Kumru Gizem, Akdemir İrem, Demir Cengiz Kaan, Ates Kenan, Erturk Sehsuvar, Nergizoglu Gokhan, Keven Kenan, Kutlay Sim, Sengul Sule
Faculty of Medicine, Department of Nephrology, Ankara University, Ankara, Türkiye.
Faculty of Medicine, Department of Clinical Microbiology and Infectious Diseases, Ankara University, Ankara, Türkiye.
BMC Nephrol. 2025 Jul 1;26(1):309. doi: 10.1186/s12882-025-04238-5.
Influenza and pneumococcal vaccinations are strongly encouraged for individuals with chronic kidney disease (CKD); however, vaccination rates remain below the target. Establishing factors influencing vaccination status may guide approaches to enhance vaccine uptake among this vulnerable patient population.
A cross-sectional study involved 307 patients diagnosed with CKD for at least one year (40.4% non-dialysis, 37.1% dialysis, and 22.5% kidney transplantation). Demographic data, clinical conditions, and social factors, such as nutritional status, frailty, and health literacy, were evaluated. The vaccination rates for influenza, and pneumococcus, along with the associated variables, have been analyzed.
The average age of the patients was 57 years (± 16), with a predominance of males (56.7%). The percentages of individuals unvaccinated for influenza, pneumococcus, and SARS-CoV-2 were 61.9%, 60.9%, and 5.9%, respectively, while only 11 patients (3.9%) received an annual influenza vaccine. Healthcare providers recommended influenza and pneumococcal vaccination to 60.3% and 37.1% of patients, 71% of whom visited a physician 5 or more times a year, respectively. The frequency of regular or infrequent influenza vaccination was significantly correlated with healthcare providers' recommendations (HR, 14.348; 95% CI, 6.842-30.086; p < 0.001), increased risk of malnutrition (HR, 2.722; 95% CI, 1.467-5.050; p:0.002), and previous pneumococcal vaccination (HR, 2.100; 95% CI, 1.180-3.737; p:0.012). Conversely, frailty was linked to reduced vaccination rates (HR, 0.198; 95% CI, 0.083-0.472; p < 0.001). In multivariable models, healthcare providers' recommendations (HR, 17.804; 95% CI, 9.353-33.892; p < 0.001) and advanced age (HR, 1.024; 95% CI, 1.001-1.046; p:0.040) were determined as factors associated with pneumococcal vaccination.
The guidance of healthcare professionals is the key factor in improving immunization rates. Developing health policies that consider factors influencing vaccine hesitancy and engage healthcare providers in the decision-making process is essential.
Not applicable.
强烈建议慢性肾脏病（CKD）患者接种流感疫苗和肺炎球菌疫苗；然而，疫苗接种率仍低于目标水平。确定影响疫苗接种状况的因素可能有助于指导提高这一脆弱患者群体疫苗接种率的方法。
一项横断面研究纳入了307例确诊CKD至少一年的患者（40.4%为非透析患者，37.1%为透析患者，22.5%为肾移植患者）。评估了人口统计学数据、临床状况以及营养状况、虚弱程度和健康素养等社会因素。分析了流感疫苗和肺炎球菌疫苗的接种率以及相关变量。
患者的平均年龄为57岁（±16），男性占多数（56.7%）。未接种流感疫苗、肺炎球菌疫苗和SARS-CoV-2疫苗的个体比例分别为61.9%、60.9%和5.9%，而只有11例患者（3.9%）接种了年度流感疫苗。医疗保健提供者向60.3%和37.1%的患者推荐了流感疫苗和肺炎球菌疫苗，其中分别有71%的患者每年就诊5次或更多次。定期或不定期接种流感疫苗的频率与医疗保健提供者的建议显著相关（风险比[HR]，14.348；95%置信区间[CI]，6.842 - 30.086；p < 0.001）、营养不良风险增加（HR，2.722；95% CI，1.467 - 5.050；p:0.002）以及既往肺炎球菌疫苗接种情况（HR，2.100；95% CI，1.180 - 3.737；p:0.012）。相反，虚弱与较低的疫苗接种率相关（HR，0.198；95% CI，0.083 - 0.472；p < 0.001）。在多变量模型中，医疗保健提供者的建议（HR，17.804；95% CI，9.353 - 33.892；p < 0.001）和高龄（HR，1.024；95% CI，1.001 - 1.046；p:0.040）被确定为与肺炎球菌疫苗接种相关的因素。
医疗专业人员的指导是提高免疫接种率的关键因素。制定考虑影响疫苗犹豫因素的卫生政策并让医疗保健提供者参与决策过程至关重要。
不适用。
