多发性硬化症患者的疫苗接种覆盖率及其决定因素——一项多中心横断面研究

IF 4.7 2区 医学 Q1 CLINICAL NEUROLOGY
Therapeutic Advances in Neurological Disorders Pub Date : 2025-01-24 eCollection Date: 2025-01-01 DOI:10.1177/17562864241309806
Paula Schade, Hai-Anh Nguyen, Julia Steinle, Kerstin Hellwig, Teodor Pelea, Philipp Franken, Birte Elias-Hamp, Veit Becker, Stefan Merkelbach, Stephan Richter, Bert Wagner, Christian Geis, Matthias Schwab, Florian Rakers
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引用次数: 0

摘要

背景:多发性硬化症(multiple sclerosis, MS)协会建议对多发性硬化症(multiple sclerosis, pwMS)患者进行完全疫苗接种,以减轻与疾病修饰疗法(disease- modified therapies, dmt)相关的感染风险。目的:考虑到疫苗接种犹豫、ms特异性疫苗接种信念、对信息来源的信任以及全科医生(gp)的作用,与健康对照组相比,分析pwMS的疫苗接种覆盖率及其决定因素。方法:这项横断面多中心观察性研究在德国6个多发性硬化症中心进行。主要终点是疫苗接种指数(VI),包括8种标准疫苗接种(范围0-1,VI越高表明疫苗接种覆盖率越高)。次要终点包括一般疫苗接种犹豫、ms特异性疫苗接种信念和对信息来源的信任。通过问卷调查、疫苗接种卡分析和对接种pwMS疫苗的全科医生的调查收集数据。结果:与健康对照组(n = 300)相比,pwMS组(n = 397)的VI有降低的趋势;0.58±0.30 vs 0.62±0.31,p = 0.057)。在接受高效dmt治疗的pwMS中,VI与没有/平台dmt治疗的患者没有显著差异。疫苗接种犹豫相对较低,在pwMS和对照组之间没有差异。疫苗接种犹豫、信念和对信息来源的信任仅解释了10%-16%的VI差异。在109名全科医生中,82%的人表示,由于担心ms相关的副作用或与dmt的相互作用,他们不愿接种pwMS。结论:尽管多发性硬化症协会明确建议对所有多发性硬化症进行全面疫苗接种,但疫苗接种覆盖率仍然低得令人担忧。大约一半的患者缺乏标准的疫苗接种覆盖率,即使是那些使用高效dmt的患者。事实上,残疾妇女的疫苗接种率往往比健康对照组还要低。疫苗接种犹豫和其他内在因素不能充分解释低疫苗接种率。由于对疫苗安全性和DMT相互作用的不确定性,全科医生不一致的疫苗接种建议可能是原因之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Vaccination coverage and its determinants in patients with multiple sclerosis-a multicenter cross-sectional study.

Background: Complete vaccination coverage is recommended by multiple sclerosis (MS) societies for patients with multiple sclerosis (pwMS) to mitigate infection risks associated with disease-modifying therapies (DMTs).

Objectives: To analyze vaccination coverage and its determinants in pwMS compared to healthy controls, considering vaccination hesitancy, MS-specific vaccination beliefs, trust in information sources, and the role of general practitioners (GPs).

Methods: This cross-sectional multicenter observational study was conducted in six German MS centers. The primary endpoint was a vaccination index (VI) comprising eight standard vaccinations (range 0-1, with higher VI indicating better vaccination coverage). Secondary endpoints included validated measures of general vaccination hesitancy, MS-specific vaccination beliefs, and trust in information sources. Data were collected through questionnaires, vaccination card analysis, and a survey of GPs who vaccinate pwMS.

Results: VI tended to be lower in pwMS (n = 397) compared to healthy controls (n = 300; 0.58 ± 0.30 vs 0.62 ± 0.31, p = 0.057). In pwMS receiving highly effective DMTs, VI did not differ significantly from those on no/platform DMTs. Vaccination hesitancy was comparably low, with no differences between pwMS and controls. Vaccination hesitancy, beliefs, and trust in information sources explained only 10%-16% of the variance in VI. Among 109 GPs, 82% cited reluctance to vaccinate pwMS due to concerns about MS-related side effects or interactions with DMTs.

Conclusion: Despite clear recommendations from MS societies for full vaccination of all pwMS, vaccination coverage remains worryingly low. Approximately half of the patients lack standard vaccination coverage, even those on highly effective DMTs. In fact, vaccination coverage in pwMS tended to be even lower than in healthy controls. Vaccination hesitancy and other intrinsic factors do not sufficiently explain the low vaccination rates. Inconsistent vaccination recommendations from GPs due to uncertainties about vaccine safety and DMT interactions likely contribute.

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来源期刊
CiteScore
8.30
自引率
1.70%
发文量
62
审稿时长
15 weeks
期刊介绍: Therapeutic Advances in Neurological Disorders is a peer-reviewed, open access journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of neurology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in neurology, providing a forum in print and online for publishing the highest quality articles in this area.
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