Pneumococcal Vaccination Rates Research Articles

S2250 Quality Improvement Initiative Improves Pneumococcal Vaccination Rates in Adult Patients with Celiac Disease

S2250 Quality Improvement Initiative Improves Pneumococcal Vaccination Rates in Adult Patients with Celiac Disease

Improving vaccination counseling rates in first time patients with cancer: A multi-disciplinary approach.

315 Background: ASCO guidelines 2024 recommend that “clinicians determine vaccination status and ensure that adults newly diagnosed with cancer about to initiate treatment are up to date on seasonal vaccines as well as age- and risk-based vaccines.” Prior to the study, Baylor Scott and White Hematology Oncology Round Rock (BSWHRR) clinic lacked a formalized process for vaccine education. The primary aim of this study was to increase vaccination counseling for first-time cancer patients with solid tumors or hematologic malignancies. The secondary endpoint was to optimize vaccination status for this group of patients. Methods: Inclusion criteria were patients 18 years or older with initial diagnosis of solid tumor or hematologic malignancy, receiving chemotherapy and/or immunotherapy for the first time, and treated within BSWHRR. Exclusion criteria were patients with subsequent malignancy, malignancy requiring second line chemotherapy and/or immunotherapy, or deceased. Patients meeting these criteria n=57 were collected during the pre-intervention period October 15-December 15. Post-intervention data n=52 was collected 6 weeks following the initiation of the intervention from February 18 – April 18. The intervention included a 2-sided handout containing current recommendations for vaccination schedules in immunocompromised adults. These handouts were provided along with counseling at 2 separate encounters (during the initial consult and during chemotherapy education). The handout included instructions for scheduling vaccines with the Baylor Scott and White Pharmacy and/or their PCP. This multi-disciplinary approach included nurse navigators, triage nurses, pharmacists, and physicians. A standardized documentation process was initiated and utilized for both consult and chemotherapy education encounters. Results: Following the introduction of vaccine education handouts and standardized documentation, vaccine counseling rates during the consult visit improved from 0% to 49%. Vaccine counseling rates during chemotherapy education visits increased from 0% to 71%. Overall, the number of patients that attended and were counseled during at least one of these visits increased from 0% to 70%. The secondary endpoint of increasing vaccination rates showed that non-seasonal vaccination rates improved. Pneumococcal vaccination rates improved from 33% to 42%, a 27% increase. Shingles coverage improved from 16% to 25%, a 56% increase. Conclusions: This study showed that a multidisciplinary approach, utilization of patient/physician education handouts, and standardization of documentation was effective in achieving a substantial increase in vaccination counseling rates for patients with newly diagnosed malignancy. The intervention was also effective in achieving the secondary endpoint of increasing pneumococcal and shingles vaccinations.

Assessment of Unwanted Side Effects of Vaccines in Cancer Patients: Where Do We Stand in Vaccination? Where Should Our Next Step Be?

For cancer patients, vaccination against diseases that can be prevented by vaccination is a crucial but often disregarded matter. Our aim was to find out how adult immunization guidelines were being used and to investigate undesirable effects after vaccination. Vaccination status against hepatitis A and hepatitis B virus, tetanus-diphtheria, pneumococcus, influenza and meningococcus of 535 patients with solid organ malignancies who were referred to the Adult Vaccination Polyclinic from oncology outpatient clinic between July 2020 and March 2024 were documented retrospectively. Data collection and statistical analyses were performed with SPSS statistical software version 22.0. The patients’ mean age±SD was 56.8±12.3. Of the patients, 329 (61.4%) are women. Breast cancer (n= 184, 34.3%), urogenital cancers (n= 89, 16.6%), and lung cancer (n= 69, 12.8%), are the most prevalent cancers among patients applying for vaccination. Pneumococcal vaccine was the most frequently administered vaccine in 515 patients (96.2%), while influenza vaccine was the least frequently administered vaccine in 12 patients (2.2%). Fifty-three (9.9%) patients had grade 1 side effects. Pain at the injection site was the most common side effect and occurred most frequently after tetanus-diphtheria vaccination. Undesirable side effects were more frequent in 7.9% (n= 42) of patients who were under treatment (p= 0.016). However, no significant relationship was found between age, sex, the disease stage and the types of treatment received and the incidence of side effects (p> 0.05). None of the participants experienced any moderate or serious post-vaccination side effects serious enough to require medical attention. Although the pneumococcal vaccination rates in our study are greater than to the literature, the application rate of other vaccines, especially influenza vaccine, is low according to current guidelines. Increased awareness of this issue among oncology physicians is suggested by the fact that about 1/5 of patients were referred to vaccination outpatient clinics. This study is extremely valuable in demonstrating to oncology physicians the rarity of vaccine side effects. Keywords: Vaccination, Immunization, Cancer patient, Solid tumor, Post-vaccination unsiderable effect

Changes in Attitudes towards Influenza and Pneumococcal Vaccination during the Subsiding COVID-19 Pandemic-Results of a Longitudinal Survey Study among Risk Groups in Germany between 2021 and 2023.

