Vaccine Uptake In Adults Research Articles

P021 Uptake, safety, and effectiveness of pneumococcal vaccination in adults with immune mediated inflammatory diseases: a UK wide study using data from the Clinical Practice Research Datalink

Abstract Background/Aims The safety and effectiveness of pneumococcal vaccine in people with immune mediated inflammatory diseases (IMIDs) is not known, which may contribute to suboptimal uptake. We investigated UK wide pneumococcal vaccine uptake in adults with IMIDs, the association between pneumococcal vaccination and disease flares, and the effectiveness of pneumococcal vaccine in preventing pneumonia in this at-risk population. Methods Adults with incident rheumatoid arthritis (RA), inflammatory bowel disease (IBD), systemic lupus erythematosus (SLE) and spondyloarthritis (SpA) prior to 31st August 2018 in the Clinical Practice Research Datalink (CPRD) Gold were included. The study was approved by CPRD research data governance (Reference 21_000614). We calculated the proportion of patients vaccinated against pneumococcal pneumonia. To investigate the association between vaccination and IMID flare, we employed a self-controlled case series analysis, adjusted for season. The study period was up-to six-month before and six-month after the date of pneumococcal vaccination. This period was partitioned into induction (14 days pre-vaccination) and exposed periods (up-to 90 days post vaccination) with the remaining time considered unexposed. Incidence rate ratios (IRR) and 95% CI were calculated. We conducted a multivariable nested case-control study to assess vaccine effectiveness. Cases were patients hospitalised with pneumonia and were matched to up to ten controls for age and sex. Multivariable conditional logistic regression was used to calculate odds ratio (OR) and 95% CI. Results We included 32,277 IMID patients: 14,151 with RA, 13,631 with IBD, 3,804 with SpA and 691 with SLE. Overall uptake of pneumococcal vaccination was 50% (95% CI 49.4% -50.5%). Vaccination uptake was significantly lower in the under 45-year-olds, in patients with IBD and in those without additional indication for vaccination at 29.7%, 38.4%, 42.7% respectively. In the safety study, data for 1001, 854, 424 vaccinated patients with primary care consultations for joint pain, AIRD flare, and IBD flare respectively were included. Vaccination against pneumococcal pneumonia was not associated with AIRD flare (IRR (95% CI) 1.07 (0.93-1.22)), primary care consultations for joint pain (IRR (95% CI) 0.95 (0.83-1.10)), and IBD flare (IRR (95% CI) 0.82 (0.64-1.06)) in the 90-days post vaccination. The vaccine effectiveness study included 25,707 patients, either with (n = 2,771) or without (n = 22,936) a hospitalisation record for pneumonia after IMID diagnosis. Patients hospitalised for pneumonia compared with their matched controls, had higher odds of current smoking, deprivation, corticosteroid prescriptions, additional indication for vaccination, primary care consultations, hospital admissions and prescriptions. In the multivariable adjusted model, pneumococcal vaccination was associated with reduced odds of hospitalisation for pneumonia (OR (95% CI) 0.88 (0.78-0.98). Conclusion The uptake of pneumococcal vaccine is low in IMID patients. Pneumococcal vaccination is not associated with IMID flare and is protective against pneumonia. These findings call for promotion of pneumococcal vaccination in IMID by health professionals. Disclosure G. Nakafero: None. M.J. Grainge: None. C.D. Mallen: Grants/research support; NIHR, MRC, Versus Arthritis and BMS. T. Card: None. J.S. Nguyen Van-Tam: Consultancies; CSL Seqirus and Moderna. Royalties; AstraZeneca and Sanofi Pasteur. A. Abhishek: Consultancies; NGM Bio, Limbic and Inflazome.. Royalties; UpToDate, Springer, Cadilla Pharmaceuticals.. Grants/research support; AstraZeneca and Oxford Immunotech..

Uptake and safety of pneumococcal vaccination in adults with immune mediated inflammatory diseases: a UK wide observational study.

