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新冠病毒病严重免疫功能低下患者便利样本中医疗必需疫苗的接种覆盖率:一项观察性队列研究

Vaccination Coverage for Medically Indicated Vaccines in a Convenience Sample of Severely Immunocompromised Patients with COVID-19: An Observational Cohort Study.

作者信息

Te Linde Elsemieke, Hensgens Marjolein P M, Vollaard Albert M, Verbon Annelies, Bruns Anke H W

机构信息

Department of Infectious Diseases, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands.

Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands.

出版信息

Vaccines (Basel). 2024 Dec 9;12(12):1383. doi: 10.3390/vaccines12121383.

Abstract

BACKGROUND

In recent decades, the number of immunocompromised patients (ICPs) has increased significantly. ICPs have an impaired immune system, making them susceptible to complicated infections. To protect them from infections, ICPs are eligible to receive several medically indicated vaccines. To obtain insight into the uptake of these medically indicated vaccines, we determined the coverage of these vaccines in ICPs.

METHODS

This observational cohort study was conducted at the University Medical Centre Utrecht, the Netherlands, from September 2021 to April 2022. All adult ICPs admitted for COVID-19 were asked to complete a questionnaire on their vaccination history (pneumococcal, herpes zoster, human papillomavirus vaccination, influenza, and COVID-19 vaccines) and history of vaccine-preventable infections. In addition, patients' vaccination history was reviewed in medical files.

RESULTS

A total of 115 patients completed the questionnaire and were included. Although all patients had an indication for pneumococcal vaccination, only 22 received it (19%). Coverage for herpes zoster was low (1%, 1/106 eligible patients). Coverage for human papillomavirus vaccination (HPV) was also low (40%, two out of five eligible patients). In contrast, 92% of patients received vaccination against SARS-CoV-2, and 77% of patients received seasonal influenza vaccination.

CONCLUSIONS

Although coverage for influenza and COVID-19 vaccination was high in ICPs, coverage for other medically indicated vaccines was low. Identifying which factors contributed to high COVID-19 and influenza vaccine uptake can help to improve vaccination rates for the other recommended vaccines. Clear guidelines for clinicians and the removal of organizational obstacles are needed to improve vaccination coverage.

摘要

背景

近几十年来,免疫功能低下患者(ICPs)的数量显著增加。ICPs的免疫系统受损,使其易发生复杂感染。为保护他们免受感染,ICPs有资格接种几种医学上推荐的疫苗。为深入了解这些医学上推荐疫苗的接种情况,我们确定了ICPs中这些疫苗的接种覆盖率。

方法

这项观察性队列研究于2021年9月至2022年4月在荷兰乌得勒支大学医学中心进行。所有因COVID-19入院的成年ICPs均被要求填写一份关于其疫苗接种史(肺炎球菌、带状疱疹、人乳头瘤病毒疫苗接种、流感和COVID-19疫苗)以及疫苗可预防感染史的问卷。此外,还在病历中查看了患者的疫苗接种史。

结果

共有115名患者完成问卷并被纳入研究。尽管所有患者都有接种肺炎球菌疫苗的指征,但只有22人接种了(19%)。带状疱疹疫苗的接种覆盖率较低(1%,106名符合条件的患者中有1人接种)。人乳头瘤病毒疫苗(HPV)的接种覆盖率也较低(40%,5名符合条件的患者中有2人接种)。相比之下,92%的患者接种了SARS-CoV-2疫苗,77%的患者接种了季节性流感疫苗。

结论

尽管ICPs中流感和COVID-19疫苗的接种覆盖率较高,但其他医学上推荐疫苗的接种覆盖率较低。确定哪些因素导致了高COVID-19和流感疫苗接种率有助于提高其他推荐疫苗的接种率。需要为临床医生制定明确的指南并消除组织障碍,以提高疫苗接种覆盖率。

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