Background: Specific vaccines are indicated for immunocompromised patients (ICPs) due to their vulnerability to infections. Recommendation of these vaccines by healthcare professionals (HCPs) is a crucial facilitator for vaccine uptake. Unfortunately, the responsibilities to recommend and administer these vaccines are not clearly allocated among HCPs involved in the care of adult ICPs. We aimed to evaluate HCPs’ opinions on directorship and their role in facilitating the uptake of medically indicated vaccines as a basis to improve vaccination practices. Methods: A cross-sectional survey was performed among in-hospital medical specialists (MSs), general practitioners (GPs), and public health specialists (PHSs) in the Netherlands to assess their opinion on directorship and the implementation of vaccination care. Additionally, perceived barriers, facilitators, and possible solutions to improve vaccine uptake were investigated. Results: In total, 306 HCPs completed the survey. HCPs almost unanimously (98%) reported that according to them, the primary treating physician is responsible for recommending medically indicated vaccines. Administering these vaccines was seen as a more shared responsibility. The most important barriers experienced by HCPs in recommending and administering were reimbursement problems, a lack of a national vaccination registration system, insufficient collaboration among HCPs, and logistical problems. MSs, GPs and PHSs all mentioned the same three solutions as important strategies to improve vaccination practices, i.e., reimbursement of vaccines, reliable and easily accessible registration of received vaccines, and arrangements for collaboration among the different HCPs that are involved in care. Conclusion: The improvement in vaccination practices in ICPs should focus on better collaboration among MSs, GPs, and PHSs, who should know each other’s expertise; clear agreement on responsibility; reimbursement for vaccines; and the availability of clear registration of vaccination history.

: Strongyloidiasis is a parasitic infection caused by the intestinal helminth Strongyloides stercoralis (S. stercoralis). It is prevalent in tropical and subtropical regions but increasingly diagnosed in nonendemic countries because of migration and travel. In immunocompromised patients, infection with S. stercoralis can lead to a potentially lethal hyperinfection syndrome. Consequently, several guidelines recommend screening immunocompromised patients for S. stercoralis IgG. We aimed to assess the yield of this screening in our tertiary hospital in the Netherlands, a nonendemic country. We performed a retrospective cohort study, in which we identified all immunocompromised patients and those expected to be immunocompromised who were tested for S. stercoralis IgG between January 2010 and April 2022. For these patients, we collected demographic and clinically relevant data from electronic patient files. Strongyloides stercoralis IgG test results were positive in 17/379 patients (4.5%), all of whom were born in an endemic country. Eosinophilia was present in 7/17 patients (41.2%). Over the years, the number of diagnostic tests performed for S. stercoralis IgG has increased significantly, but the number of positive test results per year has not. Focusing screening on patients who have lived in endemic regions and less on travelers will improve diagnostic yield. We recommend screening all immunocompromised patients from high-endemic countries and highly immunocompromised patients with relevant travel history. For less severely immunocompromised patients, screening should be individualized based on travel characteristics.

Background: In recent decades, the number of immunocompromised patients (ICPs) has increased significantly. ICPs have an impaired immune system, making them susceptible to complicated infections. To protect them from infections, ICPs are eligible to receive several medically indicated vaccines. To obtain insight into the uptake of these medically indicated vaccines, we determined the coverage of these vaccines in ICPs. Methods: This observational cohort study was conducted at the University Medical Centre Utrecht, the Netherlands, from September 2021 to April 2022. All adult ICPs admitted for COVID-19 were asked to complete a questionnaire on their vaccination history (pneumococcal, herpes zoster, human papillomavirus vaccination, influenza, and COVID-19 vaccines) and history of vaccine-preventable infections. In addition, patients’ vaccination history was reviewed in medical files. Results: A total of 115 patients completed the questionnaire and were included. Although all patients had an indication for pneumococcal vaccination, only 22 received it (19%). Coverage for herpes zoster was low (1%, 1/106 eligible patients). Coverage for human papillomavirus vaccination (HPV) was also low (40%, two out of five eligible patients). In contrast, 92% of patients received vaccination against SARS-CoV-2, and 77% of patients received seasonal influenza vaccination. Conclusions: Although coverage for influenza and COVID-19 vaccination was high in ICPs, coverage for other medically indicated vaccines was low. Identifying which factors contributed to high COVID-19 and influenza vaccine uptake can help to improve vaccination rates for the other recommended vaccines. Clear guidelines for clinicians and the removal of organizational obstacles are needed to improve vaccination coverage.

The number of immunocompromised patients (ICPs) is increasing, and these patients are vulnerable to infection and therefore eligible for additional vaccina