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慢性心脏病患者的流感疫苗接种率:在费拉拉地方卫生单位(意大利北部)连续四个免疫季节获得的结果

Influenza coverage rates in subjects with chronic heart diseases: results obtained in four consecutive immunisation seasons in the Local Health Unit of Ferrara (North Italy)".

作者信息

Stefanati Armando, Lupi Silvia, Campo Gianluca, Cocchio Silvia, Furlan Patrizia, Baldo Vincenzo, Gabutti Giovanni

机构信息

Department of Medical Sciences, University of Ferrara, via Fossato di Mortara 64b, 44121 Ferrara, Italy.

Department of Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padua, Italy.

出版信息

Arch Public Health. 2020 Oct 16;78:103. doi: 10.1186/s13690-020-00487-y. eCollection 2020.

Abstract

BACKGROUND

Seasonal influenza epidemics yearly affects 5-15% of the world's population, resulting in 3-5 million serious cases and up to 650,000 deaths. According to the 2017-2019 Italian National Immunisation Plan, free immunisation is offered to the categories at increased risk of experience the complications of the infection (over 65 years old subjects, pregnant women and individuals with underlying conditions, including chronic heart diseases). Rising evidence suggests that influenza can trigger adverse cardiovascular events therefore the vaccination is recommended for secondary prevention of cardiovascular diseases. Despite this, the influenza coverage rate in subjects with chronic heart disease is underestimated.

METHODS

The study investigated the coverage rate in four consecutive influenza seasons (from 2011/2012 to 2014/2015) in subjects that benefit from exemption from paying healthcare costs for chronic heart disease living in Local Health Unit (LHU) of Ferrara (Italy), comparing the databases of exemptions and immunisations.

RESULTS

The levels of influenza vaccine uptake were unstable, reaching the 50.3% in 2011/2012 immunisation season and falling to 42.2% in the following year. Coverage rates increased with increasing age, without achieving the 75% target, neither in over 65 years old subjects. The logistic regression analysis showed that influenza coverage rates were statistically significant different ( < 0.0001, 0.003 only for category of disease in 2011/2012 immunisation season) according to age, district of residence, category of chronic heart disease and length of exemption, but not influenced by gender.

CONCLUSIONS

The recommendation of influenza immunisation was weakly followed in individuals with chronic heart diseases. A collaboration between cardiologists, GPs, scientific societies and patient associations could successfully support influenza vaccine uptake.

摘要

背景

季节性流感疫情每年影响全球5%-15%的人口,导致300万至500万重症病例,死亡人数高达65万。根据2017-2019年意大利国家免疫计划,为感染并发症风险增加的人群(65岁以上人群、孕妇以及患有包括慢性心脏病在内的基础疾病的个体)提供免费免疫接种。越来越多的证据表明,流感可引发不良心血管事件,因此建议进行流感疫苗接种以预防心血管疾病。尽管如此,慢性心脏病患者的流感疫苗接种率仍被低估。

方法

本研究调查了意大利费拉拉地方卫生单位(LHU)中受益于慢性心脏病医疗费用豁免的人群在连续四个流感季节(2011/2012至2014/2015)的疫苗接种率,比较了豁免和免疫接种数据库。

结果

流感疫苗接种水平不稳定,在2011/2012免疫季节达到50.3%,次年降至42.2%。接种率随年龄增长而增加,但未达到75%的目标,65岁以上人群也未达到。逻辑回归分析表明,根据年龄、居住地区、慢性心脏病类别和豁免时长,流感疫苗接种率存在统计学显著差异(<0.0001,仅在2011/2012免疫季节疾病类别中有0.003),但不受性别影响。

结论

慢性心脏病患者对流感免疫接种建议的遵循程度较低。心脏病专家、全科医生、科学协会和患者协会之间的合作可以成功地促进流感疫苗的接种。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1105/7565811/0b751d413dda/13690_2020_487_Fig1_HTML.jpg

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