Li Zhourong, Feng Luzhao, Long Jiang, Xiong Yu, Li Tingting, Jiang Binshan, Yang Shuang, Fu Lin, Shi Zumin, Zhao Yong, Qi Li
Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400799, China.
School of Public Health, Chongqing Medical University, Chongqing 400016, China.
Vaccines (Basel). 2024 Aug 8;12(8):898. doi: 10.3390/vaccines12080898.
Influenza vaccination is essential for type 2 diabetes mellitus (T2DM) patients due to their higher risks of severe complications and mortality from influenza. This study investigated the willingness of T2DM patients in Chongqing, China, to receive the influenza vaccination during the 2023/2024 season, using behavioral and social drivers (BeSD) tools to improve vaccination uptake in this high-risk group.
A multi-stage sampling method was used to select participants, and face-to-face surveys were conducted in community health centers between March 1 and May 1, 2023. Binary logistic regression was used to analyze the factors influencing vaccination willingness, and standardized scores identified barriers and drivers.
Among 1672 T2DM patients, 11.7% had been vaccinated during the 2022/2023 season, and 59.6% were willing to receive the vaccination in the 2023/2024 season. Higher willingness was associated with ethnic minorities (odds ratio [OR], 3.18, 95% confidence interval [CI]: 1.58-6.39), being unemployed individuals (OR 2.69, 95% CI: 1.60-4.52), higher monthly household income per capita (OR 2.72, 95% CI: 1.65-4.50), having diabetes complications (OR 1.76, 95% CI: 1.23-2.51), sufficient vaccine knowledge (OR 1.87, 95% CI: 1.48-2.37), and previous vaccination (OR 7.75, 95% CI: 4.83-12.44). Concerning BeSDs, fear of infecting friends or family members and trust in vaccine efficacy were the predominant drivers, while high vaccine costs were the greatest barrier.
Future strategies should focus on improving vaccine knowledge, supporting healthcare workers and peer recommendations, and enhancing vaccination policies. Key interventions such as health education among high-risk groups, such as unemployed individuals, advocacy campaigns, pay-it-forward strategies, and policies for free vaccination could improve coverage in Chongqing.
由于2型糖尿病（T2DM）患者患流感后出现严重并发症和死亡的风险较高，因此流感疫苗接种对他们至关重要。本研究调查了中国重庆的T2DM患者在2023/2024季节接种流感疫苗的意愿，使用行为和社会驱动因素（BeSD）工具来提高这一高危人群的疫苗接种率。
采用多阶段抽样方法选取参与者，并于2023年3月1日至5月1日在社区卫生中心进行面对面调查。采用二元逻辑回归分析影响接种意愿的因素，并通过标准化分数确定障碍和驱动因素。
在1672名T2DM患者中，11.7%在2022/2023季节接种过疫苗，59.6%愿意在2023/2024季节接种疫苗。较高的接种意愿与少数民族（比值比[OR]，3.18，95%置信区间[CI]：1.58 - 6.39）、失业人员（OR 2.69，95% CI：1.60 - 4.52）、较高的人均家庭月收入（OR 2.72，95% CI：1.65 - 4.50）、患有糖尿病并发症（OR 1.76，95% CI：1.23 - 2.51）、具备足够的疫苗知识（OR 1.87，95% CI：1.48 - 2.37）以及既往接种史（OR 7.75，95% CI：4.83 - 12.44）有关。关于行为和社会驱动因素，担心感染朋友或家人以及对疫苗效力的信任是主要驱动因素，而疫苗成本高是最大障碍。
未来策略应侧重于提高疫苗知识、支持医护人员和同伴推荐以及加强疫苗接种政策。关键干预措施，如对失业人员等高风险群体进行健康教育、开展宣传活动、“传递爱心”策略以及免费接种疫苗政策，可提高重庆的疫苗接种覆盖率。
