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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Adherence to Advisory Committee on Immunization Practices in diabetes mellitus patients in Saudi Arabia: A multicenter retrospective study
Saleh Fahad Alqifari, Aya K Esmail, Dalal M Alarifi, Ghalya Y Alsuliman, Maram M Alhati, May R Mutlaq, Mohammed Aldhaeefi, Shaden A Alshuaibi, Palanisamy Amirthalingam, Abrar Abdallah, Afaf S Wasel, Heba R Hamad, Shoroq Alamin, Tasneem H Atia, Tariq Alqahtani
Saleh Fahad Alqifari, Palanisamy Amirthalingam, Department of Pharmacy Practice, University of Tabuk, Tabuk 71491, Saudi Arabia
Aya K Esmail, Dalal M Alarifi, Ghalya Y Alsuliman, Maram M Alhati, Shaden A Alshuaibi, Abrar Abdallah, Afaf S Wasel, Heba R Hamad, Shoroq Alamin, Tasneem H Atia, Department of Clinical Sciences, Sulaiman Alrajhi University, Qassim 52726, Saudi Arabia
May R Mutlaq, Department of Family Medicine, International Medical Center, Jeddah 23214, Saudi Arabia
Mohammed Aldhaeefi, Clinical and Administrative Pharmacy Sciences, College of Pharmacy, Howard University, Washington, DC 20059, United States
Tariq Alqahtani, Department of Pharmacology, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
Author contributions: Alqifari SF contributed to the conceptualization and project administration; Alqifari SF, Mutlaq MR, and Aldhaeefi M were involved in the methodology of this study; Alqifari SF, Amirthalingam P, and Alqahtani T analysed data; Alqifari SF, Esmail AK, Alarifi DM, Alsuliman GY, Alhati MM, Mutlaq MR, and Alshuaibi SA participated in the data interpretation; Alqifari SF, Esmail AK, Alarifi DM, Alsuliman GY, Alhati MM, Mutlaq MR, and Alshuaibi SA contributed to the writing - original draft preparation; Alqifari SF, Esmail AK, Mutlaq MR, Aldhaeefi M, Abdallah A, Wasel AS, Hamad HR, Alamin S, Atia TH, Alqahtani T took part in the writing - review and editing; Alqifari SF and Amirthalingam P were involved in the visualization; Alqifari SF, Mutlaq MR, Aldhaeefi M, and Alqahtani T participated in the supervision; and all authors have read and agreed to the published version of the manuscript.
Institutional review board statement: The study was conducted according to the guidelines of the Declaration of Helsinki. The study protocol (607-43-6007) was granted IRB approval by the Regional Research Ethics Committee - Ministry of Health, Saudi Arabia.
Informed consent statement: Informed consents have been obtained on first page of the online questionnaire. A clear information of the purpose of the study, participants rights during completing the questionnaire and withdrawal at any stage were provided. Only those who agreed to participate were able to complete the online survey.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are available on request from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Saleh Fahad Alqifari, PharmD, Assistant Professor, Chief Pharmacist, Department of Pharmacy Practice, University of Tabuk, King Faisal Road, Tabuk 71491, Saudi Arabia.
salqifari@ut.edu.sa
Received: November 8, 2023
Peer-review started: November 8, 2023
First decision: December 26, 2023
Revised: January 3, 2024
Accepted: February 18, 2024
Article in press: February 18, 2024
Published online: March 15, 2024
Processing time: 128 Days and 4.1 Hours
BACKGROUND
Patients with diabetes mellitus (DM) are predisposed to an increased risk of infection signifying the importance of vaccination to protect against its potentially severe complications. The Centers for Disease Control and Prevention/Advisory Committee on Immunization Practices (CDC/ACIP) issued immunization re-commendations to protect this patient population.
AIM
To assess the adherence of patients with DM to the CDC/ACIP immunization recommendations in Saudi Arabia and to identify the factors associated with the vaccine adherence rate.
METHODS
An observational retrospective study conducted in 2023 was used to collect data on the vaccination records from 13 diabetes care centers in Saudi Arabia with 1000 eligible patients in phase I with data collected through chart review and 709 patients in phase II through online survey.
RESULTS
Among participants, 10.01% (n = 71) had never received any vaccine, while 85.89% (n = 609) received at least one dose of the coronavirus disease 2019 (COVID-19) vaccine, and 34.83% (n = 247) had received the annual influenza vaccine. Only 2.96% (n = 21), 2.11% (n = 15), and 1.12% (n = 8) received herpes zoster, tetanus, diphtheria, and pertussis (Tdap), and human papillomavirus (HPV) vaccines, respectively. For patients with DM in Saudi Arabia, the rate of vaccination for annual influenza and COVID-19 vaccines was higher compared to other vaccinations such as herpes zoster, Tdap, pneumococcal, and HPV. Factors such as vaccine recommendations provided by family physicians or specialists, site of care, income level, DM-related hospitalization history, residency site, hemoglobin A1c (HbA1c) level, and health sector type can significantly influence the vaccination rate in patients with DM. Among non-vaccinated patients with DM, the most reported barriers were lack of knowledge and fear of side effects. This signifies the need for large-scale research in this area to identify additional factors that might facilitate adherence to CDC/ACIP vaccine recommendations in patients with DM.
CONCLUSION
In Saudi Arabia, patients with DM showed higher vaccination rates for annual influenza and COVID-19 vaccines compared to other vaccinations such as herpes zoster, Tdap, pneumococcal, and HPV. Factors such as vaccine recommendations provided by family physicians or specialists, the site of care, income level, DM-related hospitalization history, residency site, HbA1c level, and health sector type can significantly influence the vaccination rate in patients with DM.
Core Tip: Given the increasing prevalence of diabetes in Saudi Arabia, this national study sheds light on vaccine practices for patients with diabetes mellitus in Saudi Arabia with regard to the Advisory Committee on Immunization Practices vaccine recommendations. The findings of this protocol will aid decision-makers in improving preventative vaccine care for patients with diabetes.