The uptake and safety of pneumococcal vaccination in people with immune mediated inflammatory diseases (IMIDs) is poorly understood. We investigated the UK wide pneumococcal vaccine uptake in adults with IMIDs and explored the association between vaccination and IMID flare. Adults with IMIDs diagnosed on or before 01/09/2018, prescribed steroid-sparing drugs within the last 12 months and contributing data to the Clinical Practice Research Datalink Gold were included. Vaccine uptake was assessed using a cross-sectional study design. Self-controlled case series (SCCS) analysis investigated the association between pneumococcal vaccination and IMID flare. The SCCS observation period was up-to six-month before and after pneumococcal vaccination. This was partitioned into a 14-day pre-vaccination induction, 90-days post-vaccination exposed, and the remaining unexposed periods. We included 32 277 patients, 14 151 with RA, 13 631 with IBD, 3,804 with axial spondyloarthritis and 691 with SLE. Overall, 57% were vaccinated against pneumococcus. Vaccine uptake was lower in those younger than 45 years (32%), with IBD (42%), and without additional indication(s) for vaccination (46%). In the vaccine-safety study, data for 1,067, 935, and 451vaccinated patients with primary-care consultations for joint pain, AIRD flare and IBD flare respectively were included. Vaccination against pneumococcal pneumonia was not associated with primary-care consultations for joint pain, AIRD flare and IBD flare in the exposed period with incidence rate ratios (95% Confidence Interval) 0.95 (0.83-1.09), 1.05 (0.92-1.19), and 0.83 (0.65-1.06) respectively. Uptake of pneumococcal vaccination in UK patients with IMIDs was suboptimal. Vaccination against pneumococcal disease was not associated with IMID flare.

Impact of Demographic Developments and PCV13 Vaccination on the Future Burden of Pneumococcal Diseases in Germany—An Integrated Probabilistic Differential Equation Approach

Streptococcus pneumonia is the primary cause of morbidity and mortality in infants and children globally. Invasive pneumococcal disease (IPD) incidence is affected by various risk factors such as age and comorbidities. Additionally, this bacterium is a major cause of community-acquired pneumonia (CAP), leading to higher rates of hospitalization, especially among older adults. Vaccination with pneumococcal conjugate vaccines (PCVs) has proven effective, but the demographic transition in Germany poses a challenge. This study introduces a novel stochastic approach by integrating a population forecast model into a transmission dynamic model to investigate the future burden of pneumococcal diseases in three age groups (0–4, 5–59, and 60 and older). Our simulations, presented through mean predictions and 75% prediction intervals, indicate that implementing PCV13 (13-valent pneumococcal conjugate vaccine) until the year 2050 results in reduced cases of IPD and CAP in all age groups compared to scenarios without infant vaccination. However, cases with non-vaccine serotypes may persist at higher levels compared to scenarios without infant vaccination. Consequently, there may be a need for improvement in the current national vaccine policy, such as implementing the use of higher-valent PCVs and strengthening adult vaccination uptake.

Editorial introductions.

Editorial introductions.

Barriers and strength factors of adult immunization plans in seven countries of the European region

Abstract Aim The present systematic review analyzes existing strategies and policies used for adult vaccination of seven countries of the European area, emphasizing weaknesses and strengths of immunization schedules. Selected countries were Germany, France, the United Kingdom, Italy, Spain, Sweden, and Romania. Subject and methods Three main scientific databases (PubMed, Scopus, and Web of Science) were queried and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies assessing weaknesses or strengths factors, facilitators and barriers related to the adult vaccination plans were considered eligible. We included ten studies with a medium/high score at the quality assessment. Results The main barriers and strength factors for vaccination can be divided into the following categories: financial aspects (e.g., if the vaccine has a funding mechanism); logistic factors (e.g., convenience, opening times); factors related to healthcare professionals (e.g., recommendations, provision by different categories of healthcare professionals). Conclusion Substantial improvement in adult vaccination uptake is urgently necessary to decrease the burden of infectious disease on healthcare systems. Although decision-making regarding adult vaccination is complex and influenced by psychological and personal factors, addressing practical or logistical issues related to immunization plans can facilitate higher vaccination coverage.

