 through 2000-2001 influenza seasons, with the highest levels in most groups occurring in 1999-2000: 49.2% (95% confidence interval [CI], 44.1%-54.3%) among persons aged 50 to 64 years; and 22.7% (95% CI, 18.2%-27.2%) among persons aged 18 to 49 years. Influenza vaccine coverage among adults aged 18 to 64 years with cardiovascular disease is substantially below the national objective. Multiple strategies are needed to improve vaccination coverage, such as increasing the awareness of and demand for vaccination by persons with heart disease; increasing implementation by providers of practices that have been shown to increase vaccination levels; and adopting of influenza vaccination by primary care providers and specialists as a standard of care for persons diagnosed with cardiovascular disease.
患有心血管疾病的人因流感感染而住院或死亡的风险增加,他们被列入建议每年接种流感疫苗的高危人群之中。为衡量在实现2000年和2010年全国目标方面所取得的进展,该目标是使年龄在18至64岁的高危成年人每年流感疫苗接种率达到60%,我们分析了1997年至2001年全国健康访谈调查(NHIS)中有关心血管疾病患者的数据。NHIS是一项针对美国非机构化平民人口的年度横断面调查。在1996 - 97年至2000 - 2001年流感季节期间,报告接种流感疫苗的心脏病患者估计百分比相对稳定,大多数群体中最高水平出现在1999 - 2000年:50至64岁人群中为49.2%(95%置信区间[CI],44.1% - 54.3%);18至49岁人群中为22.7%(95% CI,18.2% - 27.2%)。年龄在18至64岁的心血管疾病成年人的流感疫苗接种覆盖率远低于全国目标。需要多种策略来提高疫苗接种覆盖率,例如提高心脏病患者对疫苗接种的认识和需求;增加已被证明能提高疫苗接种水平的医疗服务提供者的实施力度;以及初级保健提供者和专科医生将流感疫苗接种作为诊断为心血管疾病患者的护理标准加以采用。