In many countries, an increase in influenza and pneumococcal vaccination rates was observed during the COVID-19 pandemic. We examined how attitude, risk perception and knowledge towards influenza and pneumococcal vaccines of at-risk patients developed when the COVID-19 pandemic subsided and if COVID-19 vaccination attitude (VA) was still associated with the attitudes towards the two other vaccines. We used longitudinal data from two surveys conducted in Germany in 2021 and 2023 among persons with chronic diseases. We assessed VA, risk perception, vaccination knowledge and further psychological determinants of vaccine acceptance. Structural equation modelling using full information maximum likelihood was used to estimate multivariate regressions with planned missing data. Among 543 respondents, the influenza and pneumococcal vaccination rates remained relatively stable between 2021 and 2023. VA also remained unchanged at a moderately positive level, while COVID-19 VA decreased. A constantly positive association between COVID-19 VA and influenza as well as pneumococcal VA was found, independent from a general VA. The perceived danger of influenza increased between 2021 and 2023 and was among the strongest predictors of influenza VA. Also at the subsiding pandemic, COVID-19 VA was constantly associated with the influenza and pneumococcal VA. It seems sensible to take these aspects into account when designing future vaccination campaigns for at-risk patients. DRKS00024561. Registered 9 March 2021.

Analysis of health claims data on vaccination coverage in older adults in Bavaria, Germany: Influenza, pneumococcus and herpes zoster

BackgroundVaccination is essential, especially in older adults whose immune system function declines with age. The COVID-19 pandemic and its associated lockdowns temporarily disrupted routine vaccination services. We aimed to assess vaccination coverage for Influenza, Pneumococcus, and Herpes zoster among older adults in Bavaria over time and investigate potential pandemic effects on these rates. MethodsBased on health claims data from the Bavarian Association of Statutory Health Insurance Physicians (KVB), we estimated the percentage of adults aged 60 years and older vaccinated following the German Standing Committee on Vaccinations (STIKO) recommendation for Influenza (2012−2021), Pneumococcus (2017–2021) and Herpes zoster (2019–2021), stratified by sex and 10-year age groups. Using time series regression analysis, we estimated the effect of the pandemic period (2020−2021) on quarterly Influenza and Pneumococcal vaccination rates. ResultsIn the first year of the pandemic (2020), Influenza, Pneumococcus and Herpes zoster coverage in both sexes increased by 9.9, 8.7, and 2.5 percentage points (pp), respectively. In 2021, Influenza coverage decreased by 4.7 pp., while Pneumococcus and Herpes zoster coverage increased by 2.7 and 3.8 pp., respectively. Influenza and Pneumococcal vaccinations showed a seasonal pattern, with vaccinations occurring mainly in the fourth quarter; this pattern was distorted for Pneumococcus during the pandemic. Per the time series regression analysis, Influenza vaccination rates in the fourth quarters of 2020 and 2021 were 7.86 (95 %CI: 5.10–10.62) and 8.87 (95 %CI: 5.80–11.54) pp. higher for males and females, respectively, compared to that of the pre-pandemic period. During the pandemic, the quarterly Pneumococcal vaccination rates increased by 0.68 (95 %CI: 0.19–1.18) pp. in males and 0.80 (95 %CI: 0.30–1.30) pp. in females. ConclusionThe heightened increase in vaccination rates observed in 2020 may have resulted from increased vaccination awareness during the pandemic. As the pandemic effect wanes, more efforts are needed to sustain and increase these vaccination rates.

Pneumococcal Vaccination Rates and Associated Meningitis Events in Patients With Acute Cerebrospinal Fluid Leak.

