Clancy U, Moran I, Tuthill A
Cork University Hospital, Wilton, Cork.
Ir Med J. 2012 Oct;105(9):298-300.
The Irish Immunisation Guidelines recommend that people with diabetes mellitus receive the seasonal influenza and pneumococcal vaccines. We aimed to gather data on seasonal influenza vaccine uptake over the previous twelve months, to determine pneumococcal vaccine uptake over a lifetime, and to identify predictors that may influence likelihood of vaccine uptake. A combination of retrospective medical record review and patient questionnaire was undertaken over a three-month period in a diabetes outpatient clinic. Two hundred patients, 28.5% (n=57) with type 1 and 70.5% (n=141) with type 2 diabetes were questioned. Uptake of seasonal influenza vaccine in the previous year was 64.5%. Reported lifetime uptake rate of pneumococcal vaccine was 22%. Increasing age, increasing duration of diabetes and history of recent GP visits significantly increased frequency of influenza vaccination over a five-year period. Significant predictors of influenza vaccination over the previous 12 months included those receiving GP recommendation [OR 10.6 (95% CI 4.3-26.4)] and those aged over 65 [OR 2.8 (1.008-7.8)]. Significant predictors of pneumococcal vaccine uptake included GP recommendation [OR=63 (10-388)] and chronic kidney disease [OR=22 (1.5-312)]. Increased uptake of vaccines is desirable and may be improved by general practices targeting subsets of the population and annual auditing.
爱尔兰免疫指南建议糖尿病患者接种季节性流感疫苗和肺炎球菌疫苗。我们旨在收集过去十二个月内季节性流感疫苗接种的数据，确定一生当中肺炎球菌疫苗的接种情况，并找出可能影响疫苗接种可能性的预测因素。在一家糖尿病门诊诊所，我们在三个月的时间里采用了回顾性病历审查和患者问卷调查相结合的方法。对200名患者进行了询问，其中1型糖尿病患者占28.5%（n = 57），2型糖尿病患者占70.5%（n = 141）。上一年度季节性流感疫苗的接种率为64.5%。报告的肺炎球菌疫苗一生接种率为22%。年龄增加、糖尿病病程延长以及近期看全科医生的病史显著增加了五年内流感疫苗的接种频率。过去12个月内流感疫苗接种的显著预测因素包括接受全科医生建议的患者[比值比10.6（95%可信区间4.3 - 26.4）]以及65岁以上的患者[比值比2.8（1.008 - 7.8）]。肺炎球菌疫苗接种的显著预测因素包括全科医生的建议[比值比 = 63（10 - 388）]和慢性肾病[比值比 = 22（1.5 - 312）]。提高疫苗接种率是可取的，针对特定人群子集的一般措施和年度审核可能会有所帮助。
