Chen Chang-Hua, Wu Ming-Shiang, Wu I-Chien
Division of Infectious Diseases, Department of Internal Medicine Center for Aging and Health, Changhua Christian Hospital, Changhua City Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
Medicine (Baltimore). 2018 Feb;97(5):e9773. doi: 10.1097/MD.0000000000009773.
Older adults, particularly those with chronic obstructive pulmonary disease, are advised to receive 23-valent pneumococcal polysaccharide vaccine (PPV23). However, the PPV23 vaccination rate in Taiwan and the determinants of receipt remain unclear.We analyzed the data of 1475 community-dwelling older adults aged ≥75 years who participated in the Healthy Aging Longitudinal Study in Taiwan. Each participant received assessments of PPV23 status, sociodemographic factors (age, sex, education level, marital status, living alone, and occupation), and health-related factors (chronic diseases, smoking status, alcohol intake, physical activities, cognitive status, and physical performance). PPV23 rate was defined as the number of participants who reported receiving free PPV23 divided by the total number of candidates for free PPV23. Multinomial logistic regression analysis was applied to investigate the sociodemographic and health-related determinants of PPV23 status.A PPV23 vaccination rate of 20.7% (305/1475) was observed. Participants who were female, current smokers, and had a low peak expiratory flow were associated with PPV23 nonreceipt (all P <.05). Of the participants who had a low peak expiratory flow, low education status, and physical inactivity were associated with PPV23 nonreceipt (all P <.05).The PPV23 vaccination rate among adults aged ≥75 years was low. Older adults who were women, current smokers, or who had a low PEF were less likely to receive the PPV23. These findings support continual efforts to improve the PPV23 coverage rate in vulnerable populations.
建议老年人，尤其是患有慢性阻塞性肺疾病的老年人接种23价肺炎球菌多糖疫苗（PPV23）。然而，台湾地区PPV23的接种率及其影响因素仍不清楚。我们分析了1475名年龄≥75岁、居住在社区且参与台湾健康老龄化纵向研究的老年人的数据。每位参与者都接受了PPV23接种状况、社会人口学因素（年龄、性别、教育程度、婚姻状况、独居情况和职业）以及健康相关因素（慢性病、吸烟状况、饮酒情况、体育活动、认知状况和身体机能）的评估。PPV23接种率定义为报告接种免费PPV23的参与者人数除以免费PPV23的候选总人数。采用多项逻辑回归分析来研究PPV23接种状况的社会人口学和健康相关影响因素。观察到PPV23接种率为20.7%（305/1475）。女性、当前吸烟者以及呼气峰值流速较低的参与者与未接种PPV23相关（所有P<0.05）。在呼气峰值流速较低的参与者中，低教育水平和缺乏体育活动与未接种PPV23相关（所有P<0.05）。75岁及以上成年人的PPV23接种率较低。女性、当前吸烟者或呼气峰值流速较低的老年人接种PPV23的可能性较小。这些发现支持持续努力提高弱势群体中PPV23的覆盖率。
