Cross-sectional study on the prevalence of influenza and pneumococcal vaccination and its association with health conditions and risk factors among hospitalized multimorbid older patients

• Published in: PloS one Vol. 16; no. 11; p. e0260112
• Main Authors: Papazoglou, Dimitrios David, Baretella, Oliver, Feller, Martin, Del Giovane, Cinzia, Moutzouri, Elisavet, Aujesky, Drahomir, Schwenkglenks, Matthias, O’Mahony, Denis, Knol, Wilma, Dalleur, Olivia, Rodondi, Nicolas, Baumgartner, Christine
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 16.11.2021; Public Library of Science (PLoS)
• Subjects: Age; Aged; Aged patients; Aged, 80 and over; Ambulatory Care; Analysis; Belgium - epidemiology; Biology and Life Sciences; Care and treatment; Chronic conditions; Chronic Disease - classification; Chronic Disease - drug therapy; Chronic Disease - epidemiology; Chronic illnesses; Cochlear implants; Comorbidity; Complications; Complications and side effects; Confidence intervals; Cross-Sectional Studies; Demographics; Demography; Diabetes; Diabetes mellitus; Diagnosis; Dosage and administration; Ethics; Female; Health care; Health risks; Hospitals; Humans; Immunization; Influenza; Influenza vaccines; Influenza Vaccines - administration & dosage; Inpatients - statistics & numerical data; Internal medicine; Ireland - epidemiology; Male; Medical records; Medicine; Medicine and Health Sciences; Mortality; Multimorbidity; Netherlands - epidemiology; Older people; Patient admissions; Patient outcomes; Patients; People and Places; Pharmacy; Pneumococcal vaccine; Pneumococcal Vaccines - administration & dosage; Pneumonia; Polypharmacy; Polypharmacy - statistics & numerical data; Population; Prevalence; Prevalence studies (Epidemiology); Primary care; Public health; Quality of life; Regression analysis; Regression models; Respiratory diseases; Risk analysis; Risk Factors; Self Report; Statistical analysis; Streptococcus infections; Supervision; Switzerland - epidemiology; Transplants & implants; Vaccination; Vaccination - statistics & numerical data; Netherlands; Belgium; Switzerland; Ireland
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0260112

Older adults with chronic conditions are at high risk of complications from influenza and pneumococcal infections. Evidence about factors associated with influenza and pneumococcal vaccination among older multimorbid persons in Europe is limited. The aim of this study was to investigate the prevalence and determinants of these vaccinations in this population. Multimorbid patients aged ≥70 years with polypharmacy were enrolled in 4 European centers in Switzerland, Belgium, the Netherlands, and Ireland. Data on vaccinations, demographics, health care contacts, and comorbidities were obtained from self-report, general practitioners and medical records. The association of comorbidities or medical contacts with vaccination status was assessed using multivariable adjusted log-binomial regression models. Among 1956 participants with available influenza vaccination data (median age 79 years, 45% women), 1314 (67%) received an influenza vaccination within the last year. Of 1400 patients with available pneumococcal vaccination data (median age 79 years, 46% women), prevalence of pneumococcal vaccination was 21% (n = 291). The prevalence of vaccination remained low in high-risk populations with chronic respiratory disease (34%) or diabetes (24%), but increased with an increasing number of outpatient medical contacts. Chronic respiratory disease was independently associated with the receipt of both influenza and pneumococcal vaccinations (prevalence ratio [PR] 1.09, 95% confidence interval [CI] 1.03-1.16; and PR 2.03, 95%CI 1.22-3.40, respectively), as was diabetes (PR 1.06, 95%CI 1.03-1.08; PR 1.24, 95%CI 1.16-1.34, respectively). An independent association was found between number of general practitioner visits and higher prevalence of pneumococcal vaccination (p for linear trend <0.001). Uptake of influenza and particularly of pneumococcal vaccination in this population of European multimorbid older inpatients remains insufficient and is determined by comorbidities and number and type of health care contacts, especially outpatient medical visits. Hospitalization may be an opportunity to promote vaccination, particularly targeting patients with few outpatient physician contacts.