| Abstract |
Introduction: Type 2 diabetes mellitus is a global pandemic due to the rapid increase in new cases and it makes the human body vulnerable to infections and subsequent complications. Protection against most infections is achieved through vaccination leading to reduction in mortality and morbidity. At national level, vaccination coverage rates tend to increase, however this has not reached satisfactory levels.
Objective: The objective of this study is the evaluation of the vaccination coverage of adult patients with T2DM. The study investigates whether this population is adequately vaccinated, according to the National Vaccination Program.
Method: The study is descriptive cross-sectional study, conducted from September to December 2020. The participants consist of adult patients with T2DM, monitored in an outpatient clinic at the Venizeleio General Hospital of Heraklion. The participants were consecutively selected and the final sample consisted of 372 participants. Data were collected through interviews and from the electronic prescription system, following informed consent.
Results: The participants consisted of 200 men and 172 women. Individuals ≥60 years reached 79,5%, while average age was 68 ±10.84 years. Flu vaccination coverage for the 2018-19 flu season reached 57.8%, 73.6% for the 2019-20, and 82.5% for 2020-21 respectively. Regarding coverage against pneumococcus, for the 13-valent conjugate vaccine and the 23polysaccharide (vaccine) was 67.2% and 20.4% respectively. Vaccination coverage against varicella-zoster virus reached 32.4% among individuals who were older than 60 years and against Tetanus-Diphtheria-Pertussis rates for the T2DM patients were 1.88% and 1.07% for Hepatitis B respectively. In correlations made for influenza vaccination for all 3 years (2018-19-20) and the vaccination with the 13-valent conjugate vaccine against pneumococcus, better vaccination coverage with statistically significant differences were found in the population ≥65 y.o., as well in people who had 3 or more chronic conditions (in addition to T2DM), those being in follow up for 5 years or more, and those with insurance capacity, p≤0.003. There were no statistically significant differences between males and females, place of residence, HbA1c levels, nationality and type of medication, p>0.05. A notable finding is that 10.2% of participants were found completely unvaccinated, while 5.4% who also had no vaccinations recorded in their medical history (as adults), were vaccinated for seasonal flu in 2020.
Conclusions: The vaccination coverage of individuals suffering from T2DM, show an upward trend compared to previous years, particularly in relation to influenza and the 13-valent conjugate vaccine against pneumococcus, without this signifying its specific causes or the continuity of this upward trend. Coverage rates for the 23-valent Pneumococcal polysaccharide, the Varicella-Zoster virus, the Tetanus-Diphtheria-Pertussis, and the Hepatitis B vaccine, remain alarmingly low. Factors such as age, multimorbidity, long-term follow up and insurance capacity, found to lead to better vaccination coverage with statistically significant differences, while factors such as gender, HbA1c levels, place of residence, nationality and type of medication weren’t statistically significant. Finally, the percentage of patients with T2DM remaining completely unprotected against the aforementioned infections, plus the increased vaccination rates in older patients or in those with multimorbidity, may be due to the fact that T2DM is not yet considered as an independent risk factor associated with severe disease and complications from the aforementioned infections.
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