Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Thailand.
Hum Vaccin Immunother. 2022 Nov 30;18(6):2102840. doi: 10.1080/21645515.2022.2102840. Epub 2022 Aug 9.
Chronic obstructive pulmonary disease (COPD), often complicated by influenza or pneumococcus, is a leading cause of mortality worldwide. Vaccinations against influenza and pneumococcus are, but vaccination coverage in Thailand has not been ascertained. This study aimed to determine the determinants of influenza and pneumococcal vaccination acceptance in COPD patients. A cross-sectional study of 210 COPD patients was conducted. Demographics, vaccinations, clinical outcomes (exacerbations and hospitalizations), and pulmonary functions were collected. A total of 134 COPD patients (91.0%male) were eligible for final analysis. Of these, 102 (76.1%) and 59 (44.0%) were vaccinated against influenza and pneumococcus, respectively. The influenza-vaccinated group had a higher rate of pneumococcal vaccination than the influenza-unvaccinated group (57.8% vs 0%, < .001). Rates of influenza and pneumococcal vaccinations were higher in the pulmonologist group than in the non-pulmonologist group (71.6% vs 31.3%, < .001 and 91.5% vs 38.7%, < .001, respectively). By multivariable logistic regression analysis, influenza vaccination coverage was significantly higher among patients with bronchodilator response on pulmonary function testing. Pneumococcal vaccination coverage was significantly higher among patients who were seeing pulmonologists. Reasons for not getting influenza vaccination or pneumococcal vaccination were lack of recommendation, lack of knowledge, and misunderstanding, and in the case of pneumococcal vaccine, the expense. In conclusion, the influenza vaccination coverage in our COPD patients was considered high while the pneumococcal vaccination coverage was considered low. Physicians are advised to recommend and promote pneumococcal vaccination.
慢性阻塞性肺疾病(COPD)常并发流感或肺炎球菌,是全球主要致死病因之一。流感和肺炎球菌疫苗接种是预防的重要手段,但泰国的疫苗接种覆盖率尚未确定。本研究旨在确定 COPD 患者接受流感和肺炎球菌疫苗接种的决定因素。本研究对 210 例 COPD 患者进行了横断面研究。收集了人口统计学、疫苗接种、临床结局(加重和住院)和肺功能等数据。共有 134 例 COPD 患者(91.0%为男性)符合最终分析标准。其中,102 例(76.1%)和 59 例(44.0%)分别接种了流感和肺炎球菌疫苗。接种流感疫苗的患者中,接种肺炎球菌疫苗的比例高于未接种流感疫苗的患者(57.8%比 0%,<0.001)。在肺病专家组中,流感和肺炎球菌疫苗接种率高于非肺病专家组(71.6%比 31.3%,<0.001 和 91.5%比 38.7%,<0.001)。多变量逻辑回归分析显示,在肺功能检查中存在支气管扩张剂反应的患者中,流感疫苗接种率显著更高。在接受肺病专家治疗的患者中,肺炎球菌疫苗接种率显著更高。未接种流感疫苗或肺炎球菌疫苗的原因包括缺乏推荐、缺乏知识和误解,而在肺炎球菌疫苗的情况下,则是费用问题。总之,我们 COPD 患者的流感疫苗接种率较高,而肺炎球菌疫苗接种率较低。建议医生推荐并推广肺炎球菌疫苗接种。