To characterize the institutional utilization of pneumococcal vaccination during an index hospital admission for acute cerebrospinal fluid (CSF) leakage and associated infectious and clinical outcomes. This retrospective cohort study included patients hospitalized and treated for an acute CSF leak from January 2017 to June 2022. The primary outcome evaluated the incidence of pneumococcal vaccination during the index admission in patients without prior vaccination. Secondary outcomes evaluated the incidence of meningitis, time from CSF leak identification to meningitis, and mortality within 1 year of the index admission. A total of 94 patients were included. Nineteen (20.2%) patients received pneumococcal vaccination prior to admission. Of the 75 patients without prior vaccination, 4 (5.3%) patients received vaccination during the admission. Meningitis occurred in 5/94 (5.3%) patients and occurred 4-24 days from CSF leak identification. Mortality was observed in 9/94 (9.6%) patients. None of the meningitis cases were attributed to culture-positive findings of pneumococcal disease. The results of this study demonstrate an overall low institutional utilization of pneumococcal vaccination in patients with an acute CSF leak. Infectious and clinical outcomes reflected comparable to previous reported literature. Further evaluation into the risk-benefit relationship of vaccination omission is warranted in this patient population.

Association Between Pneumococcal Vaccination Uptake and Loneliness Among Regular Patients in Rural Community Hospitals: A Cross-Sectional Study.

Introduction Vaccination is essential for preventing infectious diseases such as pneumonia and seasonal viral infections. The COVID-19 pandemic has underscored the critical role of vaccination in public health. However, vaccination uptake can be influenced by biopsychosocial conditions. Immunocompromised individuals, for instance, face restrictions with live vaccines, and psychosocial factors like loneliness can negatively impact attitudes towards vaccination. This study aims to clarify the association between loneliness and pneumococcal vaccination rate among regular patients in a rural Japanese community. Method A cross-sectional study was conducted at Unnan City Hospital in Unnan City, a rural area in southeastern Shimane Prefecture, Japan. Participants included patients over 40 who regularly visited the general medicine department between September 1, 2023, and November 31, 2023. Data on vaccination rates for pneumococcal pneumonia and loneliness levels assessed using the Japanese version of the three-item University of California, Los Angeles (UCLA) Loneliness Scale were collected. Additional data on demographics, BMI, renal function, and comorbidities were extracted from electronic medical records. Statistical analyses were performed to identify factors associated with vaccination rates, including univariate and multivariate logistic regression. Results Out of 1,024 eligible patients, 647 participated in the study. Participants with higher loneliness had significantly lower vaccination rates for pneumococcal pneumonia (22.3% vs. 34.2%, p = 0.001). The multivariate logistic regression model showed that higher loneliness was significantly associated with lower vaccination likelihood (odds ratio (OR) = 0.54, 95% CI = 0.37-0.78, p = 0.0011). Age was positively associated with vaccination (OR = 1.08, 95% CI = 1.06-1.11, p < 0.001), whereas higher comorbidity scores (Charlson Comorbidity Index (CCI) ≥ 5) and frequent healthy eating practices were associated with lower vaccination rates. Conclusion This study demonstrates a significant association between higher loneliness levels and lower pneumococcal vaccination rates among patients in a rural Japanese community. Addressing psychosocial barriers such as loneliness could enhance vaccination uptake. Public health interventions focused on reducing loneliness and enhancing social support are essential to improving vaccination rates and preventing infectious diseases. Further research should explore the causal mechanisms and develop targeted strategies to mitigate the impact of loneliness on health behaviors.

Impact of COVID-19 on Influenza and Pneumococcal Vaccination of Psoriatic Patients in Germany: Results from Vac-Pso.

Suboptimal influenza and pneumococcal vaccination rates have been reported before the COVID-19 pandemics in certain populations at risk for severe infection. The aim of this longitudinal cohort study was to investigate changes in influenza and pneumococcal vaccination rates and patient perceptions in patients with psoriasis (PsO) before and during the pandemic. Data on vaccination, patient and disease characteristics, comorbidity, and patient perceptions were collected with questionnaires before and during the pandemic approximately one year later. Over the whole cohort who participated in the follow-up visit (n = 287; 59.2% male; mean age: 56.3 years), both influenza and pneumococcal lifetime vaccination prevalences increased significantly from 50.5% to 66.2% and from 16.0% to 41.5%, respectively. A total of 88.5% of PsO patients were interested in a COVID-19 vaccination or had already received it. The reasons for and against vaccinations changed significantly before and during the pandemic. Despite a promising increase in the vaccination prevalence in our PsO cohort, it remains important that awareness for vaccinations is encouraged and closely monitored in future research, particularly in populations at risk.

