Factors Linked to Pneumococcal Vaccination Status in Type 2 Diabetes

Pneumococcal vaccine – administration of antigenic material (vaccine) to stimulate an individual’s immune system to develop adaptive immunity to a pathogen.
Patients with diabetes are at higher risk for hospitalization and mortality because of pneumococcal infection; however, uptake of vaccination remains suboptimal.

In order to increase pneumococcal vaccine uptake in patients with type 2 diabetes, younger patients with a more recent diagnosis and fewer comorbidities should be targeted, according to study results published in Diabetes & Metabolism.

The study included information from the Alberta’s Caring for Diabetes study. Patients with type 2 diabetes were recruited between December 2011 and December 2013. At baseline, they completed a survey that collected information on sociodemographic characteristics, disease management information, health status measurements, and health service utilization. The researchers used multivariable logistic regression analyses to identify factors associated with self-reported pneumococcal vaccination status.

Of 2040 participants, the mean age was 64.4±10.7 years, mean duration of diabetes was 12±10 years, and 45% were women. The survey results indicated that 53% (n=1090) were vaccinated.

After conducting multivariable analyses, the results indicated that age ≥65 years (adjusted odds ratio [aOR], 2.52; 95% CI, 1.98-3.20), respiratory disease (aOR, 1.50, 95% CI, 1.17-1.93), and cancer (aOR, 1.45; 95% CI, 1.08-1.94) were independently associated with pneumococcal vaccination.

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The researchers also found that women (aOR, 1.46; 95% CI, 1.20-1.78), retirees (aOR, 1.48; 95% CI, 1.17-1.88), patients with diabetes ≥10 years (aOR, 1.32; 95% CI, 1.07-1.62), patients using antihypertensive medications (aOR, 1.55; 95% CI, 1.24-1.94), and patients using insulin (aOR, 1.28; 95% CI, 1.02-1.59) were more likely to be vaccinated.

Patients who had hemoglobin A1c (aOR, 1.72; 95% CI, 1.33-2.22), kidney function (aOR, 1.41; 95% CI, 1.07-1.85), or weight/waist circumference (aOR, 1.35; 95% CI, 1.06-1.71) measured by a healthcare professional in the prior year were also more likely to have been vaccinated.

“Based on this information, future programs aimed at people aged <65 years old, men, those who are currently working, those recently diagnosed with diabetes, and those with few comorbidities could have the most potential for improving pneumococcal vaccine uptake in people with diabetes,” the researchers wrote.

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Gilani F, Majumdar SR, Johnson JA, Simpson SH. Factors associated with pneumococcal vaccination in 2040 people with type 2 diabetes: a cross-sectional study [published online June 27, 2019]. Diabetes Metab. doi:10.1016/j.diabet.2019.06.003