Evaluation of vaccine uptake and opportunity of in-hospital vaccination against pneumococcus in vulnerable hospitalized patients

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-06-05 DOI:10.1016/j.vaccine.2025.127364

Elvira Marín-Caba , Alberto Benavente-Fernández , Gonzalo Morales-Jiménez , Sandra Comino-Fernández , María Isabel Cueto-Martín , Laura Lirola-Andreu , Inmaculada Guerrero-Fernández de Alba , María del Carmen Valero-Ubierna , José Juan Jiménez-Moleón , Mario Rivera-Izquierdo

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引用次数: 0

Abstract

Background

Pneumococcal infections are an increased cause of morbimortality worldwide. The most effective preventive strategy is adequate vaccination. The aim of this work was to evaluate the vaccination coverage and associated factors for vulnerable hospitalized patients, and the opportunity of vaccination within hospitalization.

Methods

Observational study conducted on a secondary care public hospital. The sample was composed of patients admitted to an Internal Medicine service, excluding participants with terminal conditions. Descriptive and bivariate analyses using chi-square and t-tests were applied. To detect profiles of non-vaccinated patients, a dendrogram was fitted using cluster analysis techniques. Multivariable logistic regression models were designed to analyse associated factors with vaccination uptake. Vaccination was finally applied if indicated.

Findings

A total of 388 patients were included. Of them, 330 (85.7 %) had indication of pneumococcal vaccination, but only 180 (54.4 %) had received any previous vaccination, and 276 with indication (83.6 %) were not correctly vaccinated. During hospitalization, 192 (49.7 %) of the admitted patients were vaccinated. Vaccination coverage was higher in patients with chronic heart failure (59.4 %) or diabetes mellitus (57.5 %) than in patients with neoplasia (50.9 %) or chronic hepatopathy (26.7 %). The main factors associated with lower vaccination coverage were sex female (OR = 1.74, 95 %CI: 1.13–2.68) and COVID-19 infection (OR = 3.50, 95 %CI: 1.36–9.01).

Interpretation

Our results suggest that hospitalized patients, mostly elderly patients with high frequency of comorbidities and indication of antipneumococcal vaccine (e.g., Internal Medicine or Geriatric services), have low vaccination uptake. Therefore, hospitalization admission could be a great opportunity to increase pneumococcal vaccination coverage in patients at risk. Further studies should confirm the associations with lower coverage to optimize future vaccination strategies.

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易感住院病人肺炎球菌疫苗摄取和住院疫苗接种机会的评估

背景肺炎球菌感染是世界范围内日益增加的致死率原因。最有效的预防策略是充分接种疫苗。这项工作的目的是评估脆弱的住院患者的疫苗接种覆盖率和相关因素，以及在住院期间接种疫苗的机会。方法对某二级公立医院进行观察性研究。样本由住院内科服务的患者组成，不包括患有绝症的参与者。采用卡方检验和t检验进行描述性和双变量分析。为了检测未接种疫苗患者的概况，使用聚类分析技术拟合了树形图。设计了多变量logistic回归模型来分析与疫苗接种有关的因素。如果有指示，最后接种疫苗。结果共纳入388例患者。其中330例（85.7%）有肺炎球菌疫苗接种指征，但仅有180例（54.4%）曾接种过肺炎球菌疫苗，有指征的276例（83.6%）未正确接种。住院期间接种疫苗192例（49.7%）。慢性心力衰竭（59.4%）或糖尿病（57.5%）患者的疫苗接种率高于肿瘤（50.9%）或慢性肝病（26.7%）患者。与低疫苗接种率相关的主要因素是性别女性（OR = 1.74, 95% CI: 1.13-2.68）和COVID-19感染（OR = 3.50, 95% CI: 1.36-9.01）。我们的研究结果表明，住院患者，主要是合并症发生率高且抗肺炎球菌疫苗适应症（如内科或老年服务）的老年患者，疫苗接种率低。因此，住院可能是增加高危患者肺炎球菌疫苗接种覆盖率的绝佳机会。进一步的研究应证实与低覆盖率的关联，以优化未来的疫苗接种策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.