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Erişkin Bağışıklamada Kaçan Fırsatlar

Yıl 2024, Cilt: 46 Sayı: 4, 585 - 591, 16.07.2024
https://doi.org/10.20515/otd.1491532

Öz

Çocukluk dönemi aşı programlarının yaygın kullanımı ile çok sayıda bulaşıcı hastalığın morbidite ve mortalitesi önemli ölçüde azaltılabilmiştir ancak erişkin yaş grubunda aşı ile önlenebilir hastalıklar halen önemli bir halk sağlığı sorunu olmaya devam etmektedir. Bu çalışmada, aşılama endikasyonu bulunan erişkin yaş grubundaki kişilerin altta yatan risk faktörlerine göre aşılanma oranlarının değerlendirilmesi amaçlanmıştır. Bu çalışmada 01.04.2024-30.04.2024 tarihleri arasında enfeksiyon hastalıkları polikliniğine başvuran 18 yaş ve üzeri olgular retrospektif olarak değerlendirilmiştir. Olguların yaş grupları veya altta yatan risk faktörlerine (diyabet, malignite, kronik akciğer, renal veya kardiyak hastalık, sağlık çalışanı vb.) göre aşılama endikasyonları ve aşılama oranları değerlendirildi. Polikliniğimizde değerlendirilen 495 olgunun %56'sını kadın hastalar oluştururken, yaş ortalaması 46,1 ± 18,1 yıl idi. Olguların %19,6'sı 65 yaş ve üzerindeydi ve %15,2'sinin aşılanmaya engel bir durumu bulunmaktaydı. Polikliniğe başvuran 177 kişide kronik hastalık saptanmazken, 201 olguda bir, 117 olguda ise iki veya daha fazla kronik hastalık mevcuttu. Kronik hastalıklar arasında en yaygın olanlar diyabet, hipertansiyon, HIV, otoimmün hastalıklar ve malignitelerdi. Olguların son 10 yıl içindeki aşılama durumlarına göre en yaygın uygulanan aşılar Covid-19, difteri/tetanoz ve pnömokok aşılarıydı. Aşılama endikasyonları benzer olmasına rağmen, tüm hasta gruplarında influenza aşısının pnömokok aşısına kıyasla daha düşük seviyelerde uygulandığı görüldü. Sağlık hizmeti sunucularının erişkin aşılaması konusunda farkındalıklarını artırmak, erişkin bağışıklama polikliniklerinde danışmanlık hizmetlerinin güçlendirilmesi, aşıya erişim kolaylığının sağlanması ve toplum bilincinin artırılması aşılamada kaçan fırsatların önüne geçilmesinde önemli bir katkı sağlayacaktır.

Etik Beyan

Etik Kurul Onayı: Çalışma Eskişehir Osmangazi Üniversitesi Girişimsel Olmayan Etik kurul tarafından onaylanmıştır. (Karar No: 18, Tarih: 02.05.2024).

Kaynakça

  • 1. Swanson KA, Schmitt HJ, Jansen KU, Anderson AS. Adult vaccination: Current recommendations and future prospects. Hum Vaccines Immunother. 2015 Jan;11(1):150–5.
  • 2. Murthy N, Wodi AP, McNally VV, Daley MF, Cineas S, Advisory Committee on Immunization Practices. Recommended Adult Immunization Schedule, United States, 2024. Ann Intern Med. 2024 Feb 20;177(2):221–37.
  • 3. Tan L. Adult vaccination: Now is the time to realize an unfulfilled potential. Hum Vaccines Immunother. 2015 Sep 2;11(9):2158–66.
  • 4. Erişkin Bağışıklama Rehberi 2024 - EKMUD [Internet]. [cited 2024 Apr 24]. Available from: https://www.ekmud.org.tr/haber/1151-eriskin-bagisiklama-rehberi-2024
  • 5. Surveillance of Influenza Vaccination Coverage — United States, 2007–08 Through 2011–12 Influenza Seasons [Internet]. [cited 2024 Apr 15]. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6204a1.htm#tab7
  • 6. Williams WW, Lu PJ, O’Halloran A, Bridges CB, Pilishvili T, Hales CM, et al. Noninfluenza Vaccination Coverage Among Adults--United States, 2012. MMWR Morb Mortal Wkly Rep. 2014;63(5).
  • 7. Sridhar S, Maleq N, Guillermet E, Colombini A, Gessner BD. A systematic literature review of missed opportunities for immunization in low- and middle-income countries. Vaccine. 2014 Dec;32(51):6870–9.
  • 8. Adult Immunization Schedule by Age | CDC [Internet]. 2024 [cited 2024 Apr 24]. Available from: https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html
  • 9. COVID-19 vaccines | WHO COVID-19 dashboard [Internet]. [cited 2024 May 6]. Available from: http://data.who.int/dashboards/covid19/vaccines
  • 10. Slifka AM, Park B, Gao L, Slifka MK. Incidence of Tetanus and Diphtheria in Relation to Adult Vaccination Schedules. Clin Infect Dis. 2021 Jan 15;72(2):285–92.
  • 11. Ostropolets A, Shoener Dunham L, Johnson KD, Liu J. Pneumococcal vaccination coverage among adults newly diagnosed with underlying medical conditions and regional variation in the U.S. Vaccine. 2022 Aug;40(33):4856–63.
  • 12. Mutlu A, Şengül E, Boz G. A cross-sectional survey study on influenza and pneumococcal vaccination rates and the factors affecting vaccination rates in hemodialysis patients in Kocaeli Province of Turkey. Ther Apher Dial. 2022;26(3):640–8.
  • 13. Kizmaz M, Kumtepe Kurt B, Çetin Kargin N, Döner 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 Nov 1;32(11):2383–91.
  • 14. Demirdogen Cetinoglu E, Uzaslan E, Sayıner A, Cilli A, Kılınc O, Sakar Coskun A, et al. Pneumococcal and influenza vaccination status of hospitalized adults with community acquired pneumonia and the effects of vaccination on clinical presentation. Hum Vaccines Immunother. 2017 Sep 2;13(9):2072–7.