The patient perspective on vaccine uptake in adults with psoriasis and eczema.

Having a chronic disease is one of the most consistent factors associated with vaccine uptake for adults in the general population, but vaccination beliefs and behaviors specific to those with chronic skin diseases have not been explored. The objective of this study was to explore factors associated with vaccine uptake and barriers to vaccination in adults with psoriasis and eczema. Virtual, video-based semi-structured interviews were performed with adults who self-reported a diagnosis of psoriasis or eczema. Interviews explored themes around healthcare decision making, perceived risks/benefits to vaccination, barriers, and vaccine knowledge. Thematic analysis was used to analyze the data. Of 34 study participants, 25 participants (74%) were females and 9 (26%) were males, with a mean age of 50.8 years (SD: 16.4, range: 24-71 yrs). Half of participants (n = 17) had psoriasis, and half (n = 17) had eczema. Participants recognized both personal and societal benefits to vaccines. Common vaccination barriers identified were access to appointments, concerns about side effects, and misinformation. Physicians, friends/family, and media, including internet resources, were health information resources identified by patients. These results summarize the unique patient perspective around vaccine uptake in adults with eczema and psoriasis and represent an important first step in a multi-pronged approach to improve vaccination rates in adults with chronic skin diseases.

Pneumococcal Disease in High-Risk Adults in Lebanon: Expert Opinion.

Pneumococcal disease affects people across all ages but is more prevalent in young children and the elderly. Despite the availability of the pneumococcal vaccine for adults, the disease burden and mortality associated with it remains a challenge. A few studies conducted in Lebanon have reported epidemiology of pneumococcal disease, concurring the high burden among adults and older adults in the region. The pneumococcal vaccine is a part of the routine immunization schedule for children, but there are no recommendations for adult vaccination. A medical advisory board was hence conducted in September 2020 to discuss the burden of pneumococcal disease (PD) among adults in Lebanon. The participants were experts from the fields of internal medicine, family medicine, hematology, cardiology, oncology, endocrinology, pulmonology, and infectious diseases. The experts reached a consensus that there is a need to take steps to increase the rate of adult vaccination uptake and create awareness among physicians, pharmacists, caregivers, and patients. The physicians should be trained on adult immunization and should actively discuss the importance of the pneumococcal vaccine, especially with high-risk adult patients. Implementing adult vaccination as a routine practice and involving various stakeholders to address the gaps can help in reducing the burden of pneumococcal disease in adults.

325 The patient perspective on vaccine uptake in adults with psoriasis and eczema

Previous studies in the United States and Europe suggest adults with chronic inflammatory skin diseases are not receiving all recommended adult vaccinations. In the general population, age >65 years and having a chronic disease are the most consistent factors associated with receipt of the influenza vaccine, but these factors have not been explored in dermatology patients. The objective of this study was to explore factors associated with vaccine uptake in adults with eczema and psoriasis. A qualitative study using virtual, semi-structured interviews was conducted in a convenience sample of adults who self-identified as having psoriasis or eczema for at least 1 year, recruited from the National Psoriasis Foundation, the National Eczema Association and dermatology clinics at Brigham and Women’s Hospital.

Editorial introductions.

Editorial introductions.

Modelling the effect of COVID-19 mass vaccination on acute hospital admissions.

