Abstract
BackgroundRecent published data on pneumococcal vaccination coverages among adults are scarce.AimTo update on pneumococcal vaccination uptakes among middle-aged and older adults in Catalonia.MethodsWe conducted a population-based retrospective observational study including 2,057,656 individuals ≥ 50 years old assigned to primary care centres managed by the Catalonian Health Institute on 1 January 2017 (date of data collection). An institutional clinical research database (SIDIAP) was used to classify persons by vaccination status for both 23-valent pneumococcal polysaccharide (PPsV23) and 13-valent pneumococcal conjugate (PCV13) vaccines, as well as to identify underlying risk conditions.ResultsOverall, 796,879 individuals (38.7%) had received PPsV23 and 13,607 (0.7%) PCV13. PPsV23 coverage increased with age: 9.2% (95,409/1,039,872) in 50–64 year olds, 63.1% (434,408/688,786) in 65–79 year olds and 81.2% (267,062/328,998) in ≥ 80 year olds (p < 0.001). PCV13 coverage also increased with age, although percentages were smaller in all age strata (4,250/1,039,872: 0.4%; 6,005/688,786: 0.9% and 3,352/328,998: 1.0%, respectively; p < 0.001). By sex, no substantial coverage differences were observed. Considering publically funded target groups for PPsV23 vaccination in Catalonia (i.e. < 65 year olds with at least one risk factor, plus all adults aged ≥ 65 years), PPsV23 coverage reached 52.8% (771,722/1,462,261) in our study population. Regarding PCV13 publicly funded targets (i.e. all-age immunocompromised persons), PCV13 coverage was 3.3% (6,617/202,348). By risk conditions, the highest PPsV23 coverage appeared in congestive heart failure (51,909/63,596; 81.6%), chronic renal disease (122,791/158,726; 77.4%) and chronic bronchitis/emphysema (96,453/132,306; 72.9%). Maximum PCV13 coverage appeared in cirrhosis (294/7,957; 3.7%), chronic renal disease (5,633/158,726; 3.5%) and chronic bronchitis/emphysema (2,859/132,306; 2.2%).ConclusionPneumococcal vaccination coverages in Catalonian adults are suboptimal, especially for PCV13.
Highlights
Infections caused by Streptococcus pneumoniae are an important cause of morbidity and mortality around the world [1]
This study reports current pneumococcal vaccination uptakes for both PPsV23 and PCV13 vaccines among the general adult population ≥ 50 years old in Catalonia in January 2017, assessing vaccine coverages by age, sex and presence of major underlying risk conditions
PCV13 coverage increased with age, it was very low in all age groups (0.4% in 50–64 years vs 0.9% in 65–79 years vs 1.0% in ≥ 80 years; p < 0.001) and was slightly greater in men than in women (0.8% vs 0.6%; p < 0.001)
Summary
Infections caused by Streptococcus pneumoniae are an important cause of morbidity and mortality around the world [1]. Few recent coverage data (i.e. after PCV13 approval for adults in 2012) are available [5,6,7]. Updated data on both PPsV23 and PCV13 vaccination coverages in adults are needed, especially that pneumococcal vaccination programmes for adults and children are routinely implemented in many settings. These data are relevant to evaluate direct and indirect protective effects (e.g. herd protection) on the population [8]. Conclusion: Pneumococcal vaccination coverages in Catalonian adults are suboptimal, especially for PCV13
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