Higher pneumococcal vaccine uptake in women than men with heart failure: age-adjusted findings from a telemonitoring survey
R Esser, N Girerd, H Hacil, H Benchimol, N Berkane, A Jagu, F Picard, M Ionescu, J Bellony, W Ben Ghezala, N Pages, S Nisse-Durgeat, O HanonAbstract
Background
Heart failure (HF) patients are prioritized for adult vaccines, yet coverage remains suboptimal. Sex-related differences in preventive care pathways may contribute to gaps, and remote monitoring programmes could support targeted reminders. Understanding sex patterns may inform implementation strategies.
Methods
In November 2025, we performed a cross-sectional, self-administered survey among HF patients enrolled in the Satelia® Cardio remote monitoring programme in France. Participants reported vaccination knowledge and attitudes and self-reported status for five vaccines: seasonal influenza (this season), seasonal COVID-19 booster (this season), pneumococcal, diphtheria–tetanus–polio–pertussis booster (DTPC), and herpes zoster. We compared women and men using chi-square tests and estimated age-adjusted odds ratios (aOR) from logistic regression models.
Results
Among 1,100 respondents (mean age 71.5 years), 379 were women (34.5%) and 718 men (65.3%) (sex not specified: 3). Vaccination was considered useful by 88.4% of women and 87.2% of men, and 96.0% of women and 96.0% of men reported knowing where to get vaccinated. Willingness to receive reminders from Satelia or the care team was similar (54.1% in women vs 55.8% in men). If vaccination was recommended by their physician, 78.1% of women and 81.3% of men reported they would get vaccinated (unsure: 17.7% vs 14.1%; no: 4.2% vs 4.6%). Self-reported influenza coverage was similar by sex (62.0% women vs 62.3% men). Pneumococcal vaccination was higher in women (42.2% vs 30.4%; p<0.001), remaining significant after age adjustment (aOR 1.67, p<0.001). DTPC coverage did not differ (40.1% vs 37.6%). Women tended to report higher herpes zoster vaccination (14.0% vs 10.2%; aOR 1.42, p=0.073) and lower seasonal COVID-19 booster uptake (28.5% vs 32.9%; aOR 0.79, p=0.093). Vaccination pathways differed modestly: men more frequently reported pharmacy vaccination for influenza and COVID-19, whereas women more often reported general practitioner vaccination (both p<0.05).
Conclusions
In remotely monitored HF patients, pneumococcal vaccination uptake was substantially higher in women than men, while influenza uptake was similar. Sex differences in vaccination pathways suggest that remote monitoring-enabled reminders and coordination with both community pharmacies and primary care could be tailored to close remaining gaps locally.