Abstract：
Immune-compromised patients (IPs) are at high risk for infections, some of which are preventable by vaccines. Specific vaccines are recommended for IP; however, the vaccination rate is suboptimal. The aim of this study is to describe the development of an IP registry and to assess vaccination rates in this population. A population-based registry of IPs was developed using an automated extraction of patient electronic health-record data in Maccabi Healthcare Services (MHS), an Israeli health maintenance organization serving over 2.4 million members. Included in the registry were patients receiving immunosuppressive therapy (IT); patients living with HIV (PLWH); solid organ and bone marrow transplant recipients (TR); patients with advanced kidney disease (AKD), and asplenic patients. We evaluated the full schedule for each vaccine\'s uptake rates for influenza, pneumococcal, meningococcal, and hepatitis B. On 1 October 2019, 32,637 adult immune-compromised patients were identified by the registry. Of them, 1647 were PLWH; 2354 were asplenic; 5317 had AKD; 23,216 were on IT; and 1824 were TR. Their mean age was 57 and 52.4% were females. The crude rate of immune compromise among adult MHS members was 2%. Vaccine coverage rate was overall low for PCV13, with only 11.9% of all IPs in the registry having received one dose. Influenza and PPV23 vaccination rates were higher (45% and 39.4%, respectively). Only 5.3% of all IPs received all three vaccines. Overall, low vaccination coverage was found among IPs. Our registry can serve to identify target-patient populations for interventions and monitor their effectiveness.
摘要：
免疫功能受损的患者（IPs）感染的风险很高，其中一些是可以通过疫苗预防的。IP推荐使用特定疫苗；然而，疫苗接种率次优。这项研究的目的是描述IP注册的发展并评估该人群的疫苗接种率。在MaccabiHealthcareServices（MHS）中使用自动提取患者电子健康记录数据开发了基于人群的IP注册表，一个以色列健康维护组织，为240多万成员提供服务。登记中包括接受免疫抑制治疗（IT）的患者;HIV感染者（PLWH）;实体器官和骨髓移植受体（TR）;晚期肾脏疾病（AKD）患者，和脾虚患者。我们评估了每种疫苗对流感的摄取率的完整时间表，肺炎球菌,脑膜炎球菌,2019年10月1日，登记处确定了32,637名成年免疫受损患者。其中,1647人是PLWH；2354人是无性系；5317人患有AKD；23,216人使用IT；1824人是TR。他们的平均年龄为57岁，女性占52.4％。成年MHS成员中免疫受损的粗率为2％。PCV13的疫苗覆盖率总体较低，注册表中所有IP中只有11.9％接受了一剂。流感和PPV23接种率较高(45%和39.4%,分别)。只有5.3%的IP接种了所有三种疫苗。总的来说,在IPs中发现疫苗接种覆盖率低。我们的注册表可以用于确定目标患者人群的干预措施，并监测其有效性。
