Boey Lise, Bosmans Eline, Ferreira Liane Braz, Heyvaert Nathalie, Nelen Melissa, Smans Lisa, Tuerlinckx Hanne, Roelants Mathieu, Claes Kathleen, Derdelinckx Inge, Janssens Wim, Mathieu Chantal, Van Cleemput Johan, Vos Robin, Vandermeulen Corinne
Leuven University Vaccinology Center , Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Environment and Health, Department of Public Health and Primary Care, KU Leuven , Leuven, Belgium.
Hum Vaccin Immunother. 2020 Sep 1;16(9):2136-2143. doi: 10.1080/21645515.2020.1763739. Epub 2020 Jul 2.
Upon exposure to vaccine-preventable diseases, certain individuals are at increased risk for complications due to preexisting diseases, age or immunosuppressive treatment. Vaccination against influenza, pneumococcal disease and hepatitis B (for some groups) is advised in addition to standard vaccination against diphtheria, tetanus and pertussis. We estimated the vaccination coverage and determinants of recommended vaccinations in patients with diabetes mellitus type 1 (n = 173) and type 2 (n = 177), chronic kidney disease (CKD) (n = 138), heart failure (n = 200), chronic obstructive pulmonary disease (COPD) (n = 187), HIV (n = 201) or solid organ transplantation (SOT) (n = 201) in a monocentric study. Vaccination data were retrieved from documents provided by patients and general practitioners, and from the Flemish vaccination register. Less than 10% had received all recommended vaccines. Overall, 29% of subjects were vaccinated against diphtheria-tetanus, 10% against pertussis, 44% against influenza, 32% against pneumococcal disease and 24% of HIV patients and 31% of CKD patients against hepatitis B. Age was positively associated with vaccination against influenza (OR:2.0, < .01) and pneumococcal disease (OR:2.6, < .001). Patients with COPD, HIV and SOT were more likely to be vaccinated against influenza (OR:2.8, < .001, OR:1.8, < .05; OR:2.0, < .001, respectively) and pneumococcal disease (OR:2.9, < .001, OR:25.0, < .001; OR:2.6, < .001, respectively) than patients with heart failure. Reason for non-vaccination were concerns about effectiveness, necessity and side effects of influenza vaccines, and not being aware of the recommendation for pneumococcal disease. Initiatives to monitor the vaccination status of vulnerable patients are needed, which is why we advocate systematic vaccination registration and frequent communication about vaccination.
接触可通过疫苗预防的疾病时，某些个体因既有疾病、年龄或免疫抑制治疗而发生并发症的风险增加。除了针对白喉、破伤风和百日咳的标准疫苗接种外，建议对流感、肺炎球菌疾病和乙型肝炎（某些人群）进行疫苗接种。我们在一项单中心研究中估计了1型糖尿病患者（n = 173）、2型糖尿病患者（n = 177）、慢性肾脏病（CKD）患者（n = 138）、心力衰竭患者（n = 200）、慢性阻塞性肺疾病（COPD）患者（n = 187）、HIV患者（n = 201）或实体器官移植（SOT）患者（n = 201）的疫苗接种覆盖率及推荐疫苗接种的决定因素。疫苗接种数据从患者和全科医生提供的文件以及弗拉芒疫苗接种登记处获取。不到10%的人接种了所有推荐疫苗。总体而言，29%的受试者接种了白喉-破伤风疫苗，10%接种了百日咳疫苗，44%接种了流感疫苗，32%接种了肺炎球菌疾病疫苗，24%的HIV患者和31%的CKD患者接种了乙型肝炎疫苗。年龄与流感疫苗接种（比值比：2.0，P<0.01）和肺炎球菌疾病疫苗接种（比值比：2.6，P<0.001）呈正相关。与心力衰竭患者相比，COPD患者、HIV患者和SOT患者接种流感疫苗（比值比分别为：2.8，P<0.001；1.8，P<0.05；2.0，P<0.001）和肺炎球菌疾病疫苗（比值比分别为：2.9，P<0.001；25.0，P<0.001；2.6，P<0.001）的可能性更大。未接种疫苗的原因包括对流感疫苗有效性、必要性和副作用的担忧，以及不了解肺炎球菌疾病的推荐。需要采取措施监测脆弱患者的疫苗接种状况，这就是我们提倡进行系统疫苗接种登记并就疫苗接种进行频繁沟通的原因。
