Influenza vaccination coverage and determinants of vaccination in peripheral arterial disease patients
Abstract
Summary:Background: In the latest American Heart Association guidelines, influenza vaccination is recommended for patients with peripheral arterial disease (PAD). The vaccination coverage in this specific population is currently unknown. This study aims to determine the adherence to influenza vaccination in a PAD population and identify associated determinants. Patients and methods. Hospitalized patients and outpatients with PAD from two university departments of vascular medicine were prospectively included. A questionnaire was administered to collect sociodemographic data, cardiovascular risk factors, influenza vaccination status, history of cardiovascular disease, and perception and knowledge about vaccination. Logistic regression was conducted to assess vaccination determinants. Results: Over a six-month period, 494 patients were included (median age 69.5, IQR [63–77], 78% male). Overall, 60.1% were either vaccinated or intended to be (Group 1). Vaccination was associated with age (odds-ratio [OR]=1.055, 95% confidence intervals [95%CI]: 1.035–1.075, p<0.0001), abdominal aorta aneurysm (OR=0.390, 95%CI: 0.229–0.664, p=0.001), chronic obstructive pulmonary disease (OR=0.545, 95%CI: 0.367–0.810, p=0.003), chronic renal disease (OR=0.630, 95%CI: 0.400–0.993, p=0.046), and valvulopathy (OR=2.444, 95%CI: 1.122–5.326, p=0.025). Only 25.3% received vaccination information mainly from their general practitioners. Among patients against vaccination, 59.9% considered themselves not concerned about potential influenza consequences on their PAD, and 37.6% did not intend to change their decision. Conclusions: This study highlights the low adherence to influenza vaccination in the PAD population of 2 university hospital centers. Vaccination is often related to age, and there is a need for adapted information regarding influenza consequences on cardiovascular disease overall, particularly on PAD. Addressing common information and advice about vaccination will be a challenge.
References
1 . Excess mortality from causes other than influenza and pneumonia during influenza. Public Health Rep 1896–1970. 1932;47(46):2159–79.
2 Acute myocardial infarction after laboratory-confirmed influenza infection. N Engl J Med. 2018;378(4):345–53.
3 . Risk of myocardial infarction and stroke after acute infection or vaccination. N Engl J Med. 2004;351(25):2611–8.
4 , Influenza vaccination after myocardial infarction: a randomized, double-blind, placebo-controlled, multicenter trial. Circulation. 2021;144(18):1476–84.
5 . Influenza vaccination and risk of hospitalization in patients with heart failure: a self-controlled case series study. Eur Heart J. 2017;38(5):326–33.
6 Influenza vaccination in patients with chronic heart failure: the PARADIGM-HF trial. JACC Heart Fail. 2016;4(2):152–8.
7 Influenza vaccine in heart failure. Circulation. 2019;139(5):575–86.
8 Influenza vaccination as secondary prevention for cardiovascular disease: a science advisory from the American Heart Association/American College of Cardiology. Circulation. 2006;114(14):1549–53.
9 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129–200.
10 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37(29):2315–81.
11 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017;135(12):e686–725.
12 . Seasonal influenza vaccination in Europe: overview of vaccination recommendations and coverage rates in the EU Member States for the 2012–13 influenza season [Internet]. LU: Publications Office; 2015 [cited 2023 Feb 8]. Available from: https://data.europa.eu/doi/10.2900/693898
13 . Vaccines against influenza: WHO position paper – May 2022 [Internet]. [cited 2023 Feb 8]. Available from: https://www.who.int/publications-detail-redirect/who-wer9719.
14 . Risk perception and information-seeking behaviour during the 2009/10 influenza A(H1N1)pdm09 pandemic in Germany. Euro Surveill. 2012;17(13):20131.
15 . Factors contributing to suboptimal vaccination against influenza: results of a nationwide telephone survey of persons with cardiovascular disease. Tex Heart Inst J. 2009;36(6):546–52.
16 . How close are countries of the WHO European Region to achieving the goal of vaccinating 75% of key risk groups against influenza? Results from national surveys on seasonal influenza vaccination programmes, 2008/2009 to 2014/2015. Vaccine. 2018;36(4):442–52.
17 . Flu vaccine coverage for recommended populations in France. Med Mal Infect. 2020;50(8):670–5.
18 Clinical and economic outcomes of a collaborative cardiology care program. Am J Manag Care. 2021;27(4):e114–22.
19 . The impact of influenza vaccination in patients with cardiovascular disease: An overview of systematic reviews. Trends Cardiovasc Med. 2021;31(5):315–20.