A System Intervention to Increase Pneumococcal Vaccination Rates in Adults Living With Human Immunodeficiency Virus Who Present for Scheduled Medical Care

Abstract Pneumococcal vaccinations are recommended for adults living with HIV; however, eligibility criteria are complex. At a clinic specializing in the care of lesbian, gay, bisexual, transgender, or queer/questioning persons, only 36% of patients who were vaccine-eligible received the vaccination. A set of decision trees was developed to guide clinic personnel in determining whether a vaccine is recommended. The provider then determined whether the vaccine was appropriate based on each patient's complete clinical presentation. When appropriate, patients were offered the vaccine at the same appointment. This practice change led to a 22% increased vaccination rate.

Improving Pneumococcal Vaccination Rates in Immunosuppressed Pediatric Patients with Rheumatic Disease.

Patients with rheumatic diseases are at a high risk of invasive pneumococcal disease due to immunosuppression. We conducted a quality improvement project, and the first aim was to increase the percentage of patients with systemic lupus erythematosus and mixed connective tissue disease that is up to date on pneumococcal vaccinations from 9.6% to 80% within one year. Subsequently, the second aim was to increase the percentage of patients on immunosuppression with systemic lupus erythematosus, mixed connective tissue disease, juvenile dermatomyositis and systemic vasculitis that is up to date on pneumococcal vaccinations from 62.6% to 80% within one year. Two process measures were up-to-date vaccination status on (1) 13-valent pneumococcal conjugated vaccine (PCV13) and (2) 23-valent pneumococcal polysaccharide vaccine (PPSV23). Our outcome measure was being fully up to date on both pneumococcal vaccinations. Interventions included an immunization algorithm, reporting of eligible patients, education, reminders, and pre-visit planning. There were shifts in the centerline for all quality measures in both phases of this project. The combined pneumococcal vaccination rate for Phase 1 increased from 9.6% to 91.1%, and this centerline was sustained. Pneumococcal vaccination rates also significantly increased for Phase 2: 68.8% to 93.4% for PCV13, 65.2% to 88.5% for PPSV23, and 62.6% to 86.5% for the combined pneumococcal vaccination rate. Quality improvement methodology significantly increased and sustained pneumococcal vaccination rates in our high-risk, immunosuppressed patients. We continue to prioritize this important initiative to mitigate the risk of invasive pneumococcal disease.

Pneumococcal Perplexity: Improving Awareness of Updated Pneumococcal Vaccination Recommendations in Two Large Military Treatment Facilities.

Vaccinations are an essential aspect of preventive medicine. In October 2021, the pneumococcal conjugate vaccine-20 (PCV-20) and PCV-15 were authorized for use in adults by the U.S. FDA. In 2022, the Advisory Committee on Immunization Practices (ACIP) subsequently published updated pneumococcal vaccination recommendations that incorporate both PCV-20 and PCV-15. Pneumococcal vaccination is effective in reducing pneumococcal disease, particularly in high-risk patient groups such as those with chronic lung disease; however, the updated dosing schedule for pneumococcal vaccinations can be quite confusing, especially if patients have previously received "older" vaccinations, such as pneumococcal polysaccharide vaccine-23 or PCV-13. The purpose of this quality improvement project was to increase providers' knowledge of current ACIP pneumococcal vaccination recommendations, including indications and dosing schedule, and to improve pneumococcal vaccination rates among eligible adults and children. Focused education sessions were presented to primary care and subspecialty residents, fellows, and staff at Brooke Army Medical Center and Wilford Hall Ambulatory Surgical Center regarding current ACIP pneumococcal vaccination recommendations. Sessions included information about PCV-15 and PCV-20 vaccines, indications for vaccination, and dosing schedules. Subjective knowledge of updated ACIP pneumococcal vaccination recommendations was assessed among primary care and subspecialty residents, fellows, and staff via an anonymous survey both pre- and post-intervention. Number of PCV-20 vaccinations given and estimated vaccination rates of patients aged 19 to 64 years with asthma were assessed pre- and post-intervention over a 6 month time span. Of surveyed providers, only 9% discussed vaccinations at every visit and 11% did not discuss vaccinations at all. There was a statistically significant increase in providers' knowledge of pneumococcal vaccination guidelines for children post-intervention (P = .01) but no statistically significant increase in knowledge for guidelines for adults, for patients that have received prior pneumococcal vaccines, or in overall confidence in recommending pneumococcal vaccines. There was a 17% increase in the number of PCV-20 vaccinations given post-intervention (198 pre-intervention, 232 post-intervention). The estimated PCV-20 vaccination rate for adults aged 19 to 64 years with asthma increased from 14.9% pre-intervention to 19.5% post-intervention (P = .33). There is a significant knowledge gap regarding ACIP pneumococcal vaccination recommendations among military providers and a low pneumococcal vaccination rate for adults aged 19 to 64 years with asthma at Joint Base-San Antonio MTFs. Focused education sessions were effective in increasing providers' knowledge of updated pneumococcal vaccination recommendations, confidence in recommending vaccines, total number of pneumococcal vaccinations given, and estimated pneumococcal vaccination rate for adults with asthma. The validity of conclusions drawn from our data were limited because of discordant numbers of survey respondents as well as potentially inaccurate estimates of pneumococcal vaccination rates pre- and post-intervention. Despite this, the results warrant continued education of pneumococcal vaccines, indications, and dosing schedules.

