Frequency and Affecting Factors of COVID-19 Vaccine Hesitancy in Patients with Diabetes

Year 2023, Volume: 13 Issue: 3, 252 - 256, 30.12.2023

Mehmet Ali Eren Hüseyin Karaaslan Sanem Gökçen Merve Kılınç Veysel Altınyaprak Gizem Ilgın Kaplan Tevfik Sabuncu

Abstract

Aim: While vaccines are the most important strategy in combating the COVID-19 epidemic, their effectiveness can be greatly affected by vaccine hesitancy. Diabetes mellitus is known as an immunecompromised condition, and COVID-19 is associated with an increased risk of morbidity and mortality in patients with diabetes mellitus. For this reason, the COVID-19 vaccine is strongly recommended for diabetic patients. This study investigated the social, demographic, and clinical factors affecting vaccination frequency and vaccine hesitancy in diabetics.
Material and Method: A cross-sectional study used a questionnaire to determine the demographic, social, and individual characteristics of the participants who were vaccinated or unvaccinated. Patients with diabetes mellitus and having the physical and mental capacity to answer the pre-prepared questions by face-to-face survey method according to the order of admission were included. There were two groups of participants: those who received the COVID-19 vaccination (Group 1=180) and those who did not (Group 2=26).
Results: The frequency of vaccination was 87.4%. A comparison of the vaccinated and unvaccinated groups did not show any significant differences in terms of gender, age, type, and duration of diabetes, smoking, insulin use, marital and educational status, living place, history of COVID-19, family members with COVID-19, and relatives who died due to COVID-19. Influenza vaccination rates were also significantly lower in the unvaccinated group than in the vaccinated group (7.7% vs. 26.1%, p=0.047).
Conclusions: Although the COVID-19 vaccination rates of our diabetic patients were higher than the general provincial rate, they were the same as in Türkiye, regardless of demographic, social, and individual characteristics. As evidenced by the COVID-19 experience, additional information and support regarding vaccination- preventable diseases could raise the rate of other recommended vaccinations among diabetic patients.

