Patterns of pneumococcal vaccination and revaccination in elderly and non-elderly adults: a Vaccine Safety Datalink study

Lisa A Jackson,Roger Baxter,Allison L Naleway,James Baggs,Edward A Belongia

doi:10.1186/1471-2334-9-37

Abstract

BackgroundPneumococcal polysaccharide vaccine (PPV) is recommended for all adults 65 years of age and older and for younger adults with high-risk conditions. While data from national surveys provide information on the proportion of adults 65 years of age and older reporting ever receipt of PPV they do not collect more detailed information, such as age at vaccination or the total number of vaccinations received. In addition, there is relatively little information available on PPV coverage in younger adults with chronic conditions. To assess contemporary patterns of pneumococcal vaccination and revaccination of adults, we conducted a cross-sectional study of adults enrolled in medical care organizations (MCOs) participating in the Vaccine Safety Datalink project.MethodsThe study population included 1.5 million adults 25 years of age and older enrolled in the four participating MCOs on December 1, 2006. PPVs administered to members of the study population prior to that date were identified from computerized immunization registries maintained by the MCOs.ResultsAmong the general population of adults 25 through 64 years of age, vaccine coverage increased from 2% in the 25–29 year old age-group to 26% in the 60–64 year old age-group. In all age-groups, coverage was substantially higher in persons defined as having a chronic high risk condition. This was particularly true for diabetes mellitus, with vaccine coverage of over 50% in the lower age-groups and 75% in those 60–64 years of age. Among adults 65 years of age and older, 82% had received at least one PPV and 18% had received two or more PPVs.ConclusionWe found higher levels of PPV coverage among adults 65 years of age and older and among younger adults with diabetes mellitus than reported by national surveys and for those groups PPV coverage approached the Healthy People 2010 national objectives. These results suggest that achieving those objectives for PPV is possible and that high vaccination coverage may be facilitated by vaccine tracking and reminder systems.

Highlights

Pneumococcal polysaccharide vaccine (PPV) is recommended for all adults 65 years of age and older and for younger adults with high-risk conditions
National surveys such as the Behavioral Risk Factor Surveillance System (BRFSS) survey indicate that pneumococcal vaccine coverage in adults t65 years has greatly increased over the past two decades, with 66% of adults t65 years interviewed in the 2005 BRFSS survey reporting past receipt of PPV [2]
Adults 25 through 64 years of age Among the general population of adults 25 through 64 years of age, vaccine coverage increased from 2% in the 25–29 year old age-group to 26% in the 60–64 year old age-group (Table 1)

Summary

Introduction

Pneumococcal polysaccharide vaccine (PPV) is recommended for all adults 65 years of age and older and for younger adults with high-risk conditions. While data from national surveys provide information on the proportion of adults 65 years of age and older reporting ever receipt of PPV they do not collect more detailed information, such as age at vaccination or the total number of vaccinations received. Once vaccinated after the age of 65, no additional doses of PPV are recommended, and revaccination is not recommended for immunocompetent persons under age 65 National surveys such as the Behavioral Risk Factor Surveillance System (BRFSS) survey indicate that pneumococcal vaccine coverage in adults t65 years has greatly increased over the past two decades, with 66% of adults t65 years interviewed in the 2005 BRFSS survey reporting past receipt of PPV [2]. There is relatively little information available on PPV coverage in younger adults with chronic conditions

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Results

Discussion

Conclusion