Influenza and pneumococcal vaccination coverage and associated factors in patients hospitalized with acute exacerbations of COPD in China:Findings from real-world dataOACSTPCDMEDLINE
Influenza and pneumococcal vaccination coverage and associated factors in patients hospitalized with acute exacerbations of COPD in China:Findings from real-world data
Background:Influenza and pneumococcal vaccination are a priority in patients with chronic obstructive pulmonary disease(COPD).However,limited information is available on vaccination coverage among patients with acute exacerbations of COPD(AECOPD)in China.This study aimed to determine the rates and associated factors of influenza and pneumococcal vaccination in patients hospitalized with AECOPD. Methods:Baseline data from a national,multicenter,hospital-based study that included adult inpatients with AECOPD between 2017 and 2021 were analyzed.The outcomes of interest were the influenza vaccination in the past year and the pneumococcal vaccination in the past 5 years.To ensure national representativeness,rates were weighted according to the distribution of hospital levels and types enrolled in this study.Multivariable Poisson regression based on mixed-effects models were used to determine the associated factors.The independent variables included the region and hospital features where the participants were located,sociodemographic characteristics(age,sex,rural/urban residence,education,etc.),and clinical indicators(COPD disease history,lung function parameters,comorbidities,etc.).The treatment profiles of the vaccinated and unvaccinated participants were compared. Results:Of 6949 eligible participants,the weighted rates of influenza/pneumococcal,influenza,and pneumococcal vaccination were 2.72%(95%confidence interval[CI]:2.34%-3.10%),2.09%(95%CI:1.76%-2.43%),and 1.25%(95%CI:0.99%-1.51%),respectively.In multivariable models,age ≥60 years(60-69 years,odds ratio[OR]:1.90,95%CI:1.11-3.25;≥80 years,OR:2.00,95%CI:1.06-3.78),geographical regions(Northern China relative to Eastern China,OR:5.09,95%CI:1.96-13.21),urban residence(OR:1.69,95%CI:1.07-2.66),a higher education level(junior high school,OR:1.77,95%CI:1.21-2.58;senior high school or above,OR:2.61,95%CI:1.69-4.03),former smoking(OR:1.79,95%CI:1.15-2.79),and regular inhaled medication treatment(OR:3.28,95%CI:2.29-4.70)were positively associated with vaccination.Patients who had experienced severe exacerbations in the past year were less likely to be vaccinated(OR:0.65,95%CI:0.45-0.96).Compared with unvaccinated participants,vaccinated participants adhered better to pharmacological and non-pharmacological treatment. Conclusions:Influenza and pneumococcal vaccination coverage are extremely low.Urgent measures are necessary to increase vaccination coverage among inpatients with AECOPD in China.
Ruoxi He;Ting Yang;Chen Wang;Xiaoxia Ren;Ke Huang;Jieping Lei;Hongtao Niu;Wei Li;Fen Dong;Baicun Li;Ye Wang
School of Population Medicine and Public Health,Chinese Academy of Medical Sciences and Peking Union Medical College,Beljing 100730,China||Department of Respiratory Medicine,National Key Clinical Specialty,Branch of National Clinical Research Center for Respiratory Disease,Xiangya Hospital,Central South University,Changsha,Hunan 410008,ChinaDepartment of Pulmonary and Critical Care Medicine,Center of Respiratory Medicine,China-Japan Friendship Hospital,Beijing 100029,China||Institute of Respiratory Medicine,Chinese Academy of Medical Sciences,Beijing 100029,China||National Center for Respiratory Medicine,Beijing 100029,China||National Clinical Research Center for Respiratory Diseases,Beijing 100029,ChinaSchool of Population Medicine and Public Health,Chinese Academy of Medical Sciences and Peking Union Medical College,Beljing 100730,China||Institute of Respiratory Medicine,Chinese Academy of Medical Sciences,Beijing 100029,China||National Center for Respiratory Medicine,Beijing 100029,China||National Clinical Research Center for Respiratory Diseases,Beijing 100029,ChinaInstitute of Respiratory Medicine,Chinese Academy of Medical Sciences,Beijing 100029,China||National Center for Respiratory Medicine,Beijing 100029,China||National Clinical Research Center for Respiratory Diseases,Beijing 100029,China||Department of Clinical Research and Data Management,Center of Respiratory Medicine,China-Japan Friendship Hospital,Beijing 100029,ChinaInstitute of Respiratory Medicine,Chinese Academy of Medical Sciences,Beijing 100029,China||National Center for Respiratory Medicine,Beijing 100029,China||National Clinical Research Center for Respiratory Diseases,Beijing 100029,ChinaSchool of Population Medicine and Public Health,Chinese Academy of Medical Sciences and Peking Union Medical College,Beljing 100730,China
Chronic obstructive pulmonary diseaseInfluenzaPneumococcalVaccineAECOPD
《中华医学杂志(英文版)》 2024 (010)
1179-1189 / 11
This study was supported by a grant from the CAMS Innovation Fund for Medical Sciences(No.2021-I2M-1-049).
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