Influenza vaccination coverage in patients with diabetes mellitus afferent to an Italian hospital

Background

Patients with type 1 (T1DM) and type 2 (T2DM) diabetes are at increased risk of vaccine-preventable diseases and their complications. The National Vaccinal Prevention Plan 2017-2019 includes specific recommendations for patients with diabetes, which in 2018 have been included in the standards of care of the Italian Diabetes Society (SID) and Italian Association of Clinical Diabetologists (AMD).

Methods

Adult diabetic patients attending the Diabetes clinic at the San Raffaele Hospital, a large teaching hospital in Milan, Italy, were surveyed with a questionnaire to investigate self-reported vaccinal history, knowledge, attitudes and practice on the recommended vaccinations, vaccinal hesitancy and information sources on the topic.

Results

Between May 16 and November 11, 2019 N = 222 T1DM and N = 57 T2DM patients were enrolled. 25.2% of T1DM and 26.3% of T2DM patients did get vaccinated annually against the flu in the past 3 year. 85.0% of T2DM patients were vaccinated at the General Practitioner's (GP) clinic, while 54.9% of T1DM patients were vaccinated by their GP and 24.4% from territorial vaccinal clinics. 54.5% of T1DM and 50.0% of T2DM patients chose not to be vaccinated because they didn't consider the vaccine useful, while the second most common reason was that they have not been advised by healthcare personnel.

Conclusions

We documented a low coverage and knowledge about influenza vaccination. Patients with diabetes trusted information and advice of diabetologists and GPs about vaccination and claimed that they would be more likely to vaccinate if vaccination were offered in the diabetes clinic. Implementing training programs for professionals and educational campaigns for patients with diabetes may improve vaccinal coverage.

Key messages

Vaccination coverage in T1DM and T2DM patients is low due to vaccination hesitancy. A strong action from care givers, in order to raise vaccination awareness in this at-risk population, is needed.