Adults with diabetes mellitus face increased risk of infections that are preventable by vaccination and are at greater risk of complications from those infections. Despite existing recommendations for adult immunization, vaccine uptake in many low- and middle-income countries remains suboptimal. Data on immunization coverage specifically among Filipino adults with diabetes have been limited, motivating the present study to quantify coverage and identify factors associated with vaccination.
This was a cross-sectional study conducted at a tertiary hospital in the Philippines. The study recruited 284 adults with diabetes from inpatient, outpatient, and community outreach settings. Participant characteristics reported in the abstract included a mean age of 61.5 years (±12.7) and 55.6% female. Analyses included crude associations and parsimonious multivariable logistic regression models for vaccine outcomes; COVID-19 vaccination was not modeled because only six participants were unvaccinated.
The investigators evaluated uptake for a set of recommended adult vaccines using prespecified operational definitions. Vaccines assessed were influenza, pneumococcal, herpes zoster, hepatitis B, tetanus-diphtheria-pertussis (Td/Tdap), and the primary COVID-19 vaccine series. The abstract does not provide the detailed operational criteria for each vaccine (for example, timing, number of doses, or specific vaccine formulations), so those details were not reported in the source abstract.
Among the 284 participants, reported vaccination coverage proportions were:
These results indicate high uptake of the COVID-19 primary series but substantially lower and variable coverage for other vaccines recommended for adults with diabetes.
The study examined sociodemographic and clinical factors associated with vaccine uptake using multivariable models when appropriate. Key associations reported in the abstract include:
The abstract notes that COVID-19 vaccination was not modeled due to very high coverage (only six participants were unvaccinated), so determinants of COVID-19 uptake were not assessed in multivariable analyses.
Commonly reported reasons for not receiving recommended vaccines included lack of provider recommendation, failure to prioritize vaccination, and financial constraints. These reasons suggest both provider- and system-level barriers, as well as patient-level prioritization and affordability issues, contributed to gaps in coverage.
Based on the observed uneven and generally low uptake of most recommended adult vaccines (with the notable exception of the COVID-19 primary series), the authors conclude that integrating routine vaccine assessment and counseling into diabetes care could help identify missed opportunities. Addressing financial and access barriers was highlighted as a necessary component to improve vaccine uptake among Filipino adults with diabetes. The findings point toward the potential role of healthcare providers in recommending vaccines and the influence of socioeconomic factors on vaccine access.
The abstract does not provide a detailed limitations section; specific limitations such as potential selection bias from recruiting at a single tertiary hospital, representativeness of the sample for the broader Filipino diabetes population, recall bias in vaccination reporting, or the exact operational definitions used for each vaccine were not reported in the abstract. Similarly, the abstract does not report model fit statistics, effect sizes (adjusted odds ratios and confidence intervals), or the precise questions used to elicit reasons for non-vaccination. Those details would need to be consulted in the full text for comprehensive appraisal.
In this cross-sectional sample of 284 Filipino adults with diabetes, uptake of recommended adult vaccines was variable: high for the COVID-19 primary series but low to moderate for influenza, pneumococcal, herpes zoster, hepatitis B, and Td/Tdap. Provider recommendation and higher household income were consistently associated with higher vaccine uptake. The authors recommend integrating vaccination assessment and counseling into diabetes care and addressing financial and access barriers to improve coverage.