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Vaccination rates low in patients hospitalized with HF
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Nearly 1 in 3 patients hospitalized for HF were not vaccinated for pneumococcal pneumonia or influenza, researchers reported in JACC: Heart Failure.
Additionally, vacation rates in this population did not improve from 2012 to 2017.
“Our data showing increasing refusal rates and stagnant to declining vaccination rates over the past 5 years are grounds for significant public health concern,” Ankeet S. Bhatt, MD, MBA, resident physician at Duke University Health System, and colleagues wrote.
The researchers analyzed fee-for-service Medicare claims data from 313,761 patients (mean age, 75 years; 49% women) from the Get With the Guidelines-Heart Failure registry who were hospitalized with HF at 392 hospitals from October 2012 to March 2017.
The overall proportion of patients who received influenza vaccination was 68%. This rate declined from 70% in the 2012-2013 influenza season to 66% in the 2016-2017 influenza season (P < .001). After adjusting for patient- and hospital-level factors, this was no longer statistically significant (OR per influenza season = 1.05; 95% CI, 0.94-1.18).
Overall, 66% of patients received pneumococcal vaccination, which decreased from 71% to 60% during the study period (P < .001). This remained statistically significant after adjustment (OR per calendar year = 0.75; 95% CI, 0.67-0.84).
Compared with hospitals with low rates of vaccination, those with high rates of influenza vaccination rates also had higher rates of defect-free care (OR = 2.72; 95% CI, 1.88-3.94). This was also seen for high rates of pneumococcal vaccination (OR = 4.52; 95% CI, 3.06-6.68).
Rates of 1-year all-cause mortality were similar for patients with linked Medicare claims who received influenza (HR = 0.96; 95% CI, 0.89-1.03) and pneumococcal vaccinations (HR = 0.95; 95% CI, 0.89-1.01) vs. those who were not vaccinated.
“Further studies are needed to assess causes for lack of improvement in vaccination rates in patients with HF and reasons for the observed disparities,” Bhatt and colleagues wrote. “Randomized controlled studies are needed to establish a relationship between vaccination and relevant clinical outcomes. Further research is needed with regard to the development of targeted, systems-level interventions that could improve respiratory vaccination rates and other performance measures for patients with HF.” – by Darlene Dobkowski
Disclosures: The Get With the Guidelines-Heart Failure program has been funded in the past through support from the American Heart Association Pharmaceutical Roundtable, GlaxoSmithKline, Medtronic and Ortho-McNeil. Bhatt reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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