Abstract
Annually, at a global level, 3 to 5 million people present severe clinical forms of seasonal influenza and up to 650 000 people die of influenza-related complications. People with chronic diseases, such as cardiovascular, pulmonary, renal, hepatic, neurologic, hematologic and metabolic diseases or those reciveing immunosuppressive therapy, constitute a high-risk population group for the development of influenza-related complications, more severe clinical course and poorer health-related outcomes. Due to all of the above, people with chronic diseases are of high priority to receive the influenza vaccine. Immunization represents the key strategy to prevent influenza both in terms of effectiveness and health care costs. Based on the World Health Organization (WHO) recommendations, adequate seasonal influenza immunization coverage among people with chronic diseases is set at 75%. However, few countries achieve this threshold. Understanding predictive factors of vaccination, at different levels of health care delivery (such as individuals, service providers, health policy), is essential to secure acceptance of influenza immunization and achieve the recommended level of vaccination coverage. In this mini review, all the available evidence regarding seasonal influenza vaccination coverage is summarized, alongside factors associated with vaccine uptake in people with chronic diseases as a whole, as well as according to specific diseases such as: cardiovascular and pulmonary disorders, diabetes and cancer. Based on the reviewed empirical evidence, a wide spectrum of factors associated with immunization against influneza was found in people who have chronic diseases. Although diverse, these factors can be systematized into 4 distinctive groups: socio-demographic characteristics, individual attitudes and beliefs, health promoting behaviors and factors related to the health care system. Further efforts are needed to improve the seasonal influenza vaccination coverage. The immunization strategy needs to include the health care system and the community to support people with chronic diseases to continously accept the influenza vaccine.
Highlights
Seasonal influenza is an acute infection of the respiratory tract usually caused by influenza viruses type A or type B
From a public health standpoint, it is essential to define risk groups that are more likely to have poorer outcomes of influneza, and for whom vaccination is highly recommended
According to the Centers of Disease Control and Prevention (CDC), three influenza vaccines are being recommended: inactivated vaccine, recombinant vaccine and live attenuated vaccine [9]
Summary
Seasonal influenza is an acute infection of the respiratory tract usually caused by influenza viruses type A or type B. The epidemic patterns are based on the antigenic features of the influenza virus, its infectious potential and susceptibility at the population level [3] These characteristics represent major factors associated with influenza-related morbidity and mortality. From a public health standpoint, it is essential to define risk groups that are more likely to have poorer outcomes of influneza, and for whom vaccination is highly recommended This strategy leads to the reduction of influenza-related mortality, ambulatory visits and hospitalizations as well as financial burden of the health care system. People with chronic diseases, such as cardiovascular, pulmonary, renal, hepatic, neurologic, hematologic, metabolic diseases or those reciveing immunosuppressive therapy, represent a high-risk population group for the development of influenza-related complications, more severe clinical course and poorer health-related outcomes [5]. People with chronic diseases are of high priority to receive the seasonal influenza vaccine, in order to reduce potential premature mortality associated with complications of influenza or underlying health status [6, 7]
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