Loubet Paul, Kernéis Solen, Groh Matthieu, Loulergue Pierre, Blanche Philippe, Verger Pierre, Launay Odile
Inserm, CIC 1417, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération d'infectiologie, Hôpital Cochin, Paris, France.
Inserm, CIC 1417, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération d'infectiologie, Hôpital Cochin, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.
Vaccine. 2015 Jul 17;33(31):3703-8. doi: 10.1016/j.vaccine.2015.06.012. Epub 2015 Jun 11.
Immunocompromised patients are at increased risk for severe influenza and invasive pneumococcal diseases. Population-specific vaccine recommendations are thus warranted. This study aimed to estimate the prevalence and predictors of influenza and pneumococcal vaccine uptake in a large cohort of patients with secondary immune deficiency.
An anonymous online survey was submitted to the members of 11 French associations of immunocompromised patients. The questionnaire included questions concerning underlying disease, care and treatment, flu and pneumococcal vaccine uptake, attitudes and knowledge about vaccination. Factors associated with vaccine uptake were assessed by multivariate logistic regression.
Among the 10,897 solicited patients, 3653 agreed to participate (33.5%): 75% were female, 20% aged 65+, 79% were followed for an autoimmune disease, 13% were solid organ recipients or waiting for transplantation and 8% were treated for hematological malignancies. 3109 (85%) participants were treated with immunosuppressive therapy. Self-reported vaccine uptake was 59% (95%CI [57-60]) against seasonal influenza and 49% (95%CI [47-50]) against pneumococcal diseases. Better knowledge of and favorable attitudes toward vaccination were positively associated with vaccine uptake while being treated with a biological therapy was negatively associated.
Despite specific recommendations regarding immunocompromised patients, influenza and pneumococcal vaccination rates do not reach recommended levels. Targeted information campaigns on vaccination toward these populations should be implemented to improve vaccine coverage and thus reduce the burden of infections.
免疫功能低下的患者患重症流感和侵袭性肺炎球菌疾病的风险增加。因此，有必要针对特定人群制定疫苗接种建议。本研究旨在评估一大群继发性免疫缺陷患者中流感疫苗和肺炎球菌疫苗的接种率及其预测因素。
向11个法国免疫功能低下患者协会的成员进行了一项匿名在线调查。问卷包括有关基础疾病、护理和治疗、流感和肺炎球菌疫苗接种情况、对疫苗接种的态度和知识等问题。通过多因素逻辑回归分析评估与疫苗接种相关的因素。
在10897名被邀请的患者中，3653人同意参与（33.5%）：75%为女性，20%年龄在65岁及以上，79%因自身免疫性疾病接受随访，13%为实体器官接受者或等待移植者，8%因血液系统恶性肿瘤接受治疗。3109名（85%）参与者接受了免疫抑制治疗。自我报告的季节性流感疫苗接种率为59%（95%可信区间[57 - 60]），肺炎球菌疾病疫苗接种率为49%（95%可信区间[47 - 50]）。对疫苗接种有更好的了解和积极态度与疫苗接种呈正相关，而接受生物治疗则与疫苗接种呈负相关。
尽管针对免疫功能低下患者有特定建议，但流感和肺炎球菌疫苗接种率未达到推荐水平。应针对这些人群开展有针对性的疫苗接种宣传活动，以提高疫苗接种覆盖率，从而减轻感染负担。