Missed Opportunities in Adult Immunization

Yıl 2024, Cilt: 46 Sayı: 4, 585 - 591, 16.07.2024
https://doi.org/10.20515/otd.1491532

Öz

The widespread utilization of childhood vaccination programs has significantly reduced the morbidity and mortality of numerous infectious diseases. However, vaccine-preventable diseases in the adult population continue to pose a significant public health challenge. This study aimed to assess vaccination rates among adults with vaccine indications based on underlying risk factors. This study retrospectively evaluated cases aged 18 and over who attended the infectious diseases outpatient clinic between April 1, 2024, and April 30, 2024. The vaccination indications and vaccination rates were evaluated based on the age groups of the cases and underlying risk factors such as diabetes, malignancy, chronic lung, kidney or heart diseases, and being healthcare workers. Among the 495 cases evaluated in our clinic, 56% were female patients, and the mean age was 46.1 ± 18.1 years. 19.6% of the cases were 65 years and older, and 15.2% had a condition that contraindicated vaccination. While no chronic diseases were detected in 177 individuals, 201 had one chronic disease, and 117 had two or more chronic diseases. The most common chronic diseases included diabetes, hypertension, HIV, autoimmune diseases, and malignancies. Based on the vaccination status of the cases over the past 10 years, the most commonly administered vaccines were for Covid-19, diphtheria/tetanus, and pneumococcal vaccinations. Despite similar vaccination indications, influenza vaccine was administered at lower rates compared to pneumococcal vaccine across all patient groups. Increasing awareness among healthcare providers about adult vaccination, strengthening counseling services in adult immunization clinics, ensuring vaccine accessibility, and raising community awareness will contribute significantly to addressing missed opportunities in vaccination.

Kaynakça

  • 1. Swanson KA, Schmitt HJ, Jansen KU, Anderson AS. Adult vaccination: Current recommendations and future prospects. Hum Vaccines Immunother. 2015 Jan;11(1):150–5.
  • 2. Murthy N, Wodi AP, McNally VV, Daley MF, Cineas S, Advisory Committee on Immunization Practices. Recommended Adult Immunization Schedule, United States, 2024. Ann Intern Med. 2024 Feb 20;177(2):221–37.
  • 3. Tan L. Adult vaccination: Now is the time to realize an unfulfilled potential. Hum Vaccines Immunother. 2015 Sep 2;11(9):2158–66.
  • 4. Erişkin Bağışıklama Rehberi 2024 - EKMUD [Internet]. [cited 2024 Apr 24]. Available from: https://www.ekmud.org.tr/haber/1151-eriskin-bagisiklama-rehberi-2024
  • 5. Surveillance of Influenza Vaccination Coverage — United States, 2007–08 Through 2011–12 Influenza Seasons [Internet]. [cited 2024 Apr 15]. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6204a1.htm#tab7
  • 6. Williams WW, Lu PJ, O’Halloran A, Bridges CB, Pilishvili T, Hales CM, et al. Noninfluenza Vaccination Coverage Among Adults--United States, 2012. MMWR Morb Mortal Wkly Rep. 2014;63(5).
  • 7. Sridhar S, Maleq N, Guillermet E, Colombini A, Gessner BD. A systematic literature review of missed opportunities for immunization in low- and middle-income countries. Vaccine. 2014 Dec;32(51):6870–9.
  • 8. Adult Immunization Schedule by Age | CDC [Internet]. 2024 [cited 2024 Apr 24]. Available from: https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html
  • 9. COVID-19 vaccines | WHO COVID-19 dashboard [Internet]. [cited 2024 May 6]. Available from: http://data.who.int/dashboards/covid19/vaccines
  • 10. Slifka AM, Park B, Gao L, Slifka MK. Incidence of Tetanus and Diphtheria in Relation to Adult Vaccination Schedules. Clin Infect Dis. 2021 Jan 15;72(2):285–92.
  • 11. Ostropolets A, Shoener Dunham L, Johnson KD, Liu J. Pneumococcal vaccination coverage among adults newly diagnosed with underlying medical conditions and regional variation in the U.S. Vaccine. 2022 Aug;40(33):4856–63.
  • 12. Mutlu A, Şengül E, Boz G. A cross-sectional survey study on influenza and pneumococcal vaccination rates and the factors affecting vaccination rates in hemodialysis patients in Kocaeli Province of Turkey. Ther Apher Dial. 2022;26(3):640–8.
  • 13. Kizmaz M, Kumtepe Kurt B, Çetin Kargin N, Döner 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 Nov 1;32(11):2383–91.
  • 14. Demirdogen Cetinoglu E, Uzaslan E, Sayıner A, Cilli A, Kılınc O, Sakar Coskun A, et al. Pneumococcal and influenza vaccination status of hospitalized adults with community acquired pneumonia and the effects of vaccination on clinical presentation. Hum Vaccines Immunother. 2017 Sep 2;13(9):2072–7.
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Bulaşıcı Hastalıklar
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Hasip Kahraman 0000-0002-5120-4877

Yayımlanma Tarihi 16 Temmuz 2024
Gönderilme Tarihi 5 Haziran 2024
Kabul Tarihi 2 Temmuz 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 46 Sayı: 4

Kaynak Göster

Vancouver Kahraman H. Erişkin Bağışıklamada Kaçan Fırsatlar. Osmangazi Tıp Dergisi. 2024;46(4):585-91.


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