Type 1 Diabetes Patients’ Practice, Knowledge and Attitudes towards Influenza Immunization

Abstract

Diabetic patients are at higher risk of developing infectious diseases and severe complications, compared to the general population. Almost no data is available in the literature on influenza immunization in people with type 1 diabetes mellitus (T1DM). As part of a broader project on immunization in diabetic patients, we conducted a cross-sectional study to: (i) report on seasonal influenza coverage rates in T1DM patients, (ii) explore knowledge, attitudes, and practices (KAPs) towards seasonal influenza in this population, and (iii) identify factors associated with vaccine uptake, including the role of family doctors and diabetologists. A survey was administered to 251 T1DM patients attending the Diabetes Clinic at San Raffaele Research Hospital in Milan, Italy and individual-level coverage data were retrieved from immunization registries. Self-reported seasonal influenza immunization coverage was 36%, which decreased to 21.7% when considering regional immunization registries, far below coverage target of 75%. More than a third (36.2%) of T1DM patients were classified as pro-vaccine, 30.7% as hesitant, 17.9% as uninformed, and 15.1% as anti-vaccine. Diabetologists resulted to be the most trusted source of information on vaccines’ benefits and risks (85.3%) and should be more actively involved in preventive interventions. Our study highlights the importance of developing tailored vaccination campaigns for people with diabetes, including hospital-based programs involving diabetes specialists.

Factors associated with influenza vaccination coverage and willingness in the elderly with chronic diseases in Shenzhen, China

“…This suggests that the coverage rate of the elderly may be influenced by younger people in the family or caregivers. 40 In line with the findings of the current study, other surveys have indicated the critical role that higher education level plays in promoting vaccination coverage and willingness. 33 , 37 , 41 Higher education level continues to be a key driver of raising utilization of health care.…”

Understanding the Barriers and Attitudes toward Influenza Vaccine Uptake in the Adult General Population: A Rapid Review

“…Sixty-one studies reported perceived barriers to receiving an influenza vaccination in the total population ( Table 4 ) [ 16 , 17 , 19 , 21 , 22 , 23 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 40 , 41 , 43 , 45 , 46 , 47 , 48 , 49 , 50 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , …”

“…The perceived barriers specific to the unvaccinated population were assessed in 20 publications. Similarly, social barriers were most commonly investigated (N = 67), although the unvaccinated population most frequently reported a perceived lack of knowledge of influenza vaccines (32.3%) [ 16 , 19 , 21 , 23 , 24 , 31 , 34 , 37 , 41 , 45 , 46 , 47 , 57 , 58 , 60 , 68 , 69 , 75 , 77 , 79 ].…”

“…Barrier types were further assessed to determine the key factors (determined by agreement rate) across the general and unvaccinated population for not receiving an influenza vaccine. The top-five barriers to influenza vaccination, as reported by the total population compared to the unvaccinated population, are illustrated in Figure 3 [ 16 , 17 , 19 , 21 , 22 , 23 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 40 , 41 , 43 , 45 , 46 , 47 , 48 , 49 , 50 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , ...…”

“…Of the 80 publications included in this review, 64 suggested strategies to overcome barriers and increase uptake of the influenza vaccine [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 38 , 39 , 40 , 41 , 42 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 58 , 59 , 60 , 61 , 62 , 64 , 65 , 67 , 68 , 69 , 70 , 72 , 73 , 75 , 76 , 78 ,…”