SAT-539 - Adult Vaccination Coverage and Determinants of Vaccine Uptake Among Filipino Adults with Diabetes Mellitus

Background:
Adults with diabetes mellitus (DM) are at increased risk for vaccine-preventable infections, and routine adult immunization is strongly recommended. Vaccination uptake among patients with DM remains suboptimal, particularly in low- and middle-income countries such as the Philippines. In these settings, local data on vaccination coverage and its determinants are scarce, underscoring the need for further investigation.

Objectives:
To determine adult vaccination coverage and identify clinical and sociodemographic factors associated with vaccine uptake among Filipino adults with diabetes mellitus.

Methods:
This prospective cross-sectional study assessed vaccination coverage for influenza, pneumococcal, shingles, hepatitis B, COVID-19, and tetanus–diphtheria–pertussis (Td/Tdap) vaccines among adult Filipino patients with diabetes mellitus (n = 284) seen in outpatient, inpatient, and medical mission settings at a tertiary hospital. Multivariable logistic regression models were used to evaluate associations between vaccine uptake and clinical and sociodemographic factors, adjusting for age, sex, income, education, glycemic control, comorbidity burden, duration of diabetes, medication adherence, and regular physician visits.

Results:
Participants had a mean age of 61.5 ± 12.7 years and 55.6% were female. Vaccination coverage varied by vaccine type: influenza 44.4%, pneumococcal 49.6%, shingles 14.4%, hepatitis B 15.5%, Td/Tdap 23.2%, and COVID-19 97.9%. Higher household income was independently associated with influenza vaccination, while pneumococcal vaccination was more likely among older adults and women. Shingles vaccination was strongly associated with higher income, whereas hepatitis B vaccination was less common among older participants. No clinical or sociodemographic factor was independently associated with Td/Tdap vaccination. COVID-19 vaccination was near-universal, limiting further inferential analysis. Across vaccines, lack of provider advice or awareness was the most frequently reported reason for non-vaccination.

Conclusion:
Adult vaccination coverage among Filipino patients with diabetes mellitus is lower than rates reported globally, except for COVID-19 vaccination. Adherence to adult vaccination recommendations is influenced by age and household income, with lack of healthcare provider recommendation identified as the predominant barrier. These findings underscore the need to strengthen routine vaccine counseling and more consistently integrate adult immunization into diabetes care. This research provides evidence that may be used by stakeholders to strengthen and tailor adult vaccination strategies for Filipino patients with diabetes.

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