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北京大学学报（医学版） ›› 2022, Vol. 54 ›› Issue (3): 505-510. doi: 10.19723/j.issn.1671-167X.2022.03.016

• 论著 • 上一篇    下一篇

2013—2019年流感季北京市住院老年人流感疫苗接种趋势分析

刘光奇1,庞元捷2,吴疆3,吕敏3,*(),于孟轲1,李雨橦1,黄旸木1,*()   

  1. 1. 北京大学公共卫生学院全球卫生学系，北京 100191
    2. 北京大学公共卫生学院流行病与卫生统计学系，北京 100191
    3. 北京市疾病预防控制中心/北京市预防医学研究中心，北京 100013
  • 收稿日期:2021-12-22 出版日期:2022-06-18 发布日期:2022-06-14
  • 通讯作者: 吕敏,黄旸木 E-mail:8872lm@163.com;ymhuang@bjmu.edu.cn
  • 基金资助:
    首都卫生发展科研专项自主创新项目(2022-2G-3017);北京市属医学科研院所机构公益发展改革试点项目(2018-1)

Trend analysis of influenza vaccination among hospitalized elderly people in Beijing, 2013-2019

Guang-qi LIU1,Yuan-jie PANG2,Jiang WU3,Min LV3,*(),Meng-ke YU1,Yu-tong LI1,Yang-mu HUANG1,*()   

  1. 1. Department of Global Health, Peking University School of Public Health, Beijing 100191, China
    2. Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
    3. Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China
  • Received:2021-12-22 Online:2022-06-18 Published:2022-06-14
  • Contact: Min LV,Yang-mu HUANG E-mail:8872lm@163.com;ymhuang@bjmu.edu.cn
  • Supported by:
    Capital Health Development Research Fund for Independent Innovation Project(2022-2G-3017);Pilot Project Fund for Public Welfare Development and Reform of Beijing Municipal Medical Research Institutes(2018-1)

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摘要：

目的: 分析2013—2019年北京市≥60岁老年人流感疫苗接种情况，探究因不同疾病住院老年人的接种趋势变化。方法: 从2013—2019年北京市老年人流感疫苗接种信息登记数据库和2013—2019年北京市城镇职工基本医疗保险数据库分别提取老年人流感疫苗接种信息和住院信息后合并分析，比较因不同疾病住院的老年人的流感疫苗接种趋势，并描述2018—2019年流感季接种人群的分布情况。结果: 北京市因心血管疾病、脑血管疾病、呼吸系统疾病和糖尿病住院的老年人的流感疫苗接种率分别为14.6%、13.4%、13.4%和11.8%，其中因心血管疾病住院老年人连续六个流感年度接种率均保持在最高，因糖尿病住院人群流感疫苗接种率保持在最低且年均下降幅度最大(-7.85%)。2018—2019年流感疫苗接种人群分布情况在不同年龄、性别、住院结局和合并症严重程度中差异有统计学意义。在因4种疾病住院的老年人中，70~79岁老年人接种率均为最高，而60~69岁老年人接种率均为最低。在因呼吸系统疾病住院的老年人中男性流感疫苗接种率优于女性，而在因糖尿病或心血管疾病住院的人群则表现相反。住院结局较差的老年人接种率更低。糖尿病患者中无共病的接种率最低(7.9%)。结论: 北京市2013—2019年因不同疾病住院的≥60岁老年人流感疫苗接种率整体呈下降趋势，应重点关注糖尿病和60~69岁老年人群的流感疫苗接种，并开展更多流感疫苗保护作用研究以支持流感疫苗在慢性病人群中的普及。

关键词: 流感疫苗, 疫苗接种覆盖率, 老年人, 慢性病

Abstract:

