Influenza and pneumococcal vaccine coverage among adults hospitalized with acute respiratory infection in France: A prospective cohort study

Abstract

Objectives

This study aimed to estimate influenza and pneumococcal vaccination coverage among adults hospitalized with severe acute respiratory infections in France from 2016 to 2022 and to analyze factors associated with vaccination.

Methods

We analyzed data from a prospective multicenter study involving adults hospitalized with severe acute respiratory infections. Descriptive and comparative analyses of influenza and pneumococcal vaccination coverage were conducted along with multivariate logistic regression to identify the factors associated with vaccination.

Results

We included 4,614 patients; 88% (4,080/4,614) had an indication for influenza vaccination. Among them, 2,181/4,080 (53%) were vaccinated against influenza. Factors associated with vaccination included age ≥65 years (adjusted odds ratio [aOR] 3.05; 95% confidence interval [CI] 2.63-3.55) and chronic respiratory diseases (aOR 1.38; 95% CI 1.20-1.59). Pneumococcal vaccination status was available for 90% (4,142/4,614) of patients, of whom 71% (2,920/4,142) had an indication for vaccination. Pneumococcal vaccination coverage was 19% (551/2,920). The factors associated with vaccination were chronic respiratory disease (aOR 2.74; 95% CI 2.22-3.40) and immunocompromised conditions other than malignancies. The vaccination coverage for each vaccine did not increase over time. Among the 3,247 patients eligible for both vaccines, 13% received both vaccines.

Conclusions

In this high-risk population, the vaccination coverage was low, particularly with pneumococcal vaccines. Therefore, improved vaccination recommendation strategies and communication are required.