title: Prevalence of vaccination rates in systolic heart failure: a prospective study of 549 patients by age, race, ethnicity, and sex in a heart failure disease management program.
abstract: Healthy People 2010 aims at immunizing 60% of high-risk adults annually against influenza and once against pneumococcal disease. The aim of this study was to evaluate the use of a standardized approach to improve vaccination rates in patients with heart failure (HF); to determine whether disparities exist based on age, race, ethnicity, or sex at baseline and follow-up; and to evaluate the impact of clinical variables on the odds of being vaccinated. A prospective study of 549 indigent patients enrolled in a systolic HF disease management program (HFDMP) began enrollment from August 2007 to January 2009 at Jackson Memorial Hospital. Patients were interviewed at their initial visit for immunization status; those without vaccinations were offered the vaccines. Prevalence of vaccination (POV) for influenza and pneumococcal disease was obtained at baseline and at follow-up. The odds ratio for being vaccinated was calculated using logistic regression. The study population comprised mostly Hispanic (56%), black (37%), and male (70%) patients, with a mean age of 56 ± 12 years and a mean ejection fraction of 25% ± 10%. The initial POV for both was 22% at baseline. At follow-up, POV improved to 60.5%. Of those not vaccinated at baseline, 17.5% refused vaccination. Odds ratios at baseline for age, race/ethnicity, and sex were 0.99 (P=.99), 0.63 (P=.08), and 0.62 (P=.14), respectively. These did not change significantly at follow-up. Prevalence of vaccination in our cohort was low. Enrollment into the HFDMP improved immunization prevalence without creating age, race, ethnicity, or sex disparities.
authors.affiliation: University of Miami Miller School of Medicine, 1611 NW 12th Avenue, Jackson Memorial Hospital North Wing 210, Miami, FL 33136, USA. Khebert1@gmail.com
authors.forename: Kathy
authors.initials: K
authors.lastname: Hebert
authors.forename: George
authors.initials: G
authors.lastname: Marzouka
authors.forename: Lee
authors.initials: L
authors.lastname: Arcement
authors.forename: Elyse
authors.initials: E
authors.lastname: Julian
authors.forename: Frank
authors.initials: F
authors.lastname: Cortazar
authors.forename: Andre
authors.initials: A
authors.lastname: Dias
authors.forename: Leonardo
authors.initials: L
authors.lastname: Tamariz
mesh_terms: D000367:Age Factors; D016001:Confidence Intervals; D019468:Disease Management; D005006:Ethnicity; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000208:ethnology* / Q000473:pathology; D006801:Humans; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010045:Outpatients; D022242:Pneumococcal Vaccines; D015995:Prevalence; D015397:Program Evaluation; D011446:Prospective Studies; D044469:Racial Groups; D012044:Regression Analysis; D012737:Sex Factors; D013223:Statistics as Topic; D013318:Stroke Volume; D013599:Systole; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*; D016277:Ventricular Function, Left
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines