{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:04:40Z","timestamp":1786122280932,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020166","name":"Flu Lab","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate influenza vaccination coverage (IVC) and persistence with annual influenza vaccination among individuals with type 1 diabetes in Denmark and to identify clinical, demographic, and socioeconomic factors associated with vaccination status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide, register\u2010based cohort study of individuals aged 1\u201364\u2009years with type 1 diabetes across the influenza seasons 2015\u20132022 in Denmark. Annual influenza vaccination status was assessed, and the cohort was stratified into age groups (1\u201318 and 19\u201364\u2009years) according to age\u2010specific vaccine recommendations. We investigated associations between non\u2010vaccination\/non\u2010persistence and demographic, clinical, and socioeconomic factors using Poisson regression to compute adjusted relative risk (aRR). Persistence was defined as receipt of influenza vaccination in more than 80% of eligible seasons during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 25\u2009473 individuals with type 1 diabetes corresponding to 168\u2009212 influenza seasons. In 2015\/16, IVC was 5.6% in children and 18.3% in adults. IVC remained stable until a marked increase in 2021\/22 (15.7% and 41.8%, respectively). In children, longer diabetes duration, HbA1c \u2265\u200953\u2009mmol\/mol, and residence in The North Denmark Region were associated with non\u2010vaccination. In adults, male sex, younger age, shorter educational attainment, and HbA1c \u2265\u200953\u2009mmol\/mol were associated with non\u2010vaccination. In both populations, factors associated with non\u2010persistence were similar to those observed with non\u2010vaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Denmark, IVC among individuals with type 1 diabetes remains well below WHO targets, highlighting the need for targeted vaccination strategies. Sociodemographic and clinical factors associated with non\u2010vaccination identify population groups where preventive efforts should be prioritised.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70965","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:49:17Z","timestamp":1781495357000},"page":"7923-7930","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influenza Vaccination Among Individuals With Type 1 Diabetes in Denmark: Coverage, Persistence, and Determinants, 2015\u20132022"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8192-1669","authenticated-orcid":false,"given":"Vithiya","family":"Karunakaran","sequence":"first","affiliation":[{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1158-4220","authenticated-orcid":false,"given":"Ida Borreby","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3114-4176","authenticated-orcid":false,"given":"Astrid","family":"Hjelholt","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Endocrinology and Internal Medicine Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Pharmacology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1043-6137","authenticated-orcid":false,"given":"Mads","family":"Kj\u00f8lby","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"},{"name":"Department of Clinical Pharmacology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Biomedicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4263-1815","authenticated-orcid":false,"given":"Esben Thyssen","family":"Vestergaard","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Paediatrics and Adolescents Medicine Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5846-345X","authenticated-orcid":false,"given":"Ole","family":"Fr\u00f8bert","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Cardiology \u00d6rebro University Hospital  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8457-5466","authenticated-orcid":false,"given":"Anders Aasted","family":"Isaksen","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3912-8234","authenticated-orcid":false,"given":"Kurt","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Aarhus  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Paediatrics and Adolescents Medicine Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0144-2024"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7434a1"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00703"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2007.07.003"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2023.03.016"},{"key":"e_1_2_9_7_1","unstructured":"Danish Health Authorities \u201cSundhedsfagligt Notat Vedr. Anbefaling af Vaccination af Personer Under 65 \u00c5r I S\u00e6rlig Risiko for Et\u00a0Alvorligt Forl\u00f8b Med Influenza Eller\/og Covid\u201019 \u201d(2023) (in English: Medical memorandum on the recommendation of vaccination of persons under 65\u2009years at particular risk of severe influenza and\/or COVID\u201019) Case no. 05\u20100600\u20102119 sst.dk."},{"key":"e_1_2_9_8_1","volume-title":"Influenza: Prevention, Diagnosis, and Treatment","author":"Hartling U.","year":"2021"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","unstructured":"Danish Endocrine Society \u201cType 1 Diabetes \u201d(2013) endocrinology.dk.","DOI":"10.1016\/S2213-8587(13)70096-2"},{"key":"e_1_2_9_10_1","unstructured":"World Health Organization \u201cPrevention and Control of Influenza Pandemics and Annual Epidemics \u201d(2003) WHA56.19."},{"key":"e_1_2_9_11_1","unstructured":"European Centre for Disease Prevention and Control \u201cSurvey Report on National Seasonal Influenza Vaccination Recommendations and Coverage Rates in EU\/EEA Countries \u201d(2024) ecdc.europa.eu."},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0323184"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2019.09.004"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S179083"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S407019"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-014-9930-3"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S245060"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S91125"},{"key":"e_1_2_9_19_1","unstructured":"Statistics Denmark \u201cDocumentation of Statistics for Highest Education Attained 2024 \u201d(2024)."},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811408483"},{"key":"e_1_2_9_21_1","unstructured":"Danish Health Authority \u201cPeople Aged 65\u2009Years and Older Are Offered Vaccination Against Influenza and Covid\u201019 2024 \u201dhttps:\/\/www.sst.dk\/en\/english\/Vaccination\u2010against\u2010influenza\u2010and\u2010covid\u201019\/65\u2010years."},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu680"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anpede.2022.07.006"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2021.1973882"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2010.07.013"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-084165"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2006.09.001"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0140197"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1360556"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2703-4"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7339a1"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.70965","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dom.70965","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.70965","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T08:50:07Z","timestamp":1786092607000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/10.1111\/dom.70965"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,14]]},"references-count":30,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/dom.70965"],"URL":"https:\/\/doi.org\/10.1111\/dom.70965","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/DOM.70965\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70965\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70965\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70965\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70965\/v1\/review1","asserted-by":"object"}]},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,14]]},"assertion":[{"value":"2026-03-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}