Trajectories of seasonal influenza vaccine uptake among French people with diabetes: a nationwide retrospective cohort study, 2006-2015.
BMC Public Health
; 19(1): 918, 2019 Jul 09.
Article
em En
| MEDLINE
| ID: mdl-31288768
ABSTRACT
BACKGROUND:
Annual seasonal influenza vaccination (SIV) is recommended for people with diabetes, but their SIV rates remain far below public health targets. We aimed to identify temporal trajectories of SIV uptake over a 10-year period among French people with diabetes and describe their clinical characteristics.METHODS:
We identified patients with diabetes in 2006 among a permanent, representative sample of beneficiaries of the French National Health Insurance Fund. We followed them up over 10 seasons (2005/06-2015/16), using SIV reimbursement claims and group-based trajectory modelling to identify SIV trajectories and to study sociodemographic, clinical, and healthcare utilization characteristics associated with the trajectories.RESULTS:
We identified six trajectories. Of the 15,766 patients included in the model, 4344 (28%) belonged to the "continuously vaccinated" trajectory and 4728 (30%) to the "never vaccinated" one. Two other trajectories showed a "progressive decrease" (2832, 18%) or sharp "postpandemic decrease" (1627, 10%) in uptake. The last two trajectories (totalling 2235 patients, 14%) showed an early or delayed "increase" in uptake. Compared to "continuously vaccinated" patients, those in the "progressively decreasing" trajectory were older and those in all other trajectories were younger with fewer comorbidities at inclusion. Worsening diabetes and comorbidities during follow-up were associated with the "increasing" trajectories.CONCLUSIONS:
Most patients with diabetes had been continuously vaccinated or never vaccinated and thus had stable SIV behaviours. Others adopted or abandoned SIV. These behaviour shifts might be due to increasing age, health events, or contextual factors (e.g., controversies about vaccine safety or efficacy). Healthcare professionals and stakeholders should develop tailored strategies that take each group's specificities into account.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vacinas contra Influenza
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Vacinação
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Diabetes Mellitus
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Influenza Humana
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
BMC Public Health
Assunto da revista:
SAUDE PUBLICA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
França