| Abstract |
Introduction: Infections in patients on biologics are a cause of significant morbidity and mortality that can be prevented primarily through self-vaccination and secondarily through vaccination of their close contacts. The studies published to date show that the vaccination coverage of patients treated with biological agents is insufficient, while not many studies have been conducted to examine the vaccination status of their relatives. The purpose of this study is to evaluate the vaccination coverage of children and adults in Heraklion Crete who are treated with biological agents, as well as their environment and in particular to determine the reasons for their possible inadequate vaccination. In addition, the study aims to highlight possible correlations between various demographic, clinical and behavioral parameters and vaccination status with each recommended vaccine, as well as to identify factors related to the favorable attitude of patients toward vaccination.
Methodology: A cross-sectional cohort study was conducted in adult and pediatric patients treated with biological agents and followed, respectively, in the Rheumatology Clinic of the University Hospital of Heraklion and in the Pediatric Clinics of the University Hospital of Heraklion and the Pediatric Clinics of the Venizeleio Hospital of Heraklion from October 2022 to January 2022. The study was carried out via face-to-face or telephone interviews with adult patients and parents of minors, based on pre-structured questionnaires and data collected from medical files and the electronic prescription system. Data analysis was performed using Microsoft Excel 2016, Datatab.net and MedCalc 2006.
Results: In adult patients, vaccination coverage was adequate only for the vaccines against COVID-19 and influenza. Pediatric patients showed adequate vaccination coverage with the vaccines of the basic scheme, except for the vaccines of adolescence (Tdap, HPV, MenACWY). They were also found to be insufficiently vaccinated against COVID-19, as well as with the additional vaccines recommended due to immunosuppression, i.e. the influenza vaccine and the pneumococcal polysaccharide vaccine. Close contacts of both adults and children had extremely low vaccination rates with the vaccines examined, except for the COVID-19 vaccine. Factors that were significantly associated with favourable attitude toward vaccination and increased vaccination coverage for influenza, pneumococcal and COVID-19 vaccines in adults were female gender and increased age, while in pediatric patients there were no statistically significant associations. Finally, the primary reason for not being vaccinated was the lack of recommendation from their doctor.
Conclusion: The results of the present study indicate that receipt of a biological agent may be underestimated, neglected, or not always taken into account in the recommendation for vaccination, and that increasing vaccination coverage rates in patients undergoing treatment with biologics and their environment is a key preventive measure which must be strengthened. For this purpose, it is considered necessary to take appropriate actions that will focus on improving information about the indications and usefulness of vaccines and promoting knowledge about them to doctors, patients and their relatives.
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Εμβολιαστική κάλυψη παιδιών και ενηλίκων που βρίσκονται υπό θεραπεία με βιολογικό παράγοντα και του περιβάλλοντός τους
