COVID-19 vaccine coverage, safety, and perceptions among patients with diabetes mellitus in China: a cross-sectional study

Haolong Li; Fan Ping; Xiaomeng Li; Zhihong Wang; Jianzhong Xiao; Hongwei Jiang; Yaoming Xue; Jinxing Quan; Hebin Yao; Xianling Zheng; Yanming Chen; Yufeng Li; Xiaohua Yu; Lingling Xu; Xinxin Feng; Siyu Wang; Yongzhe Li; Xinhua Xiao

doi:10.3389/fendo.2023.1172089

COVID-19 vaccine coverage, safety, and perceptions among patients with diabetes mellitus in China: a cross-sectional study

Front Endocrinol (Lausanne). 2023 Jun 1:14:1172089. doi: 10.3389/fendo.2023.1172089. eCollection 2023.

Authors

Haolong Li¹, Fan Ping², Xiaomeng Li^{1

3}, Zhihong Wang⁴, Jianzhong Xiao⁵, Hongwei Jiang⁶, Yaoming Xue⁷, Jinxing Quan⁸, Hebin Yao⁹, Xianling Zheng¹⁰, Yanming Chen¹¹, Yufeng Li¹², Xiaohua Yu¹³, Lingling Xu¹⁴, Xinxin Feng¹, Siyu Wang¹, Yongzhe Li¹, Xinhua Xiao²

Affiliations

¹ Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
² Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China.
³ Department of Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
⁴ Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
⁵ Department of Endocrinology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
⁶ The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
⁷ Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁸ Department of Endocrinology, Gansu Provincial People's Hospital, Lanzhou, Gansu, China.
⁹ Department of Endocrinology, Sixth Medical Center of PLA General Hospital, Beijing, China.
¹⁰ Department of Endocrinology, Handan Central Hospital, Handan, China.
¹¹ Department of Endocrinology & Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
¹² Department of Endocrinology, Capital Medical University, Beijing, China.
¹³ Department of Endocrinology, Liaoyang Central Hospital, Liaoyang, Liaoning, China.
¹⁴ Department of Endocrinology, ShenZhen Hospital, Southern Medical University, Shenzhen, Guangdong, China.

Abstract

Aims: Diabetes mellitus (DM), one of the most common chronic diseases in China, is a risk factor for SARS-COV-2 infection and poor prognosis of COVID-19. The COVID-19 vaccine is one of the key measures to control the pandemic. However, the actual coverage of COVID-19 vaccination and associated factors remain unclear among DM patients in China. We conducted this study to investigate the COVID-19 vaccine coverage, safety, and perceptions among patients with DM in China.

Methods: A cross-sectional study of a sample of 2200 DM patients from 180 tertiary hospitals in China was performed using a questionnaire developed through the Wen Juan Xing survey platform to collect information regarding their coverage, safety, and perceptions of COVID-19 vaccination. A multinomial logistic regression analysis model was performed to determine any independent relationships with COVID-19 vaccination behavior among DM patients.

Results: In total, 1929 (87.7%) DM patients have received at least one dose COVID-19 vaccine, and 271 (12.3%) DM patients were unvaccinated. In addition, 65.2% (n = 1434) were booster vaccinated against COVID-19, while 16.2% (n = 357) were only fully vaccinated and 6.3% (n = 138) were only partially vaccinated. The prevalence of adverse effects after the first dose of vaccine, the second dose of vaccine, and the third dose of vaccine were 6.0%, 6.0%, and 4.3% respectively. Multinomial logistic regression analysis showed that DM patients complicated with immune and inflammatory diseases (partially vaccinated: OR = 0.12; fully vaccinated: OR = 0.11; booster vaccinated: OR = 0.28), diabetic nephropathy (partially vaccinated: OR = 0.23; fully vaccinated: OR = 0.50; booster vaccinated: OR = 0.30), and perceptions on the safety of COVID-19 vaccine (partially vaccinated: OR = 0.44; fully vaccinated: OR = 0.48; booster vaccinated: OR = 0.45) were all associated with the three of vaccination status.

Conclusion: This study showed that higher proportion of COVID-19 vaccine coverage among patients with DM in China. The concern about the safety of the COVID-19 vaccine affected the vaccine behavior in patients with DM. The COVID-19 vaccine was relatively safe for DM patients due to all side effects were self-limiting.

Keywords: COVID-19; China; diabetes mellitus; vaccine; vaccine uptake.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19 Vaccines* / adverse effects
COVID-19* / complications
COVID-19* / epidemiology
COVID-19* / prevention & control
China / epidemiology
Cross-Sectional Studies
Diabetes Mellitus* / epidemiology
Diabetic Nephropathies*
Drug-Related Side Effects and Adverse Reactions*
Humans
SARS-CoV-2

Substances

COVID-19 Vaccines

Grants and funding

This work was supported by Beijing Natural Science Foundation (M23008), the National Key Research and Development Program of China (2018YFE0207300), Beijing Municipal Science & Technology Commission (Z211100002521021), the National High Level Hospital Clinical Research Funding (2022-PUMCH-B-124). This work is supported by Beijing Key Clinical Specialty for Laboratory Medicine - Excellent Project (No. ZK201000).