Managing high levels of acute COVID-19 bed occupancy can affect the quality of care provided to both affected patients and those requiring other hospital services. Mass vaccination has offered a route to reduce societal restrictions while protecting hospitals from being overwhelmed. Yet, early in the mass vaccination effort, the possible impact on future bed pressures remained subject to considerable uncertainty. The aim of this study was to model the effect of vaccination on projections of acute and intensive care bed demand within a 1 million resident healthcare system located in South West England. An age-structured epidemiological model of the susceptible-exposed-infectious-recovered type was fitted to local data up to the time of the study, in early March 2021. Model parameters and vaccination scenarios were calibrated through a system-wide multidisciplinary working group, comprising public health intelligence specialists, healthcare planners, epidemiologists and academics. Scenarios assumed incremental relaxations to societal restrictions according to the envisaged UK Government timeline, with all restrictions to be removed by 21 June 2021. Achieving 95% vaccine uptake in adults by 31 July 2021 would not avert the third wave in autumn 2021 but would produce a median peak bed requirement ∼6% (IQR: 1-24%) of that experienced during the second wave (January 2021). A 2-month delay in vaccine rollout would lead to significantly higher peak bed occupancy, at 66% (11-146%) of that of the second wave. If only 75% uptake was achieved (the amount typically associated with vaccination campaigns), then the second wave peak for acute and intensive care beds would be exceeded by 4% and 19%, respectively, an amount which would seriously pressure hospital capacity. Modelling influenced decision-making among senior managers in setting COVID-19 bed capacity levels, as well as highlighting the importance of public health in promoting high vaccine uptake among the population. Forecast accuracy has since been supported by actual data collected following the analysis, with observed peak bed occupancy falling comfortably within the inter-quartile range of modelled projections.

Model-Estimated Association Between Simulated US Elementary School–Related SARS-CoV-2 Transmission, Mitigation Interventions, and Vaccine Coverage Across Local Incidence Levels

With recent surges in COVID-19 incidence and vaccine authorization for children aged 5 to 11 years, elementary schools face decisions about requirements for masking and other mitigation measures. These decisions require explicit determination of community objectives (eg, acceptable risk level for in-school SARS-CoV-2 transmission) and quantitative estimates of the consequences of changing mitigation measures. To estimate the association between adding or removing in-school mitigation measures (eg, masks) and COVID-19 outcomes within an elementary school community at varying student vaccination and local incidence rates. This decision analytic model used an agent-based model to simulate SARS-CoV-2 transmission within a school community, with a simulated population of students, teachers and staff, and their household members (ie, immediate school community). Transmission was evaluated for a range of observed local COVID-19 incidence (0-50 cases per 100 000 residents per day, assuming 33% of all infections detected). The population used in the model reflected the mean size of a US elementary school, including 638 students and 60 educators and staff members in 6 grades with 5 classes per grade. Variant infectiousness (representing wild-type virus, Alpha variant, and Delta variant), mitigation effectiveness (0%-100% reduction in the in-school secondary attack rate, representing increasingly intensive combinations of mitigations including masking and ventilation), and student vaccination levels were varied. The main outcomes were (1) probability of at least 1 in-school transmission per month and (2) mean increase in total infections per month among the immediate school community associated with a reduction in mitigation; multiple decision thresholds were estimated for objectives associated with each outcome. Sensitivity analyses on adult vaccination uptake, vaccination effectiveness, and testing approaches (for selected scenarios) were conducted. With student vaccination coverage of 70% or less and moderate assumptions about mitigation effectiveness (eg, masking), mitigation could only be reduced when local case incidence was 14 or fewer cases per 100 000 residents per day to keep the mean additional cases associated with reducing mitigation to 5 or fewer cases per month. To keep the probability of any in-school transmission to less than 50% per month, the local case incidence would have to be 4 or fewer cases per 100 000 residents per day. In this study, in-school mitigation measures (eg, masks) and student vaccinations were associated with substantial reductions in transmissions and infections, but the level of reduction varied across local incidence. These findings underscore the potential role for responsive plans that deploy mitigation strategies based on local COVID-19 incidence, vaccine uptake, and explicit consideration of community objectives.

