{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:38:50Z","timestamp":1785411530315,"version":"3.56.0"},"reference-count":70,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004901","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de Minas Gerais","doi-asserted-by":"publisher","award":["APQ-03316-23"],"award-info":[{"award-number":["APQ-03316-23"]}],"id":[{"id":"10.13039\/501100004901","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004901","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de Minas Gerais","doi-asserted-by":"publisher","award":["PPE-00020-25"],"award-info":[{"award-number":["PPE-00020-25"]}],"id":[{"id":"10.13039\/501100004901","id-type":"DOI","asserted-by":"publisher"}]},{"award":["APQ-03316-23"],"award-info":[{"award-number":["APQ-03316-23"]}],"id":[{"id":"https:\/\/ror.org\/00nc55f03","id-type":"ROR","asserted-by":"publisher"}]},{"award":["PPE-00020-25"],"award-info":[{"award-number":["PPE-00020-25"]}],"id":[{"id":"https:\/\/ror.org\/00nc55f03","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"https:\/\/ror.org\/00x0ma614","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: People with diabetes are more susceptible to viral respiratory infections and worse clinical outcomes related to COVID-19 and influenza. Vaccination is considered an important prevention strategy. This study aimed to analyze the vaccination status against COVID-19 and influenza among people with diabetes mellitus and associated factors. Methods: An analytical cross-sectional study was conducted between May 2024 and May 2025 in 42 Primary Health Care Units in a municipality in Minas Gerais, Brazil. A total of 316 individuals with type 1 or type 2 diabetes mellitus participated in the study. Data were collected using a structured instrument containing socioeconomic, cultural, behavioral, and clinical variables, in addition to verification of vaccination records through physical vaccination cards and information systems. Descriptive analyses and logistic regression models were performed to estimate crude and adjusted odds ratios, with respective 95% confidence intervals. Analyses were performed using Statistical Package for the Social Sciences and Stata. Results: Adherence to COVID-19 vaccination was 21.5%, whereas influenza vaccination adherence reached 85.4%. In the multivariable analysis of COVID-19 vaccination status, previous influenza vaccination (OR = 7.74; 95% CI: 1.81\u201333.2) and alcohol consumption (OR = 2.11; 95% CI: 1.13\u20133.89) were positively associated with vaccination. Conversely, access to social media or other communication channels (OR = 0.47; 95% CI: 0.24\u20130.92) and insulin use (OR = 0.42; 95% CI: 0.21\u20130.84) were associated with lower odds of COVID-19 vaccination. Regarding influenza vaccination, positive associations were identified for religious affiliation (OR = 6.46; 95% CI: 1.79\u201323.30), previous COVID-19 vaccination (OR = 10.2; 95% CI: 2.22\u201347.06), and longer duration of diabetes diagnosis (OR = 3.47; 95% CI: 1.32\u20139.20). In contrast, alcohol consumption (OR = 0.42; 95% CI: 0.21\u20130.86), insulin use (OR = 0.35; 95% CI: 0.16\u20130.76), and absence of medical follow-up (OR = 0.34; 95% CI: 0.13\u20130.85) were associated with lower odds of influenza vaccination. Conclusions: The findings revealed a heterogeneous vaccination pattern among individuals with diabetes mellitus, in which higher influenza vaccination coverage contrasted with low adherence to COVID-19 vaccination, reflecting not only differences in the historical consolidation of immunization strategies but also contemporary dynamics related to risk perception, trust, and information circulation. The strong association with previous vaccination history suggests that vaccine adherence is part of a continuum of preventive behaviors mediated by the relationship with healthcare services and by the internalization of healthcare practices over time.<\/jats:p>","DOI":"10.3390\/vaccines14070576","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:55:11Z","timestamp":1782780911000},"page":"576","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Determinants of COVID-19 and Influenza Vaccination Among People with Diabetes Mellitus in Primary Health Care"],"prefix":"10.3390","volume":"14","author":[{"given":"Mariana Rodrigues Fernandes Alves","family":"Lemos","sequence":"first","affiliation":[{"name":"Department of Nursing in Collective Health, School of Nursing, University of S\u00e3o Paulo, S\u00e3o Paulo 01308-000, Brazil"},{"name":"Research Group on Infectious Disease Epidemiology with an Emphasis on Vaccination Research (EpiVac), University of S\u00e3o Paulo, S\u00e3o Paulo 01308-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stela de Azevedo","family":"Camtamos","sequence":"additional","affiliation":[{"name":"Unit Divin\u00f3polis, State University of Minas Gerais, Divin\u00f3polis 35501-170, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Eduarda Perp\u00e9tuo","family":"Vilano","sequence":"additional","affiliation":[{"name":"Unit Divin\u00f3polis, State University of Minas Gerais, Divin\u00f3polis 35501-170, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silmara Nunes","family":"Andrade","sequence":"additional","affiliation":[{"name":"Undergraduate Nursing Program, Federal University of S\u00e3o Jo\u00e3o del-Rei, Divin\u00f3polis 35501-296, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2650-451X","authenticated-orcid":false,"given":"Michael Jackson Oliveira de","family":"Andrade","sequence":"additional","affiliation":[{"name":"Unit Divin\u00f3polis, State University of Minas Gerais, Divin\u00f3polis 35501-170, Brazil"},{"name":"Multiuser Center for Chronic Non-Communicable Diseases of the Midwest Region of Minas Gerais (CMDCNTs COMG), State University of Minas Gerais, Divin\u00f3polis 35501-170, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3330-8007","authenticated-orcid":false,"given":"Camila Fernanda Cunha","family":"Brand\u00e3o","sequence":"additional","affiliation":[{"name":"Unit Divin\u00f3polis, State University of Minas Gerais, Divin\u00f3polis 35501-170, Brazil"},{"name":"Multiuser Center for Chronic Non-Communicable Diseases of the Midwest Region of Minas Gerais (CMDCNTs COMG), State University of Minas Gerais, Divin\u00f3polis 35501-170, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Paula Sayuri","family":"Sato","sequence":"additional","affiliation":[{"name":"Research Group on Infectious Disease Epidemiology with an Emphasis on Vaccination Research (EpiVac), University of S\u00e3o Paulo, S\u00e3o Paulo 01308-000, Brazil"},{"name":"Department of Epidemiology, School of Public Health, University of S\u00e3o Paulo, S\u00e3o Paulo 01246-904, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9236-8643","authenticated-orcid":false,"given":"Eliete Albano de Azevedo","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Undergraduate Nursing Program, Federal University of S\u00e3o Jo\u00e3o del-Rei, Divin\u00f3polis 35501-296, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2606-9754","authenticated-orcid":false,"given":"Val\u00e9ria Concei\u00e7\u00e3o de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Undergraduate Nursing Program, Federal University of S\u00e3o Jo\u00e3o del-Rei, Divin\u00f3polis 35501-296, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9629-2815","authenticated-orcid":false,"given":"Gabriela Gon\u00e7alves","family":"Amaral","sequence":"additional","affiliation":[{"name":"Department of Nursing in Collective Health, School of Nursing, University of S\u00e3o Paulo, S\u00e3o Paulo 01308-000, Brazil"},{"name":"Research Group on Infectious Disease Epidemiology with an Emphasis on Vaccination Research (EpiVac), University of S\u00e3o Paulo, S\u00e3o Paulo 01308-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"ref_1","first-page":"3991","article-title":"Prevalence of Chronic Diseases and Access to Health Services in Brazil: Evidence of Three Household Surveys","volume":"26","author":"Meira","year":"2021","journal-title":"Cienc. 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