背景:季节性流感疫苗开发的创新已导致更广泛的制剂变得可用。在评估疫苗的益处和风险时,了解人群的疫苗覆盖率,包括给药时间是很重要的。
目的:本研究旨在报告代表性,流感疫苗的摄取,不同配方的流感疫苗,以及英国初级保健前哨队列(PCSC)内的管理时间。
方法:我们使用了牛津皇家全科医师研究和监测中心的PCSC。我们纳入了在PCSC会员全科医生注册的所有年龄的患者,报告2019年9月1日至2020年1月29日之间的流感疫苗覆盖率。我们确定了流感疫苗接种者,并以年龄为特征,临床风险组,和疫苗类型。我们在国际标准组织(ISO)周报告了PCSC内的流感疫苗接种日期。将PCSC人口的代表性与国家统计局提供的人口数据进行了比较。PCSC流感疫苗覆盖率与英国卫生安全局公布的国家数据进行了比较。我们使用配对t检验来比较种群,以95%CI报告。
结果:PCSC包括来自693个一般实践的7,010,627人。与国家统计局2019年年中人口估计(23,219,730/56,286,961,41.3%;95%CI42.5%-42.6%)相比,研究人群中18-49岁的人口比例更高(2,982,390/7,010,627,42.5%;95%CI4.12%-41.3%;P<.001)。更贫困的人代表性不足,而最贫困的五分之一的人代表性过高。在研究人群中,在国家数据中,所有年龄段的人中有24.7%(1,731,062/7,010,627;95%CI24.7%-24.7%)接种了流感疫苗,相比之下,这一比例为24.2%(14,468,665/59,764,928;95%CI24.2%-24.2%;P<.001)。覆盖率最高的是65岁以上的人群(913,695/1,264,700,72.3%;95%CI72.2%-72.3%)。风险人群中接种流感疫苗的比例也较高;例如,PCSC中69.8%(284,280/407,228;95%CI69.7%-70%)的糖尿病患者接种了流感疫苗,相比之下,国家数据为61.2%(983,727/1,607,996;95%CI61.1%-61.3%;P<.001)。在PCSC,71.8%(358,365/498,923;95%CI71.7%-72%)的16-64岁人群和81.9%(748,312/913,695;95%CI81.8%-82%)的≥65岁人群可获得疫苗类型和品牌信息,与23.6%(696,880/2,900,000)和17.8%(1,385,888/7,700,000)相比,分别,国家数据中的同年龄组。疫苗接种在ISO第35周期间开始,持续到ISO第3周,并在ISO第41周期间达到峰值。疫苗接种的每周高峰是在星期六。
结论:PCSC的社会人口统计学特征与全国人口相似,并获得了更多有关风险人群的数据,疫苗品牌,和批次。这可以反映更高的数据质量。它的能力包括报告确切的管理日期。PCSC适用于开展流感疫苗覆盖率研究。
BACKGROUND: Innovation in seasonal influenza vaccine development has resulted in a wider range of formulations becoming available. Understanding vaccine coverage across populations including the timing of administration is important when evaluating vaccine benefits and risks.
OBJECTIVE: This
study aims to report the representativeness,
uptake of influenza vaccines, different formulations of influenza vaccines, and timing of administration within the English Primary Care Sentinel Cohort (PCSC).
METHODS: We used the PCSC of the Oxford-Royal College of General Practitioners Research and Surveillance Centre. We included patients of all ages registered with PCSC member general practices, reporting influenza vaccine coverage between September 1, 2019, and January 29, 2020. We identified influenza vaccination recipients and characterized them by age, clinical risk groups, and vaccine type. We reported the date of influenza vaccination within the PCSC by International Standard Organization (ISO) week. The representativeness of the PCSC population was compared with population data provided by the Office for National Statistics. PCSC influenza vaccine coverage was compared with published UK Health Security Agency\'s national data. We used paired t tests to compare populations, reported with 95% CI.
RESULTS: The PCSC comprised 7,010,627 people from 693 general practices. The
study population included a greater proportion of people aged 18-49 years (2,982,390/7,010,627, 42.5%; 95% CI 42.5%-42.6%) compared with the Office for National Statistics 2019 midyear population estimates (23,219,730/56,286,961, 41.3%; 95% CI 4.12%-41.3%; P<.001). People who are more deprived were underrepresented and those in the least deprived quintile were overrepresented. Within the
study population, 24.7% (1,731,062/7,010,627; 95% CI 24.7%-24.7%) of people of all ages received an influenza vaccine compared with 24.2% (14,468,665/59,764,928; 95% CI 24.2%-24.2%; P<.001) in national data. The highest coverage was in people aged ≥65 years (913,695/1,264,700, 72.3%; 95% CI 72.2%-72.3%). The proportion of people in risk groups who received an influenza vaccine was also higher; for example, 69.8% (284,280/407,228; 95% CI 69.7%-70%) of people with diabetes in the PCSC received an influenza vaccine compared with 61.2% (983,727/1,607,996; 95% CI 61.1%-61.3%; P<.001) in national data. In the PCSC, vaccine type and brand information were available for 71.8% (358,365/498,923; 95% CI 71.7%-72%) of people aged 16-64 years and 81.9% (748,312/913,695; 95% CI 81.8%-82%) of people aged ≥65 years, compared with 23.6% (696,880/2,900,000) and 17.8% (1,385,888/7,700,000), respectively, of the same age groups in national data. Vaccination commenced during ISO week 35, continued until ISO week 3, and peaked during ISO week 41. The in-week peak in vaccination administration was on Saturdays.
CONCLUSIONS: The PCSC\'s sociodemographic profile was similar to the national population and captured more data about risk groups, vaccine brands, and batches. This may reflect higher data quality. Its capabilities included reporting precise dates of administration. The PCSC is suitable for undertaking studies of influenza vaccine coverage.