Bare Idris, Crawford Jennifer, Pon Kendell, Farida Negeen, Dehghani Payam
College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Saskatoon Health Region, Saskatoon, Saskatchewan, Canada.
Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada.
Am J Cardiol. 2018 Feb 15;121(4):491-494. doi: 10.1016/j.amjcard.2017.11.008. Epub 2017 Dec 11.
Immunization against influenza is a critical, but perhaps underappreciated prevention of morbidity and mortality in the cardiac population. The purpose of the present study is to examine influenza vaccination rates in adults with congenital heart disease (ACHD). A secondary purpose is to explore whether there is an association between demographic, medical, and behavioral variables and receipt of the influenza vaccination. Of the 183 consecutive ACHD patients who were contacted, 123 responded to our telephone survey. Mean age was 38.4 ± 14.7, with the most common type of lesion complexity being moderate (65.3%), followed by simple (21.0%) and severe (13.7%). Overall, 53 respondents reported undergoing influenza vaccination in the previous season. Fifty-two percent of all subjects claimed they were notified of the benefits of vaccination by their physician. Univariate analysis revealed that older age (p = 0.006), female gender (p = 0.027), perceived susceptibility to influenza illness (p <0.001), perceived severity of the influenza illness (p <0.001), perceived benefits of the influenza vaccination (p <0.001), side effects from previous immunization (p = 0.006), and physician recommendation (p = 0.008) were predictors of receipt of influenza vaccination. On multivariate analyses, however, only side effects from previous immunization was a predictor (odds ratio = 0.34 [95% confidence interval 0.13 to 0.91]), whereas physician recommendation was numerically, but not statistically, significant (odds ratio 2.01 [95% confidence interval 0.85 to 4.78]). Our study demonstrated that less than 50% of ACHD population receives influenza vaccination. We believe educating both the patients about the side effects of vaccination and the physicians about their role in counseling ACHD patients will increase the vaccination rates in this high-risk population.
流感免疫接种对于预防心脏疾病人群的发病和死亡至关重要，但可能未得到充分重视。本研究的目的是调查先天性心脏病成年患者（ACHD）的流感疫苗接种率。次要目的是探讨人口统计学、医学和行为变量与流感疫苗接种之间是否存在关联。在连续联系的183例ACHD患者中，123例回复了我们的电话调查。平均年龄为38.4±14.7岁，最常见的病变复杂程度类型为中度（65.3%），其次是简单型（21.0%）和严重型（13.7%）。总体而言，53名受访者报告上一季接受了流感疫苗接种。所有受试者中有52%称他们的医生告知了疫苗接种的益处。单因素分析显示，年龄较大（p = 0.006）、女性（p = 0.027）、感知到的流感易感性（p <0.001）、感知到的流感疾病严重性（p <0.001）、感知到的流感疫苗接种益处（p <0.001）、既往免疫接种的副作用（p = 0.006）以及医生建议（p = 0.008）是流感疫苗接种的预测因素。然而，多因素分析显示，只有既往免疫接种的副作用是预测因素（比值比 = 0.34 [95%置信区间0.13至0.91]），而医生建议在数值上有意义，但无统计学意义（比值比2.01 [95%置信区间0.85至4.78]）。我们的研究表明，不到50%的ACHD人群接受流感疫苗接种。我们认为，既要对患者进行疫苗接种副作用的教育，也要对医生进行其在为ACHD患者提供咨询方面作用的教育，这将提高这一高危人群的疫苗接种率。
