KU Leuven Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
KU Leuven Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Can J Cardiol. 2021 Sep;37(9):1472-1479. doi: 10.1016/j.cjca.2021.04.010. Epub 2021 May 5.
Influenza vaccination is the most commonly recommended immune prevention strategy. However, data on influenza vaccination in patients with congenital heart disease (CHD) are scarce. In this study, our goals were to: (1) measure vaccination coverage rates (VCRs) for influenza in a large cohort of children, adolescents, and adults with CHD; (2) identify patient characteristics as predictors for vaccination; and (3) investigate the effect of influenza vaccination on hospitalization.
A nationwide cohort study in Belgium included 16,778 patients, representing 134,782 vaccination years, from the Belgian Congenital Heart Disease Database Combining Administrative and Clinical Data (BELCODAC). Data over 9 vaccination years (2006-2015) were used, and patients were stratified into 5 age cohorts: 6 months to 4 years; 5-17 years; 18-49 years; 50-64 years; and 65 years and older.
In the respective age cohorts, the VCR was estimated to be 6.6%, 8.0%, 23.9%, 46.6%, and 72.8%. There was a steep increase in VCRs as of the age of 40 years. Multivariable logistic regression showed that higher anatomical complexity of CHD, older age, presence of genetic syndromes, and previous cardiac interventions were associated with significantly higher VCRs. Among adults, men had lower and pregnant women had higher VCRs. The association between influenza vaccination and all-cause hospitalization was not significant in this study.
The influenza VCR in people with CHD is low, especially in children and adolescents. Older patients, particularly those with complex CHD, are well covered. Our findings should inform vaccination promotion strategies in populations with CHD.
流感疫苗接种是最常推荐的免疫预防策略。然而，患有先天性心脏病 (CHD) 的患者的流感疫苗接种数据却很少。在这项研究中，我们的目标是：(1) 测量大量患有 CHD 的儿童、青少年和成人的流感疫苗接种覆盖率 (VCR)；(2) 确定患者特征作为疫苗接种的预测因素；(3) 调查流感疫苗接种对住院的影响。
这项在比利时进行的全国性队列研究纳入了来自比利时先天性心脏病数据库结合行政和临床数据 (BELCODAC) 的 16778 名患者，代表了 134782 个疫苗接种年。使用了 9 年的疫苗接种数据（2006-2015 年），并将患者分为 5 个年龄组：6 个月至 4 岁；5-17 岁；18-49 岁；50-64 岁；65 岁及以上。
在相应的年龄组中，VCR 估计分别为 6.6%、8.0%、23.9%、46.6%和 72.8%。自 40 岁起，VCR 急剧上升。多变量逻辑回归显示，CHD 的解剖结构复杂性较高、年龄较大、存在遗传综合征和先前的心脏干预与更高的 VCR 显著相关。在成年人中，男性的 VCR 较低，孕妇的 VCR 较高。在这项研究中，流感疫苗接种与全因住院之间没有显著关联。
患有 CHD 的人流感疫苗接种率较低，尤其是儿童和青少年。年龄较大的患者，尤其是患有复杂 CHD 的患者，接种率较高。我们的研究结果应该为 CHD 人群的疫苗接种推广策略提供信息。