Keywords

COVID-19 vaccine, diabetes mellitus, vaccine hesitancy

References

• 1. OurWorld In Data. Coronavirus (COVID-19) Vaccinations, 2022. Available from: https://ourworldindata.org/covid-vaccinations (Last accessed October 12, 2022).
• 2. European Centre for Disease Prevention and Control. COVID-19 vaccination, 2022. Available from: https://www.ecdc.europa.eu/en/covid-19/prevention-and-control/vaccines
• 3. Patwary MM, Bardhan M, Disha AS, Hasan M, Haque MZ, Sultana R, et al. Determinants of COVID-19 Vaccine Acceptance among the Adult Population of Bangladesh Using the Health Belief Model and the Theory of Planned Behavior Model. Vaccines 2021;9(12):1393.
• 4. Randolph HE, Barreiro LB. Herd Immunity: Understanding COVID-19. Immunity 2020;52(5):737–41.
• 5. Hou Z, Tong Y, Du F, Lu L, Zhao S, Yu K, et al. Assessing COVID-19 Vaccine Hesitancy,Confidence, and Public Engagement: A Global Social Listening Study. J Med Internet Res 2021;23: e27632.
• 6. WHO. Ten Threats to Global Health in 2019. Available from: https://www.who.int/news-room/spotlight/ten-threats-toglobal-health-in-2019 (accessed on 1 September 2021)
• 7. Steinmetz L. Sociodemographic predictors of and main reasons for COVID-19 vaccine hesitancy in eastern Oslo: a cross-sectional study. BMC Public Health 2022;22(1):1878.
• 8. Berbudi A, Rahmadika N, Tjahjadi AI, Ruslami R. Type 2 Diabetes and its Impact on the Immune System. Curr Diabetes Rev 2020;16(5):442-9. doi: 10.2174/1573399815666191024085838.
• 9. Kumar A, Arora A, Sharma P, Anikhindi SA, Bansal N, Singla V, et al. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes Metab Syndr 2020;14(4):535-45.
• 10. Boroumand AB, Forouhi M, Karimi F, Moghadam AS, Naeini LG, Kokabian P, et al. Immunogenicity of COVID-19 vaccines in patients with diabetes mellitus: A systematic review. Front Immunol 2022;13:940357. doi: 10.3389/fimmu.2022.940357.
• 11. T.C. Sağlık Bakanlığı Covıd-19 Aşısı Bilgilendirme Platformu Available from: https://covid19asi.saglik.gov.tr/ (accessed on 18 March 2022)
• 12. Eser B, Özer M, Çiçek TE. COVID-19 pandemic management and results of Turkey. City Health Journal 2021;2(1):26-34.
• 13. Choi JY. COVID-19 in South Korea. Postgrad Med J 2020;96 (1137):399-402 doi: 10.1136/postgradmedj-2020-137738.
• 14. COVID-19 Aşısı Ulusal Uygulama Stratejisi Available from: https://covid19asi.saglik.gov.tr/TR-77706/covid-19-asisi-ulusal-uygulama-stratejisi.html (accessed on 9 November 2022)
• 15. American Diabetes Association. Comprehensive medical evaluation and assessment of comorbidities: standards of medical care in diabetes-2020. Diabetes Care 2020;43(Suppl 1):37-47.
• 16. Freedman MS, Hunter P, Ault K, Kroger A. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older - United States, 2020. MMWR Morb Mortal Wkly Rep 2020;69:133-5.
• 17. Satman I, Akalin S, Cakir B, Altinel S; diaVAX Study Group. The effect of physicians' awareness on influenza and pneumococcal vaccination rates and correlates of vaccination in patients with diabetes in Turkey: an epidemiological Study "diaVAX". Hum Vaccin Immunother 2013;9:2618-26.
• 18. Arslan IE, Altinova A, Gazi FT. Awareness of hepatitis B, influenza and pneumococcal vaccine among diabetic patients. Gazi Med J 2016; 27:115-7.
• 19. Demirci I, Haymana C, Salman S, TEMD Study Group. Rates and associates of influenza and pneumococcus vaccination in diabetes mellitus: A nationwide cross-sectional study (TEMD vaccination study). World J Diabetes 2021;12(12):2107-18.
• 20. Jiménez-Garcia R, Lopez-de-Andres A, Hernandez-Barrera V, Gómez-Campelo P, San Andrés-Rebollo FJ, et al. Influenza vaccination in people with type 2 diabetes, coverage, predictors of uptake, and perceptions. Result of the MADIABETES cohort a 7 years follow up study. Vaccine 2017;35(1):101-8.
• 21. Geneev C, Mathew N, Jacob JJ. Vaccination Status, Knowledge, and Acceptance of Adult Vaccinations against Respiratory Illness among Patients with Type 2 Diabetes Mellitus. Indian J Endocrinol Metab 2018;22(2):280-2.
• 22. Küçükali H, Ataç Ö, Palteki AS, Tokaç AZ, Hayran O. Vaccine Hesitancy and Anti-Vaccination Attitudes during the Start of COVID-19 Vaccination Program: A Content Analysis on Twitter Data. Vaccines (Basel). 2022;10(2):161
• 23. Looijmans-Van den Akker I, Verheij TJ, Buskens E, Nichol KL, Rutten GE, Hak E. Clinical effectiveness of first and repeat influenza vaccination in adult and elderly diabetic patients. Diabetes Care 2006;29:1771-6
• 24. Saaddine JB, Cadwell B, Gregg EW, Engelgau MM, Vinicor F, Imperatore G, et al. Improvements in diabetes processes of care and intermediate outcomes: United States, 1988-2002. Ann Intern Med 2006;144:465-74
• 25. Jiménez-García R, Jimenez I, Garrido PC, Hernández-Barrera V, de Andres AL, del Barrio JL, et al. Coverage and predictors of influenza vaccination among adults with diabetes in Spain. Diabetes Res Clin Pract 2008;79:510-7