EVALUATION OF ADULT PATIENTS' ATTITUDES AND BEHAVIORS ABOUT INFLUENZA, PNEUMOCOCCAL, HERPES ZOSTER AND TETANUS VACCINES: A SINGLE-CENTER SURVEY STUDY

Öz

OBJECTIVE: The key component of preventive health care is adult immunization. The aim of this study was to assess the patients’ knowledge about adult vaccination and the vaccination rates of patients admitted to the family medicine outpatient clinics. MATERIAL AND METHODS: A total of 442 patients were included in the study. Patient demographic and clinic characteristics were evaluated. Patients' vaccination status with influenza, pneumococcal vaccine, herpes zoster, and tetanus and their knowledge levels about adult vaccines were questioned. RESULTS: The median age of the patients was 42 (min-max: 18-97) and 227 (51.4%) of them were female. Vaccination rates were found 32.6% for tetanus, 21.7% for influenza, 3.6% for pneumococcal, and 2.5% for herpes zoster. Patients with co-morbidities vaccination rates were found to be very low. The pneumococcal vaccination rate was 2.8%, the tetanus vaccination rate was 19.7% , and the influenza vaccination rate was 33.8% in geriatric patients. No patient older than 65 has ever received the zona vaccination. The rate of patients who had herpes zoster, pneumococcal vaccine, and tetanus vaccine was higher among university graduates. Fear of side effects (20%), difficulty in accessing the vaccine (6%), high vaccination prices (1%) were among the reasons why patients did not have vaccinated, and 16% of the patients stated that they did not believe in the benefits of vaccine. CONCLUSIONS: In conclusion, we are still far below the desired levels of adult vaccination in our study population, and it is important to increase patients awareness of adult immunizations.

Anahtar Kelimeler

• Preventive medicine
• Vaccination
• Influenza
• Tetanus

ERİŞKİN HASTALARIN İNFLUENZA, PNÖMOKOK, HERPES ZOSTER VE TETANOS AŞILARI HAKKINDA TUTUM VE DAVRANIŞLARININ DEĞERLENDİRİLMESİ: TEK MERKEZLİ ANKET ÇALIŞMASI

Öz

AMAÇ: Erişkin aşılaması, koruyucu sağlık hizmetlerinin anahtar bileşenidir. Bu çalışmanın amacı, aile hekimliği polikliniklerine başvuran hastaların erişkin aşıları ve aşılama oranları hakkındaki bilgilerini değerlendirmektir. GEREÇ VE YÖNTEM: Çalışmaya toplam 442 hasta dahil edildi. Hastaların demografik ve klinik özellikleri değerlendirildi. Hastaların influenza, pnömoni, herpes zoster ve tetanos aşı durumları ve erişkin aşıları hakkındaki bilgi düzeyleri sorgulandı. BULGULAR: Hastaların ortanca yaşı 42 (min-maks: 18-97) olup 227'si (%51,4) kadındı. Tetanos için aşılama oranları %32,6, influenza için %21,7, pnömokok aşısı için %3,6 ve herpes zoster için %2,5 olarak bulundu. Komorbiditesi olan hastaların aşılanma oranları beklenenden daha düşük bulundu. Geriatrik hastalarda pnömokok aşılama oranı %2,8, tetanos aşılama oranı %19,7, influenza aşılama oranı %33,8’idi. 65 yaş üstü hiçbir hasta herpes zoster aşı yaptırmamıştı. Üniversite mezunlarında herpes zoster, pnömokok ve tetanos aşısı yaptıranların oranı daha yüksekti. Hastaların aşı yaptırmama nedenleri arasında yan etki korkusu (%20), aşıya ulaşma zorluğu (%6), aşı fiyatlarının yüksekliği yer alırken (%1), hastaların %16’sı aşının yararlarına inanmadığını belirtti. SONUÇ: Çalışma grubumuzda erişkin bağışıklama hızı beklenen seviyenin altındadır ve bu oranı artırmak için hastaların erişkin aşıları konusunda bilinçlendirilmesi önemlidir.

Anahtar Kelimeler

• Koruyucu hekimlik
• Aşılama
• İnsan İnfluenzası
• Tetanos

Kaynakça

1. 1. Türkiye Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Uzmanlık Derneği (EKMUD), Erişkin Bağışıklama Rehberi 2016.https://www.ekmud.org.tr/rehberler/1-ekmud-rehberleri, Acsess Date: 01.02.2022.
2. 2. Centers for Disease Control and Prevention (CDC).Recommended Adult Immunization Schedule for ages 19 years or older 2021. https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined- schedule.pdf, Acsess Date: 01.02.2022.
3. 3. Türkiye İstatistik Kurumu (TUİK), İstatistiklerle Yaşlılar. https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Yaslilar-2019-33712, Acsess Date: 01.02.2022.
4. 4. Weinberger B. Vaccines for the elderly: current use and future challenges. Immun Ageing. 2018;15 (3):1-8.
5. 5. Crooke SN, Ovsyannikova IG, Poland GA, Kennedy RB. Immunosenescence and human vaccine immune responses. Immun Ageing. 2019;16 (25):1-6.
6. 6. Ozisik L, Calik Basaran N, Oz SG, Sain Guven G, Durusu Tanriover M. Perceptions and Attitudes of Patients About Adult Vaccination and Their Vaccination Status: Still a Long Way to Go? Med Sci Monit. 2017;29 (23):3178-84.
7. 7. Yürüyen G, Toprak İD, Kutlu Y. Hekimlerde Erişkin Aşılaması Farkındalığı. Bosphorus Med J. 2019;6(3):89-93.
8. 8. Bilgili P, Çakmak T, Aşık Z. Erişkinlerin erişkinlik dönemi aşıları. Türkiye Aile Hekimliği Dergisi. 2013;17(3):113-118.

