Sociodemographic, health and behavioral factors associated with influenza vaccination uptake among patients with diabetes in Singapore: A cohort registry-based study

Objective: With the low uptake of influenza vaccination among patients with diabetes mellitus in many countries, this study aims to investigate how sociodemographic, health and behavioral factors collectively predict vaccination uptake among patients in Singapore. Methods: A retrospective study was...

Full description

Saved in:
Bibliographic Details
Main Authors: Siang Joo Seah, Gek Hsiang Lim, Sungwon Yoon, Yong Mong Bee
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Preventive Medicine Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2211335525001755
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849318201106628608
author Siang Joo Seah
Gek Hsiang Lim
Sungwon Yoon
Yong Mong Bee
author_facet Siang Joo Seah
Gek Hsiang Lim
Sungwon Yoon
Yong Mong Bee
author_sort Siang Joo Seah
collection DOAJ
description Objective: With the low uptake of influenza vaccination among patients with diabetes mellitus in many countries, this study aims to investigate how sociodemographic, health and behavioral factors collectively predict vaccination uptake among patients in Singapore. Methods: A retrospective study was conducted using the SingHealth Diabetes Registry. Patients aged 21 and above with diabetes mellitus from 2013 onwards were selected. Data on demographic and clinical characteristics, attendance at eye and foot screenings, smoking status, and influenza vaccination records from 2013 to 2020 were analyzed with the Prentice, William and Peterson Gap Time model and binomial logistic regression. Results: A total of 184,882 patients, contributing 1,106,085 influenza vaccination records from 2013 to 2020 were analyzed. Age, ethnicity, housing type, duration of diabetes, and attendance at eye or foot screenings were associated with receiving at least one vaccination and with regular annual vaccinations over an eight-year period. Compared to patients without complications screening, those who underwent eye and foot screenings were 1.19 times (95 % CI 1.16, 1.22) and 1.20 times (95 % CI 1.18, 1.23) more likely, respectively, to have received at least one vaccination. They were also 1.41 times (95 % CI 1.20, 1.66) and 1.45 times (95 % CI 1.23, 1.70) more likely, respectively, to have received regular vaccination. Conclusions: Attendance at eye and foot screenings among patients with diabetes mellitus was associated with higher influenza vaccination uptake, both at least once and annually. Bundling influenza vaccination with eye and foot screenings may improve vaccination uptake at the population level.
format Article
id doaj-art-ca357de147ff40249f2846d4378e3956
institution Kabale University
issn 2211-3355
language English
publishDate 2025-08-01
publisher Elsevier
record_format Article
series Preventive Medicine Reports
spelling doaj-art-ca357de147ff40249f2846d4378e39562025-08-20T03:50:58ZengElsevierPreventive Medicine Reports2211-33552025-08-015610313610.1016/j.pmedr.2025.103136Sociodemographic, health and behavioral factors associated with influenza vaccination uptake among patients with diabetes in Singapore: A cohort registry-based studySiang Joo Seah0Gek Hsiang Lim1Sungwon Yoon2Yong Mong Bee3Centre for Population Health Research and Implementation, Regional Health System, Singapore Health Services Pte Ltd, Address: 167 Jalan Bukit Merah #22-10 Tower 5 Connection One, Singapore 150167, SingaporeHealth Services Research Unit, Singapore General Hospital, Outram Road, Singapore 169608, SingaporeCentre for Population Health Research and Implementation, Regional Health System, Singapore Health Services Pte Ltd, Address: 167 Jalan Bukit Merah #22-10 Tower 5 Connection One, Singapore 150167, Singapore; Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore 169857, SingaporeDepartment of Endocrinology, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore 169856, Singapore; Corresponding author.Objective: With the low uptake of influenza vaccination among patients with diabetes mellitus in many countries, this study aims to investigate how sociodemographic, health and behavioral factors collectively predict vaccination uptake among patients in Singapore. Methods: A retrospective study was conducted using the SingHealth Diabetes Registry. Patients aged 21 and above with diabetes mellitus from 2013 onwards were selected. Data on demographic and clinical characteristics, attendance at eye and foot screenings, smoking status, and influenza vaccination records from 2013 to 2020 were analyzed with the Prentice, William and Peterson Gap Time model and binomial logistic regression. Results: A total of 184,882 patients, contributing 1,106,085 influenza vaccination records from 2013 to 2020 were analyzed. Age, ethnicity, housing type, duration of diabetes, and attendance at eye or foot screenings were associated with receiving at least one vaccination and with regular annual vaccinations over an eight-year period. Compared to patients without complications screening, those who underwent eye and foot screenings were 1.19 times (95 % CI 1.16, 1.22) and 1.20 times (95 % CI 1.18, 1.23) more likely, respectively, to have received at least one vaccination. They were also 1.41 times (95 % CI 1.20, 1.66) and 1.45 times (95 % CI 1.23, 1.70) more likely, respectively, to have received regular vaccination. Conclusions: Attendance at eye and foot screenings among patients with diabetes mellitus was associated with higher influenza vaccination uptake, both at least once and annually. Bundling influenza vaccination with eye and foot screenings may improve vaccination uptake at the population level.http://www.sciencedirect.com/science/article/pii/S2211335525001755Influenza vaccinationType 1 diabetes mellitusType 2 diabetes mellitusSocioeconomic determinantPreventive health behaviorClinical characteristic
spellingShingle Siang Joo Seah
Gek Hsiang Lim
Sungwon Yoon
Yong Mong Bee
Sociodemographic, health and behavioral factors associated with influenza vaccination uptake among patients with diabetes in Singapore: A cohort registry-based study
Preventive Medicine Reports
Influenza vaccination
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Socioeconomic determinant
Preventive health behavior
Clinical characteristic
title Sociodemographic, health and behavioral factors associated with influenza vaccination uptake among patients with diabetes in Singapore: A cohort registry-based study
title_full Sociodemographic, health and behavioral factors associated with influenza vaccination uptake among patients with diabetes in Singapore: A cohort registry-based study
title_fullStr Sociodemographic, health and behavioral factors associated with influenza vaccination uptake among patients with diabetes in Singapore: A cohort registry-based study
title_full_unstemmed Sociodemographic, health and behavioral factors associated with influenza vaccination uptake among patients with diabetes in Singapore: A cohort registry-based study
title_short Sociodemographic, health and behavioral factors associated with influenza vaccination uptake among patients with diabetes in Singapore: A cohort registry-based study
title_sort sociodemographic health and behavioral factors associated with influenza vaccination uptake among patients with diabetes in singapore a cohort registry based study
topic Influenza vaccination
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Socioeconomic determinant
Preventive health behavior
Clinical characteristic
url http://www.sciencedirect.com/science/article/pii/S2211335525001755
work_keys_str_mv AT siangjooseah sociodemographichealthandbehavioralfactorsassociatedwithinfluenzavaccinationuptakeamongpatientswithdiabetesinsingaporeacohortregistrybasedstudy
AT gekhsianglim sociodemographichealthandbehavioralfactorsassociatedwithinfluenzavaccinationuptakeamongpatientswithdiabetesinsingaporeacohortregistrybasedstudy
AT sungwonyoon sociodemographichealthandbehavioralfactorsassociatedwithinfluenzavaccinationuptakeamongpatientswithdiabetesinsingaporeacohortregistrybasedstudy
AT yongmongbee sociodemographichealthandbehavioralfactorsassociatedwithinfluenzavaccinationuptakeamongpatientswithdiabetesinsingaporeacohortregistrybasedstudy