Department of research, The Danish Heart Foundation, Vognmagergade 7, 3rd floor, 1120 Copenhagen, Denmark.
Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark.
Eur Heart J Qual Care Clin Outcomes. 2023 Aug 7;9(5):474-481. doi: 10.1093/ehjqcco/qcac049.
Influenza vaccination protects against morbidity and mortality in patients with cardiovascular disease (CVD). We aimed to describe influenza vaccine uptake in patients with CVD in a universal-access healthcare system.
Using nationwide Danish registries, we included all patients with prevalent CVD, defined as heart failure (HF), atrial fibrillation (AF), ischemic heart disease (IHD), or stroke during three consecutive influenza seasons (October-December 2017-2019). The outcome was relative frequency of influenza vaccination across strata of patient characteristics.
There was an average of 397 346 patients with CVD yearly during 2017-2019. Vaccine uptake was 45.6% for the whole population and ranged from 55.0% in AF to 61.8% in HF among patients aged ≥65 years. Among patients aged <65 years, uptake was 32.6% in HF, 19.0% in AF, 21.1% in IHD, and 18.3% in stroke. There was a lower uptake with decreasing age: 21.6% in HF, 5.5% in AF, 7.4% in IHD, and 6.3% in stroke among males aged <45 years, as opposed to 25.5% in HF, 11.5% in AF, 13.8% in IHD, and 12.1% in stroke for males aged 45-54 years. In the further stratified analyses, uptake ranged from a low of 2.5% for males <45 years with AF who were not vaccinated the previous season to a high of 87.0% for females ≥75 years with IHD who were vaccinated the previous season.
Seasonal influenza vaccine uptake is suboptimal among patients with CVD, even in a universal-access healthcare system with free-of-charge vaccinations. Vaccine uptake was particularly low among young patients.
流感疫苗可预防心血管疾病(CVD)患者的发病率和死亡率。我们旨在描述在普及医疗保健系统中 CVD 患者的流感疫苗接种情况。
我们使用全国性的丹麦登记处,纳入了三个连续的流感季节(2017 年至 2019 年 10 月至 12 月)中患 CVD 的所有患者,定义为心力衰竭(HF)、心房颤动(AF)、缺血性心脏病(IHD)或中风。结局是根据患者特征分层的流感疫苗接种相对频率。
2017-2019 年期间,每年平均有 397346 例 CVD 患者。总人口中疫苗接种率为 45.6%,年龄≥65 岁的患者中,AF 为 55.0%,HF 为 61.8%。年龄<65 岁的患者中,HF 为 32.6%,AF 为 19.0%,IHD 为 21.1%,中风为 18.3%。随着年龄的降低,接种率降低:年龄<45 岁的男性 HF 为 21.6%,AF 为 5.5%,IHD 为 7.4%,中风为 6.3%,而年龄 45-54 岁的男性 HF 为 25.5%,AF 为 11.5%,IHD 为 13.8%,中风为 12.1%。在进一步分层分析中,接种率从年龄<45 岁且既往未接种的 AF 男性的 2.5%到年龄≥75 岁且既往接种过的 IHD 女性的 87.0%不等。
即使在普及医疗保健系统中提供免费疫苗接种,CVD 患者的季节性流感疫苗接种率仍然不理想,尤其是年轻患者。