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一组乳糜泻患者的疫苗接种状况及对疫苗的态度

Vaccination Status and Attitudes towards Vaccines in a Cohort of Patients with Celiac Disease.

作者信息

Costantino Andrea, Michelon Marco, Roncoroni Leda, Doneda Luisa, Lombardo Vincenza, Costantino Claudio, Vecchi Maurizio, Elli Luca

机构信息

Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.

出版信息

Vaccines (Basel). 2022 Jul 27;10(8):1199. doi: 10.3390/vaccines10081199.

Abstract

(1) Background: The identification of vaccination status and attitudes towards vaccines among celiac disease (CD) patients is of great importance, but it has not yet been investigated. The aim of this study was to investigate coverage against vaccine-preventable diseases (VPDs), attitudes towards vaccinations, and its determinants among CD patients. (2) Methods: An anonymous web-based validated questionnaire was sent to a mailing list of CD adult patients. Patients were asked to self-report their previous vaccinations and attitudes towards vaccinations, which were defined as positive, negative, and partially positive/negative. The influencing factors towards vaccinations were investigated, and crude and adjusted odds ratios (AdjORs) with 95% confidence intervals (CIs) were calculated. (3) Results: The questionnaire was sent to 412 patients, with a response rate of 31.6% (130 patients, 105 women, median age 40 years, interquartile range 36-51). Patients self-reported vaccination against the following diseases: 73.8% tetanus, 42.3% flu, 20% measles, mumps and rubella, 19.2% meningitis, and 16.2% pneumococcus. Thirty-two people (24.6%) did not remember all of their previous vaccinations. In total, 104 (80%) respondents had a positive attitude towards vaccines, 25 (19.2%) a partially positive/negative one, and 1 a negative one. The determinants significantly influencing the positive attitude were being a graduate (AdjORs 7.49) and a belief in the possible return of VPDs with declining vaccination coverage rates (AdjORs 7.42), while the use of complementary and alternative medicines (AdjORs 0.11) and past negative experience (AdjORs 0.16) were associated with a negative attitude. (4) Conclusions: Despite four out of five CD patients showing a strong positive attitude towards vaccinations, one out of five had a partially negative one. Only a minority (16-20%) reported being vaccinated against some VPDs potentially harmful to their CD because of hyposplenism, such as meningitis and pneumococcus. The low vaccination rate against some VPDs, in spite of the 80% of CD patients stating a positive attitude towards vaccination, may be explained in part by patients' vaccine hesitancy and in part by a possible role of physicians in under-prescribing vaccinations to these patients. These results may be a starting point for developing specific vaccination campaigns to increase vaccination rates against VPDs in CD patients.

摘要

(1) 背景:乳糜泻(CD)患者的疫苗接种状况及对疫苗的态度至关重要,但尚未得到研究。本研究旨在调查CD患者中疫苗可预防疾病(VPD)的接种覆盖率、对疫苗接种的态度及其决定因素。(2) 方法:向CD成年患者邮件列表发送一份经过验证的匿名网络问卷。要求患者自行报告既往疫苗接种情况及对疫苗接种的态度,态度分为积极、消极和部分积极/消极。调查疫苗接种的影响因素,并计算粗比值比和调整比值比(AdjORs)及其95%置信区间(CIs)。(3) 结果:向412名患者发送了问卷,回复率为31.6%(130名患者,105名女性,中位年龄40岁,四分位间距36 - 51岁)。患者自行报告接种过以下疾病疫苗:破伤风73.8%、流感42.3%、麻疹、腮腺炎和风疹20%、脑膜炎19.2%、肺炎球菌16.2%。32人(24.6%)记不清所有既往接种情况。总共104名(80%)受访者对疫苗持积极态度,25名(19.2%)持部分积极/消极态度,1名持消极态度。显著影响积极态度的决定因素是拥有大学学历(AdjORs 7.4)和认为随着疫苗接种覆盖率下降VPD可能复发(AdjORs 7.42),而使用补充和替代药物(AdjORs 0.11)和过去的负面经历(AdjORs 0.16)与消极态度相关。(4) 结论:尽管五分之四的CD患者对疫苗接种持强烈积极态度,但五分之一的患者持部分消极态度。只有少数(16 - 20%)报告因脾功能减退接种过一些对其CD可能有害的VPD疫苗,如脑膜炎和肺炎球菌疫苗。尽管80%的CD患者表示对疫苗接种持积极态度,但某些VPD疫苗接种率低,部分原因可能是患者对疫苗的犹豫态度,部分原因可能是医生对这些患者疫苗处方不足。这些结果可能是开展特定疫苗接种活动以提高CD患者VPD疫苗接种率的起点。

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