Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Transpl Infect Dis. 2023 Apr;25(2):e14010. doi: 10.1111/tid.14010. Epub 2023 Jan 30.
Vaccinations against preventable respiratory infections such as Streptococcus pneumoniae and influenza are important in immunosuppressed solid organ transplant (SOT) recipients. Little is known about the role of age, race, ethnicity, sex, and sociodemographic factors including rurality, or socioeconomic status (SES) associated with vaccine uptake in this population.
We conducted a population-based study using the Rochester Epidemiology Project, a medical records linkage system, to assess socioeconomic and demographic factors associated with influenza and pneumococcal vaccination rates among adult recipients of solid organ transplantation (aged 19-64 years) living in four counties in southeastern Minnesota. Vaccination data were obtained from the Minnesota Immunization Information Connection from June 1, 2010 to June 30, 2020. Vaccination rate was assessed with Poisson and logistic regression models.
A total of 468 SOT recipients were identified with an overall vaccination rate of 57%-63% for influenza and 56% for pneumococcal vaccines. As expected, vaccination for pneumococcal vaccine positively correlated with influenza vaccination. Rural patients had decreased vaccination in both compared to urban patients, even after adjusting for age, sex, race, ethnicity, and SES. Although the population was mostly White and non-Hispanic, neither vaccination differed by race or ethnicity, but influenza vaccination did by SES. Among organ transplant groups, liver and lung recipients were least vaccinated for influenza, and heart recipients were least up-to-date on pneumococcal vaccines.
Rates of vaccination were below national goals. Rurality was associated with undervaccination. Further investigation is needed to understand and address barriers to vaccination among transplant recipients.
针对可预防呼吸道感染（如肺炎链球菌和流感）的疫苗接种对免疫抑制的实体器官移植（SOT）受者很重要。对于年龄、种族、民族、性别以及与该人群疫苗接种率相关的社会人口因素（包括农村或社会经济地位（SES））的作用知之甚少。
我们使用罗切斯特流行病学项目（一种医疗记录链接系统）进行了一项基于人群的研究，以评估明尼苏达州东南部四个县的成年实体器官移植受者（年龄在 19-64 岁之间）中与流感和肺炎球菌疫苗接种率相关的社会经济和人口统计学因素。接种疫苗的数据来自明尼苏达州免疫信息连接，时间为 2010 年 6 月 1 日至 2020 年 6 月 30 日。使用泊松和逻辑回归模型评估接种疫苗率。
共确定了 468 例 SOT 受者，流感疫苗接种率总体为 57%-63%，肺炎球菌疫苗接种率为 56%。如预期的那样，肺炎球菌疫苗的接种与流感疫苗的接种呈正相关。与城市患者相比，农村患者的两种疫苗接种率均较低，即使在调整了年龄、性别、种族、民族和 SES 后也是如此。尽管该人群主要是白人和非西班牙裔，但种族或民族均与接种疫苗无关，但 SES 与流感疫苗接种有关。在器官移植组中，肝和肺移植受者的流感疫苗接种率最低，心脏移植受者的肺炎球菌疫苗接种率最低。
接种疫苗率低于国家目标。农村地区与疫苗接种不足有关。需要进一步调查，以了解和解决移植受者接种疫苗的障碍。
