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Abstract

Background

Recent published data on pneumococcal vaccination coverages among adults are scarce.

Aim

To update on pneumococcal vaccination uptakes among middle-aged and older adults in Catalonia.

Methods

We 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.

Results

Overall, 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%).

Conclusion

Pneumococcal vaccination coverages in Catalonian adults are suboptimal, especially for PCV13.

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/content/10.2807/1560-7917.ES.2019.24.29.1800446
2019-07-18
2019-08-23
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.29.1800446
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References

  1. Örtqvist A, Hedlund J, Kalin M. Streptococcus pneumoniae: epidemiology, risk factors, and clinical features. Semin Respir Crit Care Med. 2005;26(6):563-74.  https://doi.org/10.1055/s-2005-925523  PMID: 16388428 
  2. Centers for Disease Control and Prevention (CDC). Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practice (ACIP). MMWR Morb Mortal Wkly Rep. 1997;46(RR-8):1-24.  PMID: 9132580 
  3. Centers for Disease Control and Prevention (CDC). Licensure of 13-valent pneumococcal conjugate vaccine for adults aged 50 years and older. MMWR Morb Mortal Wkly Rep. 2012;61(21):394-5. PMID: 22647745 
  4. The Office of Disease Prevention and Health Promotion. Healthy people 2020. Immunization and Infectious Diseases. [Accessed 22 Mar 2019]. Available from: https://www.healthypeople.gov/2020/topics-objectives/topic/Immunization-and-Infectious-Diseases/objectives#4670
  5. Norris T, Vahratian A, Cohen RA. Vaccination Coverage Among Adults Aged 65 and Over: United States, 2015. NCHS Data Brief. 2017;281(281):1-8. PMID: 28696200 
  6. Black CL, Williams WW, Warnock R, Pilishvili T, Kim D, Kelman JA. Pneumococcal Vaccination Among Medicare Beneficiaries Occurring After the Advisory Committee on Immunization Practices Recommendation for Routine Use Of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine for Adults Aged ≥65 Years. MMWR Morb Mortal Wkly Rep. 2017;66(27):728-33.  https://doi.org/10.15585/mmwr.mm6627a4  PMID: 28704347 
  7. Vila-Corcoles A, Ochoa-Gondar O, Hospital I, de Diego C, Satué E, Bladé J, et al. Pneumococcal vaccination coverages among low-, intermediate-, and high-risk adults in Catalonia. Hum Vaccin Immunother. 2016;12(11):2953-8.  https://doi.org/10.1080/21645515.2016.1210744  PMID: 27454779 
  8. Tsaban G, Ben-Shimol S. Indirect (herd) protection, following pneumococcal conjugated vaccines introduction: A systematic review of the literature. Vaccine. 2017;35(22):2882-91.  https://doi.org/10.1016/j.vaccine.2017.04.032  PMID: 28449971 
  9. Generalitat de Catalunya. Prevenció de la malaltia pneumocòccica en els adults i en els infants a partir dels 5 anys a Catalunya. [Prevention of pneumococcal disease in adults and children from 5 years of age in Catalonia]. Programa de vacunacions. Agència de Salut Pública de Catalunya. Gener de 2014. Spanish. [Accessed 8 Jun 2018]. Available from: http://canalsalut.gencat.cat/web/.content/home_canal_salut/professionals/temes_de_salut/vacunacions/documents/arxius/prevencio_neumo_catalunya_adults.pdf
  10. Picazo JJ, González-Romo F, García Rojas A, Peréz-Trallero E, Gil Gregorio P, de la Cámara R, et al. Consenso sobre la vacunación anti-neumocócica en el adulto con patología de base. [Consensus document on pneumococcal vaccination in adults with risk underlying clinical conditions]. Rev Esp Quimioter. 2013;26(3):232-52. Spanish.  PMID: 24080892 
  11. World Medical Association. WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects. [Accessed 14 Mar 2018]. Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/
  12. IDESCAT. Web de l'estadística oficial de Catalunya. [Statistical Institute of Catalonia]. [Accessed 25 Mar 2018]. Available from: http://www.idescat.cat
  13. World Health Organization (WHO). International Classification of Diseases (ICD). ICD-10 version. Geneva: WHO. [Accessed 25 Mar 2018]. Available from: www.who.int/classifications/icd/en
  14. Information system for the development of research in primary care (SIDIAP data base). [Accessed 25 Feb 2018]. Available from: http://www.sidiap.org/
  15. García-Gil MdelM, Hermosilla E, Prieto-Alhambra D, Fina F, Rosell M, Ramos R, et al. Construction and validation of a scoring system for the selection of high-quality data in a Spanish population primary care database (SIDIAP). Inform Prim Care. 2011;19(3):135-45.  https://doi.org/10.14236/jhi.v19i3.806  PMID: 22688222 
  16. U.S. Food and Drug Administration (FDA). FDA expands use of Prevnar 13 vaccine for people ages 50 and older. Silver Spring: FDA; 2011. Available from: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm285431.htm