Objective: To analyze the influenza vaccination trend of hospitalized elderly people (≥ 60 years old) in Beijing from 2013 to 2019. Methods: The influenza vaccination status and hospitalization information of elderly people were extracted from the Beijing Elderly Influenza Vaccination database (2013-2019) and the Beijing Urban Employee Basic Medical Insurance database (2013-2019), se-parately. The influenza vaccine coverage rates and annual percentage change were calculated to compare the vaccination trends of elderly people hospitalized due to different diseases. The subjects in 2018-2019 influenza season were divided into different groups according to demographic status, health conditions and hospitalization outcomes to describe and compare the distribution of influenza vaccination rates. Results: The influenza vaccine coverage rates among the elderly people hospitalized due to cardiovascular diseases, cerebrovascular diseases, respiratory diseases or diabetes mellitus were 14.6%, 13.4%, 13.4% and 11.8%, respectively. The influenza vaccination rate among those hospitalized for cardiovascular diseases remained the highest across six influenza seasons and those hospitalized for diabetes mellitus remained the lowest. The largest annual decline of influenza vaccine coverage rate was observed among the hospitalized elderly due to diabetes mellitus (-7.85%). The distribution of vaccinated population was significantly associated with age, gender, hospitalization outcome and comorbidities among the hospitalized elderly people with specific diseases in 2018-2019. Among the elderly people hospitalized due to four different diseases, the vaccination rate of the patients aged 70-79 years was higher than that of the other age groups and that of the patients aged 60-69 years was the lowest. Among the elderly people hospitalized due to respiratory diseases, the vaccination rate of men was higher than that of women, while the situation reversed among the elderly people hospitalized due to cardiovascular diseases and diabetes mellitus. Vaccination rates decreased among the older adults with poor hospitalization outcomes. Among the elderly people hospitalized due to diabetes mellitus, those with 0 comorbidity had the lowest vaccination rate (7.9%). Conclusion: The trend of influenza vaccine coverage rates among the elderly people in Beijing from 2013 to 2019 was downward. We should pay more attention to influenza vaccination in elderly people with diabetes mellitus and aged 60-69 years, and carry out more research on the protective effects of influenza vaccine to promote influenza vaccine coverage among people with chronic diseases.

Key words: Influenza vaccines, Vaccination coverage, Aged, Chronic diseases

中图分类号: 

  • R186

表1

2013—2019年因不同疾病住院的老年人流感疫苗接种情况[n (%)]"

Year Diabetes mellitus Cardiovascular diseases Cerebrovascular diseases Respiratory diseases
2013-2014 1 819 (16.0) 5 844 (19.4) 4 668 (16.6) 5 114 (16.6)
2014-2015 2 071 (13.5) 6 061 (15.7) 5 136 (14.2) 5 805 (14.5)
2015-2016 2 002 (11.9) 6 073 (14.1) 5 038 (12.9) 5 620 (12.8)
2016-2017 1 928 (10.1) 5 886 (12.2) 4 738 (11.0) 5 703 (11.7)
2017-2018 2 770 (11.7) 9 273 (14.8) 8 821 (14.4) 8 766 (13.8)
2018-2019 2 687 (10.4) 9 370 (13.6) 8 729 (12.7) 8 441 (12.5)
Total 13 277 (11.8) 42 507 (14.6) 37 130 (13.4) 39 449 (13.4)
APC -7.63 -5.81 -4.11 -4.57

表2

2018—2019年北京市因不同疾病住院老年人流感疫苗接种情况"

Items Diabetes mellitus Cardiovascular diseases Cerebrovascular diseases Respiratory diseases
Vaccination coverage rate/% P Vaccination coverage rate/% P Vaccination coverage rate/% P Vaccination coverage rate/% P
Age < 0.001 0.001 0.883 < 0.001
  60-69 years 7.3 9.6 9.3 10.0
  70-79 years 15.6 19.2 17.0 16.6
  ≥80 years 12.9 14.4 12.9 11.6
Gender < 0.001 < 0.001 < 0.001 < 0.001
  Male 9.4 13.2 12.7 13.3
  Female 11.3 14.1 12.7 11.6

表3

2018—2019年北京市因不同疾病住院老年人流感疫苗接种情况(按住院情况分类)"

Items Diabetes mellitus Cardiovascular diseases Cerebrovascular diseases Respiratory diseases
Vaccination coverage rate/% P Vaccination coverage rate/% P Vaccination coverage rate/% P Vaccination coverage rate/% P
CCI 0.143 < 0.001 < 0.001 < 0.001
  0 7.9 14.4 11.3 15.1
  1-2 10.1 14.2 13.7 14.0
  3-4 10.6 13.2 12.1 11.1
  ≥5 10.1 10.2 10.2 8.4
Readmission 0.120 < 0.001 < 0.001 < 0.001
  No 10.5 13.8 13.3 13.2
  Yes 9.5 11.3 8.8 8.2
Death 0.034 < 0.001 < 0.001 < 0.001
  No 10.4 13.7 12.8 13.0
  Yes 3.2 8.7 7.5 4.8
Ht < 0.001 < 0.001 < 0.001 < 0.001
  0 10.9 14.4 13.8 14.1
  1 10.6 13.3 12.8 12.7
  ≥2 7.5 10.5 7.8 8.4
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