Abstract 13632: The Relationship Between Health Information Technology Use and Pneumococcal Vaccine Uptake in Adults With Heart Disease

Introduction: Health information technology (HIT) has been shown to influence medication adherence and healthy behaviors. This influence may increase the uptake of vaccines especially in high risk groups. Hypothesis: HIT use may be associated with increase pneumococcal vaccine uptake in adults ≥ 40 years with heart disease. Methods: Using the National Health Interview Survey data, 2,134 united states adults ≥ 40 years with heart disease were analyzed in this cross-sectional study. The independent variables were: Use of the internet to (1) to look up health information (2) to fill a prescription and (3) to schedule a medical appointment and use of an email (4) to communicate with a healthcare provider, which were dichotomous. The dependent variable was pneumococcal vaccine uptake which was also dichotomous. Chi-square analysis was used to identify group differences. Multiple logistic regression was used to analyze the association between HIT utilization and pneumococcal vaccine uptake. Results: Those who use the internet to fill up prescription and to communicate with their healthcare provider were more likely to take up the PCV [AOR 1.56; 95% CI 1.03, 2.37, p =.035] and [AOR 1.95; 95% CI 1.23, 3.10, p =.005] respectively. Compared to those who did not use HIT in any form, those who used HIT in at least three or four forms had a higher PCV uptake [AORs 1.93; 95% CI 1.19, 3.13, p-value .008] and [AOR 2.33 95% CI 1.22, 4.47, p-value .011] respectively. Conclusions: Our analysis shows a positive association of HIT utilization and pneumococcal vaccine uptake. It further stresses the importance of electronic health in preventive medicine. Larger studies should evaluate the relationship between different uses of health information technology and different vaccines uptake.

Surveillance of Vaccination Coverage Among Adult Populations -United States, 2018.

Surveillance of Vaccination Coverage Among Adult Populations -United States, 2018.

87. Impact of State of Residence on Adult Vaccination Uptake: A Multilevel Modeling Approach

BackgroundPrevious studies on adult vaccination coverage found inter-state variability that persists after adjusting for individual demographic factors. Assessing the impact of state-level factors may help improve uptake strategies. This study aimed to:• Update previous estimates of state-level, model-adjusted coverage rates for influenza; pneumococcal; tetanus, diphtheria, and acellular pertussis (Tdap); and herpes zoster (HZ) vaccines (individually and in compliance with all age-appropriate recommended vaccinations)• Evaluate effects of individual and state-level factors on adult vaccination coverage using a multilevel modeling framework.MethodsBehavioral Risk Factor Surveillance System (BRFSS) survey data (2015–2017) were retrospectively analyzed. Multivariable logistic regression models estimated state vaccination coverage and compliance using predicted marginal proportions. BRFSS data were then combined with external state-level data to estimate multilevel models evaluating effects of state-level factors on coverage. Weighted odds ratios and measures of cluster variation were estimated.ResultsAdult vaccination coverage and compliance varied by state, even after adjusting for individual characteristics, with coverage ranging as follows:• Influenza (2017): 35.1–48.1%• Pneumococcal (2017): 68.2–80.8%• Tdap (2016): 21.9–46.5%• HZ (2017): 30.5–50.9%Few state-level variables were retained in final multilevel models, and measures of cluster variation suggested substantial residual variation unexplained by individual and state-level variables. Key state-level variables positively associated with vaccination included health insurance coverage rates (influenza/HZ), pharmacists’ vaccination authority (HZ), presence of childhood vaccination exemptions (pneumococcal/Tdap), and adult immunization information system participation (Tdap/HZ).ConclusionAdult vaccination coverage and compliance continue to show substantial variation by state even after adjusting for individual and state-level characteristics associated with vaccination. Further research is needed to assess additional state or local factors impacting vaccination disparities.FundingGlaxoSmithKline Biologicals SA (study identifier: HO-18-19794)Disclosures Shannon Hunter, MS, GSK (Other Financial or Material Support, Ms. Hunter is an employee of RTI Health Solutions, who received consultancy fees from GSK for conduct of the study. Ms. Hunter received no direct compensation from the Sponsor.) Diana Garbinsky, MS, GSK (Other Financial or Material Support, The study was conducted by RTI Health Solutions, which received consultancy fees from GSK. I am a salaried employee at RTI Health Solutions and received no direct compensation from GSK for the conduct of this study..) Elizabeth M. La, PhD, RTI Health Solutions (Employee) Sara Poston, PharmD, The GlaxoSmithKline group of companies (Employee, Shareholder) Cosmina Hogea, PhD, GlaxoSmithKline (Employee, Shareholder)

Where are the keys to improve vaccine uptake in adults and elders in European countries?

