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英国自身免疫性风湿病患者流感疫苗接种的预测因素和时间趋势:一项全国性前瞻性队列研究。

Predictors and temporal trend of flu vaccination in auto-immune rheumatic diseases in the UK: a nationwide prospective cohort study.

机构信息

Academic Rheumatology, University of Nottingham, Nottingham, UK.

Epidemiology and Public Health, University of Nottingham, Nottingham, UK.

出版信息

Rheumatology (Oxford). 2018 Oct 1;57(10):1726-1734. doi: 10.1093/rheumatology/key156.

Abstract

OBJECTIVES

To examine temporal trend in uptake of seasonal influenza vaccine (SIV) in the UK and explore disease and demographic factors associated with vaccination.

METHODS

From the Clinical Practice Research Datalink, 32 751 people with auto-immune rheumatic diseases prescribed DMARDs between 2006 and 2016 were identified. The proportion vaccinated between 1 September of one year and 31 March of the next year was calculated and stratified by age, other indications for vaccination, auto-immune rheumatic diseases type and number of DMARDs prescribed. Stata and Joinpoint regression programs were used.

RESULTS

SIV uptake was high in those aged ⩾65 years (82.3 and 80.7% in 2006-07 and 2015-16, respectively). It was significantly lower in other age groups, but improved over time with 51.9 and 61.9% in the 45-64 year age group, and 32.3 and 50.1% in the <45 year age group being vaccinated in 2006-07 and 2015-16, respectively. While 64.9% of the vaccinations in those ⩾65 years old occurred by 3 November, in time to mount a protective immune response before the influenza activity becomes substantial in the UK, only 38.9% in the 45-64 year and 26.2% in the <45 year age group without any other reason for vaccination received SIV by this date. Women, those with additional indications for vaccination, on multiple DMARDs and with SLE were more likely to be vaccinated.

CONCLUSION

SIV uptake is low in the under 65s, and the majority of them are not vaccinated in time. Additional effort is required to promote timely uptake of SIV in this population.

摘要

目的

研究英国季节性流感疫苗(SIV)接种的时间趋势,并探讨与接种相关的疾病和人口统计学因素。

方法

从临床实践研究数据链接中,确定了 2006 年至 2016 年间开具 DMARDs 的 32751 名自身免疫性风湿病患者。计算了当年 9 月 1 日至次年 3 月 31 日之间的接种比例,并按年龄、其他接种指征、自身免疫性风湿病类型和开具的 DMARDs 数量进行分层。使用 Stata 和 Joinpoint 回归程序。

结果

≥65 岁人群的 SIV 接种率较高(2006-07 年和 2015-16 年分别为 82.3%和 80.7%)。其他年龄组的接种率明显较低,但随着时间的推移有所改善,2006-07 年和 2015-16 年 45-64 岁年龄组的接种率分别为 51.9%和 61.9%,<45 岁年龄组的接种率分别为 32.3%和 50.1%。虽然≥65 岁人群中有 64.9%的人在 11 月 3 日之前接种了疫苗,以在流感活动在英国变得活跃之前产生保护性免疫反应,但在没有其他接种原因的情况下,45-64 岁年龄组只有 38.9%,<45 岁年龄组只有 26.2%。女性、有其他接种指征、使用多种 DMARDs 和患有系统性红斑狼疮的人更有可能接种疫苗。

结论

65 岁以下人群的 SIV 接种率较低,其中大多数人未能及时接种。需要进一步努力,以促进这一人群及时接种 SIV。

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