Time trends (2012-2020) and sex differences for influenza vaccination uptake among individuals with chronic obstructive pulmonary disease in Spain.

Objective: We aim to assess trends in the influenza vaccination rate among COPD patients, identify which groups have higher rates, and analyze differences by sex. Methods: Cross-sectional study based on data from the European Health Survey for Spain carried out in the years 2020 and 2014 and from the Spanish National Health Interview Survey for the years 2017 and 2012. The study population comprised all persons aged ≥40 years. Results: 65,447 participants interviewed in the four surveys analyzed. COPD prevalence 5.9% (n=3855). IV uptake among COPD patients was 57.8% versus 28.6% for those without COPD (p <0.001). Men with COPD reported higher uptake in all the surveys studied. The uptake did not show a significant variation overtime for neither man nor woman with COPD. By age groups, among COPD subjects, uptake reached the highest value in 2020 (70.9%) for those aged ≥65 years, with a slight, but not significant, improvement from year 2012 (67.1%). However, among those aged 40 to 64 years the uptake was 33.3% in 2020 with a significant reduction from 2012 (39.4%; p=0.039). Multivariable logistic showed no significant changed in uptake overtime among participants with COPD. Men were vaccinated more frequently than women (OR 1.28; 95%, CI 1.12-1.47) and the probability of receiving the vaccine rose with age. Conclusions: In COPD patients, influenza vaccination uptake is below desirable levels and has not improved from 2012 to 2020. Current result suggests a worsening of uptake among younger COPD individuals. Sex differences are found, with consistent and constant lower uptake among women with COPD.