The Uptake of Pneumococcal and Seasonal Influenza Vaccinations Based on Perceptions and Attitudes Toward the COVID-19 Vaccine Among Patients With Diabetes.

Objective In this study, we aimed to assess the rates of pneumococcal and seasonal influenza vaccinations among elderly and nonelderly diabetes patients andexamine their perceptions and attitudes toward the coronavirus disease 2019 (COVID-19) vaccine. Methods A single-center study was conducted among patients with diabetes, employing a structured survey encompassing sociodemographic data, vaccination records, and the COVID-19 vaccine perception and attitude scale. Results Among the 280 diabetes patients in our study, the vaccination rates for COVID-19, seasonal influenza, and pneumococcal vaccines were 96.1%, 16.8%, and 17.5%, respectively. A higher cumulative dosage of the COVID-19 vaccine was associated with older age (r = 0.463; p<0.001), increased safety score (r = 0.479; p<0.001), and lower conspiracy theory score (r = -0.336; p<0.001). Participants who had received COVID-19 and influenza vaccines were observed to have significantly higher safety scores related to COVID-19 vaccines (p<0.001; d = 2.381and p = 0.008; d = 0.525, respectively).Notably, vaccination rates for influenza and pneumococcus were significantly different between nonelderly and elderly patients (8.7% vs. 29.6%; p<0.001 and 13.4% vs. 24.1%; p = 0.022). Elderly patients with diabetes were 3.3 times more likely to receive the influenza vaccine than nonelderly participants [odds ratio (OR) = 3.319; 95% confidence interval (CI) = 1.592 - 6.920; p = 0.001] and had a higher safety score related to COVID-19 vaccines (OR= 1.076; 95% CI = 1.011 - 1.146; p = 0.021). Conclusions Both influenza and pneumococcal vaccination rates were below the desired targets in this study. The vaccination rates among the nonelderly diabetes population suggest that this group may be more likely to neglect to receive vaccination compared to the elderly diabetes population. The association between vaccination rates and post-pandemic safety perceptions highlights the critical need to implement public health strategies specifically designed to address and improve safety-related information dissemination.

Effectiveness of a Program to Raise Awareness About Pneumococcal Vaccination Among Physicians and Patients with Chronic Respiratory Diseases: A Multicenter Cohort Study.

There is a need to increase patient and clinician awareness on the effectiveness of pneumococcal vaccination in at-risk groups. The aim of the study was to evaluate the effect of reminders for physicians and patients using the vaccination tracking system created in the hospital information management system (HIMS) on the vaccination rate, and the effect of pneumococcal vaccination on pneumonia-related hospitalization and mortality over a 12-month period. This prospective observational cohort study was undertaken during a 2-year period in 3 tertiary care centers. Patients were followed up for 12 months following vaccination, and hospital admissions and mortality were recorded via HIMS. During the campaign, HIMS transmitted pneumococcal immunization reminder messages in accordance with guideline recommendations to physicians' computers and patients' mobile phones. Educational posters on pneumococcal vaccination were posted in outpatient clinics. Regular seminars on the evidence for pneumococcal vaccination were organized. All patients who were hospitalized during the follow-up period for chronic obstructive pulmonary disease (COPD), asthma, lung cancer, or pneumonia were analyzed in relation to their vaccination history regarding clinical outcomes. A total of 29530 patients were included in the study. During the study period, the annual vaccination rate increased by 74.4% and reached 4.8% in 3 hospitals (P = .001). The rates were 3.9% in patients older than 65 years without comorbidities and 5.2% in those with COPD and asthma (P = .002). In pneumococcal vaccine recipients, pneumonia-related hospital mortality was lower (relative risk (RR) = 0.19, CI 0.09-0.35, P < .001). It is possible to raise the rate of pneumococcal vaccination through awareness campaigns. Individuals with COPD and asthma are more willing to receive pneumococcal vaccination. Among patients hospitalized for pneumonia, prior pneumococcal vaccination is associated with lower mortalit.