  17. The Committee for Medicinal Products for Human Use. European Medicines Agency (EMA). Prevenar 13. Pneumococcal polysaccharide conjugate vaccine (13-valent, adsorbed). London: EMA; 2011. Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Summary_of_opinion/human/001104/WC500112838.pdf
  18. Hosmer DW, Lemeshow SA. Applied Logistic Regression. 2nd ed. New York, NY: John Wiley & Sons, Inc.; 2000. p. 223-59.
  19. Bonten MJ, Huijts SM, Bolkenbaas M, Webber C, Patterson S, Gault S, et al. Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. N Engl J Med. 2015;372(12):1114-25.  https://doi.org/10.1056/NEJMoa1408544  PMID: 25785969 
  20. Eilers R, de Melker HE, Veldwijk J, Krabbe PFM. Vaccine preferences and acceptance of older adults. Vaccine. 2017;35(21):2823-30.  https://doi.org/10.1016/j.vaccine.2017.04.014  PMID: 28412075 
  21. Giese C, Mereckiene J, Danis K, O’Donnell J, O’Flanagan D, Cotter S. Low vaccination coverage for seasonal influenza and pneumococcal disease among adults at-risk and health care workers in Ireland, 2013: The key role of GPs in recommending vaccination. Vaccine. 2016;34(32):3657-62.  https://doi.org/10.1016/j.vaccine.2016.05.028  PMID: 27255466 
  22. Fedson DS, Nicolas-Spony L, Klemets P, van der Linden M, Marques A, Salleras L, et al. Pneumococcal polysaccharide vaccination for adults: new perspectives for Europe. Expert Rev Vaccines. 2011;10(8):1143-67.  https://doi.org/10.1586/erv.11.99  PMID: 21810065 
  23. Spindler C, Hedlund J, Jasir A, Normark BH, Ortqvist A. Effects of a large-scale introduction of the pneumococcal polysaccharide vaccine among elderly persons in Stockholm, Sweden. Vaccine. 2008;26(43):5541-6.  https://doi.org/10.1016/j.vaccine.2008.06.073  PMID: 18602961 
  24. Begum F, Pebody R. Annual pneumococcal polysaccharide vaccine uptake in 65 years old and over for England. Influenza immunization uptake monitoring programme. Department of Health and Health Protection Agency, 2008. [Accessed 15 Jul 2018]. Available from: http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1216711845635
  25. Bossuyt N, Van Casteren V. Pneumococcal vaccination coverage in elderly people in Belgium. Arch Public Health. 2005;63:185-98.
  26. Bonanni P, Ferro A, Guerra R, Iannazzo S, Odone A, Pompa MG, et al. Vaccine coverage in Italy and assessment of the 2012-2014 National Immunization Prevention Plan. Epidemiol Prev. 2015;39(4) Suppl 1;146-58. PMID: 26499433 
  27. Tomczyk S, Bennett NM, Stoecker C, Gierke R, Moore MR, Whitney CG, et al. Centers for Disease Control and Prevention (CDC). Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥65 years: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2014;63(37):822-5. PMID: 25233284 
  28. World Health Organization (WHO). Weekly epidemiological record. Pneumococcal vaccines. WHO position paper – 2012. Geneva: WHO. [Accessed 8 May 2018]. Available from: http://www.who.int/wer/2012/wer8714.pdf?ua=1.
  29. European Centre for Disease Prevention and Control (ECDC). Vaccine Schedule. Recommended immunisations for pneumococcal disease. Stockholm: ECDC. [Accessed 8 Jun 2018]. Available from URL: http://vaccine-schedule.ecdc.europa.eu/Pages/Scheduler.aspx
  30. Castiglia P. Recommendations for pneumococcal immunization outside routine childhood immunization programs in Western Europe. Adv Ther. 2014;31(10):1011-44.  https://doi.org/10.1007/s12325-014-0157-1  PMID: 25300593 
  31. Vila-Córcoles A, Ochoa-Gondar O, Ester F, Sarrá N, Ansa X, Saún NEVAN Study Group. Evolution of vaccination rates after the implementation of a free systematic pneumococcal vaccination in Catalonian older adults: 4-years follow-up. BMC Public Health. 2006;6(1):231.  https://doi.org/10.1186/1471-2458-6-231  PMID: 16981982 
  32. Torres de Mier MV, Masa Calles J, Barricarte Gurrea A. Estimación de población de grupos de riesgo en España. Grupo de trabajo vacunación frente a neumococo en grupos de riesgo 2015 de la Ponencia de Programas y Registro de Vacunaciones. Utilización de la vacuna frente a neumococo en grupos de riesgo. [Population estimation of risk groups in Spain. Working group of pneumococcal vaccination in risk groups 2015 of the Program Presentation and Vaccination Registry. Use of the vaccine against pneumococcus in risk groups]. Comisión de Salud Pública del Consejo Interterritorial del Sistema Nacional de Salud. Ministerio de Sanidad, Servicios Sociales e Igualdad. 2015. [Accessed 22 Mar 2019]. Available from: http://www.mscbs.gob.es/profesionales/saludPublica/prevPromocion/vacunaciones/docs/Neumococo_Gruposriesgo.pdfhttp://www.mscbs.gob.es/profesionales/saludPublica/prevPromocion/vacunaciones/docs/Neumococo_Gruposriesgo.pdf
  33. Jain A, van Hoek AJ, Boccia D, Thomas SL. Lower vaccine uptake amongst older individuals living alone: A systematic review and meta-analysis of social determinants of vaccine uptake. Vaccine. 2017;35(18):2315-28.  https://doi.org/10.1016/j.vaccine.2017.03.013  PMID: 28343775 
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