Factors associated with pandemic influenza A/H1N1 vaccine coverage in a French cohort of HIV-infected patients

• Published in: Vaccine 2011-08, Vol.29 (34), p.5638-5644
• Main Authors: Cotte, L, Voirin, N, Richard, C, Brochier, C, Schlienger, I, Lack, P, Lina, B, Vanhems, P, Zoulim, F
• Format: Article
• Language: English
• Subjects: A/H1N1; Age Factors; Allergy and Immunology; Antiretroviral agents; Antiretroviral drugs; Applied microbiology; Asthma; Biological and medical sciences; Body mass index; Cancer; Cardiomyopathy; Chronic obstructive pulmonary disease; Diabetes; Disease Outbreaks; Disease Outbreaks - prevention & control; Family physicians; Female; France; Fundamental and applied biological sciences. Psychology; gender; Hepatology; HIV; HIV Infections; HIV Infections - immunology; Human immunodeficiency virus; Human viral diseases; Humans; Immunization; Infectious diseases; influenza; Influenza A Virus, H1N1 Subtype; Influenza A Virus, H1N1 Subtype - immunology; Influenza, Human; Influenza, Human - epidemiology; Influenza, Human - immunology; Influenza, Human - prevention & control; Life Sciences; Male; Mass Vaccination; Medical sciences; men; Microbiology; Miscellaneous; Multivariate analysis; odds ratio; pandemic; Pandemic influenza; Pandemics; Patient Acceptance of Health Care; Patient Compliance; patients; physicians; Population; Pregnancy; Public health; Risk factors; Sexual Behavior; Sexually transmitted diseases; STD; Streptococcus pneumoniae; Swine flu; vaccination; Vaccine coverage; Vaccines; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects); Variables; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Virology; winter; Womens health
• ISSN: 0264-410X; 1873-2518; 0264-410X
• DOI: 10.1016/j.vaccine.2011.06.013

Abstract Background A mass influenza A/H1N1 vaccination campaign took place in France during the 2009 winter. Overall, 7.9% of the general population was vaccinated. However, vaccine coverage data are missing for at-risk groups. Methods A vaccination centre was implemented for HIV-infected patients followed-up in a French University Hospital. Demographical, clinical and biological characteristics were collected. Adjusted odds ratios (aOR) were calculated to identify factors associated with being vaccinated against A/H1N1 influenza. Results A/H1N1 vaccine coverage was 44.4% (635/1430) in HIV-infected patients. In univariate analysis, uptake of vaccination was significantly associated with male gender, men who have sex with men, age ≥ 50 years, ≥1 seasonal influenza risk factor, longer HIV disease, longer duration of antiretroviral therapy, greater number of lines of antiretroviral treatments, lower nadir CD4, recent HIV-RNA < 50 copies/ml, previous pneumococcal vaccination, >2 visits to the unit during the study period and follow-up by a physician who assessed ≥100 patients/year (senior physician). CDC stage, recent CD4 count, diabetes, BMI > 30 and pregnancy were not associated with vaccination. After multivariate analysis, vaccination remained significantly associated with age ≥50 years (aOR 1.56, CI 1.16–2.09), time since HIV diagnosis (aOR per 1 year 1.02, CI 1.00–1.04), previous pneumococcal vaccination (aOR 2.56, CI 1.96–3.34), >2 visits to the unit (aOR 5.09, CI 3.87–6.68) and follow-up by a senior physician (aOR 1.73, CI 1.20–2.48). Conclusion A/H1N1 vaccination was more successful in HIV-infected patients than in the French general population. Organization of the vaccination in a convenient location and implication of the physicians seem to be determining factors for A/H1N1 acceptability in this population.