Improving vaccination of the elderly is one of the most important challenges in the coming years, as it was for infant's decades ago. Insufficient vaccine uptake in the elderly can be considered a concern with regard to the burden of vaccine preventable diseases in this growing population. The purpose of this paper is to have an overview on the different steps involved in decision policy making from the regulatory agencies until people are vaccinated. Examples of different policies within European countries will be compared for influenza, streptococcal and zoster infections. For each step, key improvements to increase vaccine uptake in this specific population will be proposed.

Latin American Adult Immunisation Advocacy Summit: Overcoming regional barriers to adult vaccination.

Older adults in Latin America are at an increased risk of hospitalisation, ill health, catastrophic disability and death due to vaccine-preventable diseases such as influenza, herpes zoster, and pneumonia. The Latin American Adult Immunisation Advocacy Summit, held in Mexico City, gathered 40 experts in health, ageing and immunisation from 12 Latin American countries to explore good practices of adult vaccination, key country and regional barriers, and strategies to overcome these barriers. The Summit comprised of introductory lectures, plenary panels and breakout sessions with the overarching goal of improving adult vaccination uptake rates throughout the region. Several key messages and recommendations arose from the Summit. Delegates agreed upon the need for a paradigm shift in thinking towards a life course perspective on vaccination to sustain good health throughout life and promote well-being, dignity and functional capacity in older age. Delegates revealed the need for national financial commitment to fixed and irrevocable funding for universal vaccination and the urgent requirement for robust scientific, epidemiologic research in Latin American communities on the cost benefits of such coverage. The recommendations were strengthened through a common understanding of the unique multisectoral and multidisciplinary collaborations essential to influence and help shape public policy.

Factors affecting influenza vaccination in adults aged 50-64 years with high-risk chronic diseases in South Korea

ABSTRACT Influenza is a communicable disease with most of the mortality burden falling on high-risk populations and those with pre-existing comorbidities and chronic diseases. In South Korea, adults aged 50–64 years are recommended for influenza vaccination, but no government financial support is offered to encourage vaccination uptake, which has led to suboptimal vaccination rates and significant public health concerns. The purpose of this study was to identify the factors affecting influenza vaccine uptake in adults aged 50–64 years and to compare high-risk and non-high-risk groups. We conducted randomized telephone questionnaires in South Korea on influenza vaccination-related behavioural factors in adults aged 50–64 years based on their vaccination history during the 2015–2016 flu season. The vaccination rate was 29.9% in non-high-risk adults aged 50–64 years and 41.3% in high-risk adults aged 50–64 years, which is considerably lower than the 81.7% rate in adults aged ≥65 years. Individuals who reported awareness of the potential severity of influenza, the importance and safety of vaccination, and who had experienced influenza after immunization or received a healthcare recommendation reported higher influenza vaccination rates. Therefore, highlighting awareness of influenza disease and vaccination through public campaigns and by information from healthcare professionals could represent opportunities to improve vaccination uptake in this population.

