‘Concerning’: Many older patients undervaccinated for pneumococcus, study finds
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More than half of patients aged 65 years or older at a health system in Nebraska were undervaccinated for pneumococcus based on CDC recommendations, according to newly presented data.
The study results, which were presented at the National Foundation for Infectious Diseases Annual Conference on Vaccinology Research, “demonstrate a potential gap in both provider and patient education regarding the current CDC recommendations,” Erin Faloon, an MD student at Creighton University School of Medicine, and Meera Varman, MB, BS, a professor of medicine at the school, wrote.
In their abstract, the researchers noted that the CDC previously recommended that all patients aged 65 years or older receive both the PPSV23 and PCV13 vaccinations. That recommendation changed in 2019 to include only PPSV23.
“The low pneumococcal vaccine coverage rates are concerning. This is a reminder to clinicians to prioritize vaccinations,” Kathleen M. Neuzil, MD, MPH, FIDSA, professor of vaccinology and director of the Center for Vaccine Development and Global Health at the University of Maryland School of Medicine, told Healio.
“For public health officials, as the authors note, the pneumococcal vaccine recommendations have changed over time, making it difficult for providers to keep up,” said Neuzil, who was not involved in the study.
Faloon and Varman analyzed pneumococcal vaccination rates and demographic information from at-risk patients at CHI clinics in Omaha, Nebraska. They defined at-risk patients as individuals aged 65 years or older, people with diabetes, cochlear implant recipients or patients with HIV.
Of the 26,944 patients aged 65 years or older, 51.32% were undervaccinated according to CDC guidance. Of the patients analyzed, 28.15% received only the PCV13 vaccine, and 23.17% had not received any pneumococcal vaccines.
Neuzil said that confusing recommendations, a lack of support from providers and a lack of attention to adult immunization all contribute to the vaccination gap. Neuzil also said that taking advantage of all opportunities to vaccinate patients, administering the pneumococcal vaccine at the same time as the influenza vaccine, and strong recommendations for the vaccine from health care providers can all help address the disparity.
“Individual health care organizations might look into their own vaccine coverage. Measurement tells us where there are gaps or deficiencies and leads to plans to address them,” she said. “We know a lot about adult vaccine coverage and uptake and the themes above — access and convenience, seeing every patient encounter as an opportunity for vaccination and strong health care provider recommendations — are consistent themes for improving coverage.”
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Faloon E, et al. Assessing pneumococcal vaccination rates in an adult population. Presented at: NFID Annual Conference on Vaccinology Research; April 26-27, 2021 (virtual meeting).
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