9. 9. Sahan S, Demirbilek Y, Sonmez C, et al. Epidemiological Study of Tetanus Seropositivity Levels in Different Age Groups in Ankara Province, Turkey, 2017. Jpn J Infect Dis. 2019;72(1):14-18.
10. 10. Ahmad Hamidi A, Gelmez Tas B, Gunduz A, et al. Immunization rates of pneumococcal, influenza and tetanus vaccines and knowledge and attitudes of adult patients who receive inpatient treatment at hospital: Point prevalence study. Hum Vaccin Immunother. 2018;14(11):2649-53.
11. 11. Lu PJ, O'Halloran A, Kennedy ED, et al. Awareness among adults of vaccine-preventable diseases and recommended vaccinations, United States, 2015. Vaccine. 2017;35(23):3104-3115.
12. 12. Boey L, Bosmans E, Ferreira LB, et al. Seroprevalence of Antibodies against Diphtheria, Tetanus and Pertussis in Adult At-Risk Patients. Vaccines (Basel). 2021;9(1):1-10.
13. 13. Buchy P, Badur S. Who and when to vaccinate against influenza. Int J Infect Dis. 2020;93:375-387.
14. 14. Guclu OA, Demirci H, Ocakoglu G, et al. Relationship of pneumococcal and influenza vaccination frequency with health literacy in the rural population in Turkey. Vaccine. 2019;37(44):6617-6623.
15. 15. Li K, Yu T, Seabury SA, Dor A. Trends and disparities in the utilization of influenza vaccines among commercially insured US adults during the COVID-19 pandemic. Vaccine. 2022;40(19):2696-2704.
16. 16. Kwong EW, Pang SM, Choi PP, Wong TK. Influenza vaccine preference and uptake among older people in nine countries. J Adv Nurs. 2010;66(10):2297-308.
17. 17. Adadan Guvenc I, Parildar H, Sahin MK, Erbek SS. Better knowledge and regular vaccination practices correlate well with higher seasonal influenza vaccine uptake in people at risk: Promising survey results from a university outpatient clinic. Am J Infect Control. 2017;45(7):740-45.
18. 18. Matanock A, Lee G, Gierke R, Kobayashi M, Leidner A, Pilishvili T. Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged 65 Years: Updated Recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2019;68(46):1069-75.
19. 19. Kopp A, Mangin O, Gantzer L, et al. Pneumococcal vaccination coverage in France by general practitioners in adults with a high risk of pneumococcal disease. Hum Vaccin Immunother. 2021;17(1):162-69.
20. 20. Demirci I, Haymana C, Salman S, et al. Rates and associates of influenza and pneumococcus vaccination in diabetes mellitus: A nationwide cross-sectional study (TEMD vaccination study). World journal of diabetes. 2021;12(12):2107-18.
21. 21. Blasi F, Akova M, Bonanni P, et al. Community-acquired pneumonia in adults: Highlighting missed opportunities for vaccination. Eur J Intern Med. 2017;37:13-18.
22. 22. Mutlu H, Coskun F, Sargin M. The incidence and awareness of vaccination among people aged 65 and over applied to a family medicine outpatient clinic. Ankara Medical Journal. 2018;1:1-13.
23. 23. Centers for Disase Control and Prevention (CDC), Shingles (Herpes Zoster) Vaccines 2020. https://www.cdc.gov/vaccinesafety/vaccines/shingles-herpes-vaccine.html, , Acsess Date: 01.02.2022.
24. 24. Kızmaz M, Kumtepe Kurt B, Cetin Kargin N, Doner E. Influenza, pneumococcal and herpes zoster vaccination rates among patients over 65 years of age, related factors, and their knowledge and attitudes. Aging Clin Exp Res. 2020;32(11):2383-91.
25. 25. Lin J, Dobbins T, Wood JG, et al. Effectiveness of the live-attenuated herpes zoster vaccine 2 years after its introduction in Australia. Vaccine. 2021;39(10):1493-98.
26. 26. Sun Y, Kim E, Kong CL, et al. Effectiveness of the recombinant zoster vaccine in adults aged 50 and older in the United States: a claims-based cohort study. Clin Infect Dis. 2021; 73 (6):949-56.
27. 27. Nicholls LAB, Gallant AJ, Cogan N, et al. Older adults' vaccine hesitancy: Psychosocial factors associated with influenza, pneumococcal, and shingles vaccine uptake. Vaccine. 2021;39(26):3520-27.