Pharmacist impact on pneumococcal vaccination rates through incorporation of pharmacist‐led opportunistic inpatient vaccination intervention

AbstractBackgroundPneumococcal disease continues to be a large source of morbidity and mortality despite the availability of effective prevention via immunisation and treatment measures.AimTo assess the impact of a pharmacist‐led opportunistic inpatient pneumococcal vaccination intervention on overall 13‐valent pneumococcal conjugate vaccine (13vPCV) rates in eligible hospitalised subacute patients, aged 70 years and above.MethodThis study was a pre‐ and post‐intervention study conducted across two study sites at Monash Health, a large metropolitan health service in Victoria, Australia. Phase 1 (pre‐intervention, August–October 2022) involved auditing the vaccine‐eligibility of patients on admission and subsequent administration during inpatient stay. Phase 2 (intervention phase, October–December 2022) implemented the pharmacist‐led opportunistic inpatient pneumococcal vaccine intervention. Following screening, identified vaccine‐eligible patients were recommended to the treating physician via verbal discussion and Microsoft Teams for consideration of vaccination administration in hospital. The proportion of eligible patients vaccinated was compared between the pre‐intervention and intervention groups. This project was exempt for ethics approval due to the local policy requirements that constitute research by the Monash Health Human and Research Ethics Committee (Reference no: RES‐22‐0000‐454Q). The justification for this ethics exemption was as follows: the project complies with the National Health and Medical Research Council's Ethical considerations in quality assurance and evaluation activities; auditing the percentage of vaccine‐eligible and non‐vaccinated patients did not require written consent per local requirements; and it is standard practice to obtain verbal consent, followed by documentation on electronic medical records, for inpatient vaccinations. Informed consent was obtained from participants via verbal consent after the distribution of written medical information on the 13vPCV, as well as verbal information provided by the medical team.ResultsA total of 360 patients were included in the study. Overall, 139 (77.2%) patients in the pre‐intervention and 143 (79.4%) patients in the intervention phase were eligible for vaccination (non‐vaccinated with age indication). The proportion of patients receiving inpatient 13vPCV was higher in the intervention group compared to the pre‐intervention group (43.4 vs 2.2%, p &lt; 0.001).ConclusionThe results indicate that incorporating a pharmacist‐led opportunistic inpatient pneumococcal vaccination intervention can significantly increase pneumococcal vaccination in hospital.

Preventive Care Practices: A Retrospective Database Study of Influenza and Pneumococcal Vaccination Among Adults with Diabetes

Background: Diabetes mellitus is a prevalent chronic disease that significantly increases the risk of complications from infections such as influenza and pneumococcal disease. Despite established recommendations for vaccination, coverage rates among adults with diabetes remain suboptimal. This study aims to analyze trends in influenza and pneumococcal vaccination rates among adults with diabetes using the United States Diabetes Surveillance System (USDSS) database. Methods: This retrospective database study utilized data from the USDSS from 2000 to 2022, which provides comprehensive nationwide data on diabetes care. The study population included adults aged 18 and above with a documented diagnosis of diabetes. Data were extracted on demographic variables (age, sex, race/ethnicity), clinical characteristics (type of diabetes, duration of diabetes, comorbid conditions), and vaccination records. Descriptive statistics summarized demographic and clinical characteristics, while temporal trends in vaccination rates were analyzed using graphical representations. Results: Over the past two decades, influenza vaccination rates among adults with diabetes increased from 41.4% in 2000 to 56.7% in 2019, reflecting improved awareness and healthcare practices, though slightly dipping to 54.2% in 2022. In contrast, pneumococcal vaccination rates showed more variability, starting at 29.3% in 2000, peaking at 39.4% in 2018, and declining to 30.2% in 2022, indicating challenges in maintaining high coverage. Influenza vaccination rates showed an overall increasing trend across all demographic groups: rates among Hispanic individuals increased from 32.1% in 2000 to 55.4% in 2022, non-Hispanic Whites from 43.4% to 52.7%, and non-Hispanic Blacks from 39.2% to 44.5%. Pneumococcal vaccination rates also increased but displayed more variability; Hispanic rates peaked at 33.3% in 2016, non-Hispanic Whites at 45.6% in 2019, and non-Hispanic Blacks at 41.7% in 2017. Higher educational attainment was consistently associated with higher vaccination rates for both vaccines. Conclusions: This study highlights significant improvements in influenza and pneumococcal vaccination rates among adults with diabetes over the past two decades. However, disparities remain, particularly among racial and educational groups. Targeted strategies are necessary to address these disparities and enhance vaccination coverage, ultimately reducing the risk of severe infections in this vulnerable population.

