Abstract

Objective: This study aimed to evaluate the role and importance of adult vaccination clinics in immunizing individuals with diabetes with the pneumococcal conjugate vaccine (PCV13), influenza vaccine, hepatitis B vaccine, tetanus-diphtheria (Td) vaccine, and herpes zoster vaccine.

Methods: This descriptive study was conducted in 14 tertiary healthcare institutions with Family Medicine Clinics. The vaccination histories of individuals diagnosed with diabetes were reviewed, and information on PCV13, influenza, hepatitis B, Td, and herpes zoster vaccines was provided. Participants were informed about the adult vaccination clinic, if available at the institution, and followed up for one month to assess whether they received the recommended vaccines.

Results: A total of 388 participants were included, with a median age of 60 years; 55.4% of the participants were female. Only 27.8% were aware of the existence of an adult vaccination clinic in their institution. Prior to the study, 43.3% had received Td, 42.3% had received influenza vaccine, 21.4% had received PCV13, and 13.1% had received hepatitis B vaccine; only one person had received the herpes zoster vaccine. Physician recommendation was the most influential factor for vaccination (88.9%), while the most common reason for vaccine refusal was distrust in vaccines (57.9%). At the end of the one-month follow-up, 20.6% of participants had received at least one of the recommended vaccines; PCV13 was the most commonly administered vaccine among those who received any. Among them, 93.8% had applied to institutions with an adult vaccination clinic (p=0.011). A statistically significant association was found between receiving the PCV13 vaccine and the presence of an adult vaccination clinic (p=0.002). In contrast, no such association was observed for Td, influenza, or hepatitis B vaccines (p>0.05).

Conclusion: Vaccination rates among individuals with diabetes remain low. However, the presence of adult vaccination clinics and providing structured information significantly increase vaccine uptake. Strengthening these services could improve immunization coverage in this high-risk group.

Show References

References

  1. History of Vaccination – A Brief of Vaccination [Internet]. Geneva: World Health Organization (WHO). [erişim 1 Eylül 2024]. https://www.who.int/news-room/spotlight/history-of-vaccination/a-brief-history-of-vaccination
  2. Vaccines and immunization [Internet]. Geneva: World Health Organization (WHO). [erişim 1 Eylül 2024]. https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1
  3. Global Vaccine Action Plan [Internet]. Geneva: World Health Organization (WHO). [erişim 1 Eylül 2024]. https://www.who.int/teams/immunization-vaccines-and-biologicals/strategies/global-vaccine-action-plan
  4. Al-Jabri M, Rosero C, Saade EA. Vaccine-preventable diseases in older adults. Infect Dis Clin North Am. 2023;37(1):103-21. [CrossRef]
  5. Diabetes basics [Internet]. Brussels: International Diabetes Federation (IDF). [erişim 1 Eylül 2024]. https://idf.org/about-diabetes/what-is-diabetes/
  6. Delamaire M, Maugendre D, Moreno M, Le Goff MC, Allannic H, Genetet B. Impaired leucocyte functions in diabetic patients. Diabet Med. 1997;14(1):29-34. [CrossRef]
  7. Wang IK, Lin CL, Chang YC, et al. Effectiveness of influenza vaccination in elderly diabetic patients: a retrospective cohort study. Vaccine. 2013;31(4):718-24. [CrossRef]
  8. Macounová P, Ar RM. [Vaccines recommended for diabetic patients]. Vnitr Lek. 2020;66(5):301-7. Czech.
  9. Vaccine information for adults [Internet]. Atlanta: Centers for Disease Control and Prevention (CDC). [erişim 1 Eylül 2024].  https://www.cdc.gov/vaccines/adults/rec-vac/health-conditions/diabetes/infographic/images/global/footer/diabates_en.pdf
  10. Diyabet [Internet]. İstanbul: Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği – Klimik Aşı Platformu. [erişim 9 Ocak 2025].  https://asi.klimik.org.tr/risk-gruplari/diyabet
  11. Kırık A, Yekdeş AC, Eroğlu M, Ürk A, Alpay Y. [Vaccination education and rates in diabetic patients]. FLORA. 2020;25(4):536-43. Turkish. [CrossRef]
  12. Apaydın H, Aydın A, Doğan B, Yılmaz SA, Pala E, Basat SU. Influenza, hepatitis B and pneumococcal vaccination rates and factors influencing vaccination status in patients with diabetes. Sakarya Tıp Dergisi. 2021;11(1):148-54. [CrossRef]
  13. Zimmerman RK, Santibanez TA, Janosky JE, et al. What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and Veterans Affairs practices. Am J Med. 2003;114(1):31-8. [CrossRef]
  14. Kolobova I, Nyaku MK, Karakusevic A, Bridge D, Fotheringham I, O’Brien M. Vaccine uptake and barriers to vaccination among at-risk adult populations in the US. Hum Vaccin Immunother. 2022;18(5):2055422. [CrossRef]
  15. Stratoberdha D, Gobis B, Ziemczonek A, Yuen J, Giang A, Zed PJ. Barriers to adult vaccination in Canada: A qualitative systematic review. Can Pharm J (Ott). 2022;155(4):206-18. [CrossRef]
  16. Işık AC, Akın S, Aladağ N, Şimşek EE. Pneumococcal, influenza, hepatitis B, and tetanus vaccination rate and vaccine awareness in patients with type 2 diabetes. Endocrinol Res Pract 2020;24:327-34. [CrossRef]
  17. Welch VL, Metcalf T, Macey R, et al. Understanding the barriers and attitudes toward influenza vaccine uptake in the adult general population: a rapid review. Vaccines (Basel). 2023;11(1):180. [CrossRef]
  18. Mastrovito B, Lardon A, Dubromel A, Nave V, Beny K, Dussart C. Understanding the gap between guidelines and influenza vaccination coverage in people with diabetes: a scoping review. Front Public Health. 2024;12:1360556. [CrossRef]
  19. Hill-Briggs F, Fitzpatrick SL. Overview of social determinants of health in the development of diabetes. Diabetes Care. 2023;46(9):1590-8. [CrossRef]
  20. Rossboth S, Lechleitner M, Oberaigner W. Risk factors for diabetic foot complications in type 2 diabetes-A systematic review. Endocrinol Diabetes Metab. 2020;4(1):e00175. [CrossRef]
  21. Çaşkurlu H, Aydın Ö, Ergen P. [Evaluation of adult vaccinations at a city hospital in İstanbul between 2015-2020]. STED. 2022;31(3):209-13. Turkish. [CrossRef]
  22. Coşkun B, Ayhan M, Güner R. [Adult vaccination unit experience: city hospital model]. J Ankara Univ Fac Med. 2023;76(3):213-9. Turkish. [CrossRef]
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