Vaccination rates, facilitators and barriers for influenza, pneumococcal and SARS-CoV-2 vaccination among sepsis survivors: a Mid-German Sepsis Cohort survey

Abstract Sepsis survivors often suffer from chronic immune dysfunction, leading to frequent rehospitalization and recurrent sepsis. Vaccinations are effective in preventing common infections in sepsis survivors. However, vaccination behavior in this vulnerable population remains unknown. Prospective interviewer-administered survey performed between 04/2023 and 04/2024 among sepsis survivors in Germany. Participants were recruited from the Mid-German Sepsis Cohort (MSC) 6 to 8 years after initial inclusion. We assessed risk perception, cues to action and barriers for vaccination against influenza, pneumococci and SARS-CoV-2. Predictors for the vaccination status of each of the three infections were identified by logistic regression analyses. Among 174 survivors, vaccination rates against influenza and pneumococci rose from 57.3 to 70.7% and from 31.4 to 60.5% 3 months to 8 years post-sepsis, respectively. A total of 135 patients (77.6%) had full vaccination coverage against SARS-CoV-2 at the time of the survey. Higher age and an intermediate vs. low education increased the odds for influenza vaccination. No associations between sociodemographic indicators and the vaccination status against pneumococci and SARS-CoV-2 were found. Vaccination counselling by a general practitioner increased the odds for vaccination between 5.5-fold (influenza) and 3.2-fold (pneumococci) in the multiple regression analyses. The review of general vaccination status was associated with a 4.7-fold increase of influenza vaccination rates and 3.1-fold increase of SARS-CoV-2 vaccination rates. Among patients with at least one missing vaccination (n = 92), impaired mobility (16.8%), long waiting times in the practice (14.8%) and fear of infection in the practice (14.7%) were the most relevant barriers. There are considerable vaccination gaps in sepsis survivors. Pro-active vaccination counselling and checks of vaccination status by general practitioners may offer a great potential to increase vaccination rates and thus should be considered as an important element of sepsis aftercare.