Abstract
Background: Diabetes mellitus is a prevalent chronic disease that significantly increases the risk of complications from infections such as influenza and pneumococcal disease. Despite established recommendations for vaccination, coverage rates among adults with diabetes remain suboptimal. This study aims to analyze trends in influenza and pneumococcal vaccination rates among adults with diabetes using the United States Diabetes Surveillance System (USDSS) database.
Methods: This retrospective database study utilized data from the USDSS from 2000 to 2022, which provides comprehensive nationwide data on diabetes care. The study population included adults aged 18 and above with a documented diagnosis of diabetes. Data were extracted on demographic variables (age, sex, race/ethnicity), clinical characteristics (type of diabetes, duration of diabetes, comorbid conditions), and vaccination records. Descriptive statistics summarized demographic and clinical characteristics, while temporal trends in vaccination rates were analyzed using graphical representations.
Results: Over the past two decades, influenza vaccination rates among adults with diabetes increased from 41.4% in 2000 to 56.7% in 2019, reflecting improved awareness and healthcare practices, though slightly dipping to 54.2% in 2022. In contrast, pneumococcal vaccination rates showed more variability, starting at 29.3% in 2000, peaking at 39.4% in 2018, and declining to 30.2% in 2022, indicating challenges in maintaining high coverage. Influenza vaccination rates showed an overall increasing trend across all demographic groups: rates among Hispanic individuals increased from 32.1% in 2000 to 55.4% in 2022, non-Hispanic Whites from 43.4% to 52.7%, and non-Hispanic Blacks from 39.2% to 44.5%. Pneumococcal vaccination rates also increased but displayed more variability; Hispanic rates peaked at 33.3% in 2016, non-Hispanic Whites at 45.6% in 2019, and non-Hispanic Blacks at 41.7% in 2017. Higher educational attainment was consistently associated with higher vaccination rates for both vaccines.
Conclusions: This study highlights significant improvements in influenza and pneumococcal vaccination rates among adults with diabetes over the past two decades. However, disparities remain, particularly among racial and educational groups. Targeted strategies are necessary to address these disparities and enhance vaccination coverage, ultimately reducing the risk of severe infections in this vulnerable population.