Targeting vaccine gaps across the lifespan in heart failure: age-stratified uptake of five adult vaccines in a remote monitoring programme
A Hacil, N Girerd, R Esser, N Berkane, H Benchimol, 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 several adult vaccines, yet uptake is heterogeneous and may vary by age. Remote monitoring programmes could enable age-tailored reminders. We assessed patterns in vaccine knowledge, intention, and self-reported uptake in an HF cohort.
Methods
Cross-sectional, self-administered survey among HF patients enrolled in the Satelia® Cardio remote monitoring programme in France in November 2025. Participants reported knowledge/attitudes and self-reported status for seasonal influenza and COVID-19 booster (this season), pneumococcal, DTPC booster, and herpes zoster vaccination. Outcomes were described across age groups (18–49, 50–64, 65–74, 75–84, ≥85 years).
Results
Among 1,100 respondents (mean age 71.5 years), age distribution was 18–49: 5.5%, 50–64: 22.7%, 65–74: 27.1%, 75–84: 29.3%, and ≥85: 15.5%. Knowledge of age-recommended vaccines increased from 40.0% (18–49) to ~80% from 65 years onward, and perceived usefulness rose from 78.3% to 92.9%; knowing where to get vaccinated increased from 85.0% to 98.2%. Reported access difficulties were uncommon and declined with age (5.0% to 0.0%). Self-reported influenza uptake rose with age (35.0% in 18–49 to 71.8% in ≥85). Seasonal COVID-19 booster uptake showed a steeper gradient (8.3% to 42.4%). Pneumococcal vaccination peaked in 65–74 years (43.3%) compared with 20.0% in 18–49 and 28.8% in ≥85. DTPC uptake was higher in younger groups and declined after 75 years (43.3% in 18–49 vs ~35% in ≥75). Herpes zoster vaccination remained low overall, <5% below 65 years and ~14–15% from 65 years onward. Interest in programme reminders decreased in the oldest group (61.7% in 18–49 vs 47.6% in ≥85).
Conclusions
Vaccination uptake in remotely monitored HF patients displayed distinct age-patterns: strong gradients for influenza and seasonal COVID-19 booster, a mid-older peak for pneumococcal vaccination, and persistently low herpes zoster uptake. Remote monitoring programmes may support age-tailored strategies—prioritizing younger HF patients for influenza/COVID prompts, mid-older groups for pneumococcal catch-up, and older adults for DTPC/zoster gap reduction—while addressing engagement barriers in the oldest patients.