Coverage of Recommended Vaccination Among Adult Patients With Asthma in Riyadh, Saudi Arabia

Abstract

Introduction Asthma prevalence among Saudi adults aged 20-44 years in Riyadh is high, with 11.3% reporting physician-diagnosed asthma, exceeding rates in most countries using similar methods. In Aseer province, one out of five adults is estimated to have asthma. Patients with asthma are at higher risk of morbidity and mortality from influenza, pneumococcal, and COVID-19 infections. In Saudi Arabia, the recommended vaccinations for patients with asthma include annual influenza, pneumococcal, and COVID-19 vaccination. Our aim in this study is to estimate the coverage rate of influenza, pneumococcal, and COVID-19 vaccines in patients with asthma who follow up in Riyadh's second health cluster's primary care centers. Methods This cross-sectional descriptive study design assessed the coverage rate of recommended vaccinations among patients with asthma. We adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines when reporting the results. Data on patients with asthma was collected from the electronic health records of patients with asthma in Raqeem, a national governmental primary care center electronic health record. Vaccination data were collected from national vaccination records in Seha. Prescribed medications were collected from Wasfaty, a platform for primary care prescriptions. Results Overall, 2,689 records of patients with asthma were collected, with 1,441 (53.59%) being males. The median age was 37 years (IQR = 20). Of the patients, 2,273 (84.53%) were Saudi, and 502 (18.67%) received the 2023-2024 influenza vaccine. Only seven (0.26%) patients received the pneumococcal vaccine, while 2,502 (93.05%) patients received any of the COVID-19 vaccines. Patients vaccinated for influenza were significantly older than unvaccinated patients (p < 0.05). Patients prescribed high-dose corticosteroids in the six months prior to the start of the season were significantly more likely to be vaccinated than patients without prescription (p < 0.05). Conclusion This study underscores systemic barriers to achieving optimal immunization rates and highlights significant gaps in understanding among patients and healthcare providers. These findings emphasize the need for targeted public health measures, including improved documentation, enhanced education, and stronger recommendations from healthcare professionals during routine asthma management visits. Coordinated efforts by healthcare institutions, such as integrating reminders into electronic health systems, public health initiatives, and further research on vaccination challenges, are vital to increasing vaccination rates in this vulnerable population.

Keywords: asthma; high dose corticosteroids; influenza coverage; influenza vaccine; pneumococcal vaccine; seasonal influenza vaccine; vaccination.

Figure 1. Age distribution by vaccination status.