1173. Risk of Pneumococcal Disease and Rate of Pneumococcal Vaccination Among Medicare Beneficiaries Aged 65 Years and Older Residing in Long-Term Care Facilities — United States, September 1, 2014 – December 31, 2019

Abstract Background Adults living in long-term care (LTC) facilities are at increased risk of respiratory infectious diseases, including pneumococcal disease. On August 13, 2014, the Advisory Committee on Immunization Practices recommended 13-valent pneumococcal conjugate vaccine (PCV13) in addition to 23-valent pneumococcal polysaccharide vaccine (PPSV23) for adults aged ≥65 years based on data that showed PCV13 vaccination confers protection against all-cause community-acquired pneumonia (CAP) and invasive pneumococcal disease (IPD). We assessed PCV13 vaccination coverage and incidence of CAP and IPD among Medicare beneficiaries with ≥1 LTC stay. Methods We identified Medicare Fee-for-Service beneficiaries aged ≥65 years with no prior PCV13 receipt and ≥1 LTC facility stay during September 1, 2014 through December 31, 2019 through Minimum Data Set assessments and skilled nursing facility claims. PCV13 and PPSV23 vaccination history was determined through Medicare claims using Healthcare Common Procedure Coding System and Current Procedural Terminology codes. Incident IPD and CAP outcomes were identified through inpatient Medicare claims using International Classification of Diseases diagnosis codes (ICD-9-CM/ICD-10-CM). Outcome incidence was calculated based on time during and outside LTC stays. PCV13 coverage was assessed by LTC residency status on December 31, 2019. Results There were 3,643,248 beneficiaries with ≥1 LTC facility stay during the observation period. Beneficiaries were majority white (89.9%), female (62.1%), aged ≥75 years (67.7%), and had ≥1 chronic medical condition (55.7%); 25.6% had received PPSV23 vaccination at the study start date. By December 31, 2019, PCV13 coverage was 55.3%; coverage among those residing in and outside a LTC facility was 47.5% and 57.3%, respectively. Incidence of CAP and IPD were higher during LTC compared with time outside LTC stay (incidence rate ratio 3.17 [95% CI: 3.15, 3.19] and 1.90 [95% CI: 1.80, 2.00] for CAP and IPD, respectively) (Table). Conclusion Incidence of IPD and CAP were higher during an LTC stay compared with time residing outside of a LTC facility. PCV13 coverage was lower among those in LTC. Improving pneumococcal vaccination coverage may help mitigate the risk of IPD and CAP in this population. Disclosures All Authors: No reported disclosures

Post COVID19 vaccination burnout?: Providers’ perspectives on patients with lung cancer.

401 Background: Patients with solid cancers undergoing chemotherapy or immunotherapy face increased risk of infections due to their immunosuppression and are recommended to undergo routine vaccination. However, despite increased attention to vaccination with the COVID19 pandemic, vaccination rates remain suboptimal among patients with cancer. Methods: Retrospective chart review was used to determine baseline rates of COVID19, Influenza, and Pneumococcal vaccination among a cohort of newly diagnosed patients with lung cancer at multi-site academic cancer center from 2018-2022 (n = 624). An anonymous survey was distributed to all Hematology-Oncology providers (n = 101) at the same institution with questions on current practice on accessing vaccination records and barriers to vaccinating patients starting chemotherapy and/or immunotherapy. Results: The baseline documented COVID-19 vaccination rate was 29.6%, while the baseline documented influenza and pneumococcal vaccination rates were 27.2% and 1.42%, respectively. Survey response was 32.7% (n = 33). Respondents were 60.0% Female (n = 15), 52.0% 30 - 39 years old (n = 13), 56.0% Attending Physicians (n = 14), 28.0% Fellow Physicians (n = 7), and 16.0% Nurse Practitioners (n = 4). 54.5% and 57.6% of respondents always recommended or discussed COVID19 and influenza vaccination, respectively, with their patients on chemotherapy or immunotherapy regardless of cancer type. 12.1% of respondents always recommended pneumococcal vaccination with their patients. The most common moderate barriers to COVID19 and influenza vaccination were “not having enough time” (COVID19, n = 12, 40.0%), (Influenza, n = 7, 26.9%), and “forgetting to bring up vaccines during the visit” (COVID19, n = 12, 40.0%), (Influenza, n = 9, 34.9%). “Not knowing when to administer the vaccine” was a moderate barrier to pneumococcal vaccination in 53.8% of respondents (n = 14). The most common preferred method for obtaining vaccination record information was through patient interview (n = 14, 63.6%). Similar trends were noted when limited to providers who cared for patients with lung cancer. Conclusions: Patients with lung cancer at this academic medical center were found to have low documented rates for COVID19, influenza, and pneumococcal vaccination. Common barriers in vaccination included lack of time and forgetting to bring up vaccination, but lack of knowledge of vaccination timing was only a significant barrier for pneumococcal vaccination. Improvement initiatives to address these identified factors are forthcoming.