Not Just for Kids: How to Improve Adult Vaccination Uptake in Canada

Vaccinations and booster shots aren’t just for kids. Adult vaccination rates urgently need a booster shot in Canada. Better and more regular uptake of vaccines during adulthood and retirement could improve the well-being of older Canadians and offset some of the challenges associated with an aging society. Despite clinical evidence showing the value of immunization against infectious diseases in the adult population, insufficient attention to lifetime immunization policies persists. This Commentary suggests creating formal approaches, based on applied behavioural design concepts, for improved adult immunization uptake. Influenza should be a pivot point. Even though the seasonal influenza vaccine suffers from relatively lower clinical efficacy than other vaccines, the related lack of confidence in its usefulness is exacerbated by doubts among healthcare workers. Still, the routine nature of the seasonal influenza shot does make it a pivotal part of adult immunization schedules. It should be used to prompt healthcare providers to review a patient’s overall immunization status, helping to develop databases to monitor and encourage other adult vaccines. This Commentary utilizes behavioural economic policy design issues and suggests major changes to the way Canadian provinces and territories monitor and ensure uptake of vaccines among adults. Alongside a digital strategy to create databases to monitor coverage of all adult vaccines, policies should build upon many patients’ preference to get their annual influenza shot at their local pharmacy by expanding pharmacists access to immunization databases, building greater links to primary care, and expanding pharmacists’ ability to set up immunization reminders for patients upon pharmacy visits, plus encouraging the use of digital apps. Going forward, the focus should shift to overcoming complacency with more use of automatic scheduling and reminders. Pharmacies, often a very convenient location for most urban-dwelling Canadians, could act as important parts of multidisciplinary primary care efforts to gather data on publicly funded adult vaccines – likely through digital platforms – and create reminders and prompts to overcome complacency as well.

Adult immunisation: A key element of public health programs: Synopsis of Asia Pacific Adult Immunisation Meeting, Tokyo, 1-2 December 2016.

To (i) improve scientific knowledge and understanding of the importance of adult vaccination within a public health framework; (ii) share an understanding of the principles of good practice that have improved adult vaccination uptake rates; (iii) appreciate the diverse nature of country-specific barriers; and (iv) reach consensus on principles of a call to action to increase adult vaccination uptake rates. Non-governmental organisations, the International Federation on Ageing and Friends of International Federation on Ageing Japan, convened the Asia Pacific Adult Immunisation Meeting, herein referred to as the 'Asia Pacific Meeting'. Delegates identified fundamental barriers to adult vaccination similar to those reported at previous meetings in Latin America and Europe and formed a road map to respond to key barriers in countries represented at the Asia Pacific Meeting. Older people are uniquely vulnerable to vaccine-preventable diseases and therefore need to be the target of a series of actions intended to improve uptake rates in this subpopulation.

Pneumococcal and influenza vaccine uptake in adults with inflammatory bowel disease in France: Results from a web-based study

BackgroundDespite specific immunization guidelines for immunocompromised patients, there is a dearth of studies on inflammatory bowel disease (IBD) population in France. AimsTo estimate the prevalence and predictors of influenza and pneumococcal vaccination rates in a sample of French IBD adults. MethodsAn anonymous online survey was submitted to members of several French immunocompromised patients’ associations during the winter 2016. ResultsOverall, there were 199/1625 (12%) participants with an IBD. Among these, 32% were <30 years old, 85% were male, and 62% were treated with immunosuppressive therapy. Self-reported influenza vaccine uptake was 34% (95% CI [28–41]) and 38% (95% CI [31–44]) for pneumococcal vaccines. Healthcare provider’s (HCP) recommendation for vaccination (adjusted OR 12.7 95% CI [5.6–28.8]), immunosuppressive therapy (aOR 2.3 [1.1–5.3]), better knowledge of vaccination (aOR 3.2 [1.1–9.2]) and favorable attitudes towards vaccination (aOR 3.4 [1.2–9.5]) were positively associated with influenza vaccine uptake. Vaccine recommendation by HCPs was the only independently associated factor with pneumococcal vaccines uptake (OR 187.7 [24.8–1422.5]). ConclusionImmunization rates in our sample do not reach recommended levels. Factors associated with vaccination included high knowledge, favorable attitudes towards vaccination and recommendation for vaccination. This underlines the role of health care providers in contact with IBD patients.