Pneumococcal and influenza vaccine awareness in individuals over 65 years

Aims: Vaccination is of great importance due to the increased risk of infection as a result of changes in the immune system with aging and the weak immune response against these infections. In this study, it was aimed to determine the pneumococcal and influenza vaccination awareness and vaccination rates of individuals aged 65 years and over, to direct the unvaccinated individuals to be vaccinated and to protect them from possible infections and complications.&#x0D; Methods: A questionnaire form was filled in by asking demographic information, awareness of influenza and pneumococcal vaccines and the status of vaccination of individuals aged 65 years and over who applied to the clinic between June and September 2020. Unvaccinated individuals were referred to the vaccination unit.&#x0D; Results: A total of 553 elderly individuals aged 65 years and over, 338 women and 215 men, were included in the study. Among the study participants, the rate of patients with awareness of influenza/pneumococcal vaccine was 48.5%. Although the vaccination awareness rate was higher in males, non-smokers, those with higher education level, those with at least one of the comorbidities such as hypertension, coronary artery disease, hyperlipidemia, chronic renal failure, vaccination rates were lower in patients with these comorbidities and additionally diabetes mellitus. The majority of individuals with awareness were informed by healthcare workers. The rate of vaccination among the individuals participating in the study was 18.4%. Vaccination was higher in individuals with awareness. While 5.3% of those who were not vaccinated were hospitalized for pneumonia, those who were vaccinated did not have pneumonia severe enough to require hospitalization.&#x0D; Conclusion: In order to fight with the increasing vaccine hesitancy in our society, healthcare workers should be educated, the media should be supported, and vaccination should be encouraged in every clinic application.

Prevalence Rates of Pneumococcal Vaccination in IBD and 30-Day Clinical Outcomes in Patients With IBD and Pneumococcal Disease Stratified by Receipt of Pneumococcal Vaccination: A Multi-Network Study.

Lay Summary This study sought to assess outcomes associated with pneumococcal vaccination in adult inflammatory bowel disease patients. Results found unvaccinated patients had higher adverse outcomes, including greater risk of hospitalization, ICU admission, ventilation, and mortality. These findings underscore the importance of pneumococcal vaccination.

Hemodiyaliz hastalarında aşılanma oranları ve farkındalığı

Aims: Vaccination is main risk reducing strategy for vaccine-preventable infections in chronic kidney disease (CKD) patients, but vaccination rates in hemodialysis patients are not at the desired level. In this study, we aimed to search the rates of influenza, pneumococcal, hepatitis B and coronavirus disease-2019 (COVID-19) vaccination, the vaccination awareness and the reasons for not taking vaccination in hemodialysis patients.&#x0D; Methods: In this cross-sectional study, 232 CKD patients undergoing hemodialysis in two centers for at least six months were included. The patients completed the questionnaire about vaccination. The data about patients’ history of vaccination regarding influenza, pneumococcal, hepatitis B and COVID-19 vaccines; patients’ attitudes and knowledge about vaccination; the source of information about vaccination were collected via this questionnaire.&#x0D; Results: The rates of pneumococcal, influenza, hepatitis B and COVID-19 vaccination were 9.9%, 56.6%, 38.8% and 87.1%, respectively. In patients with missing vaccination, the main reasons for not taking vaccination were lack of knowledge about vaccination (48.7%), the thought that the vaccine is not beneficial (12.5%) and fear of adverse effects (3.4%). The main sources of information about vaccination were healthcare workers (90.5%), radio/televison (1.7%) and internet (1.7%). &#x0D; Conclusion: Our findings showed that the rates of influenza, pneumococcal and hepatitis B vaccination were below the targeted levels and the main reason was the lack of information about vaccination and the main source of information about vaccination was health personnel. Strategies should be developed to increase the awareness and rate of vaccination for vaccine-preventable infections in CKD patients.