Sacco Patricia, Myers Kelley, Poulos Christine, Sweeney Carolyn, Hollis Kelly, Snow Vincenza, Vietri Jeffrey T
RTI Health Solutions, Research Triangle Park, NC, USA.
Pfizer, Inc., New York, NY, USA.
Infect Dis Ther. 2019 Dec;8(4):657-670. doi: 10.1007/s40121-019-00266-5. Epub 2019 Sep 23.
In 2014, the Advisory Committee on Immunization Practices (ACIP) of the US Centers for Disease Control and Prevention (CDC) recommended 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) for all adults aged ≥ 65 years, with a commitment to revisit the recommendation for PCV13 because of declining vaccine-type disease. The Evidence-to-Recommendation framework used by the ACIP includes review of evidence regarding feasibility and stakeholder acceptability, but no surveys of vaccinator preferences have been published in the literature.
Physicians (N = 700), physician assistants (N = 100), pharmacists (N = 100), and nurse practitioners (N = 100) who recently prescribed, administered, or recommended adult pneumococcal vaccine were surveyed in March 2018. Object-case best-worst scaling was used to assess preferences among potential recommendation scenarios: retaining the then-current 2014 recommendation without a scheduled re-evaluation, retaining with a scheduled re-evaluation, revising PCV13 to Category B (retaining PPSV23 as Category A), removing PCV13 (retaining PPSV23 as Category A), and removing both PCV13 and PPSV23.
Providers' most preferred recommendations were retaining the 2014 recommendation with another planned re-evaluation (52.6%) and retaining the then-current recommendation without planned re-evaluation (40.0%). Few preferred changing PCV13 to Category B (3.2%), removing PCV13 (3.7%), or removing both pneumococcal vaccines (0.5%).
The majority of vaccinators surveyed preferred to retain the 2014 recommendation, either with another scheduled reassessment or indefinitely.
Pfizer, Inc.
2014年，美国疾病控制与预防中心（CDC）的免疫实践咨询委员会（ACIP）建议，所有65岁及以上成年人先接种13价肺炎球菌结合疫苗（PCV13），随后接种23价肺炎球菌多糖疫苗（PPSV23），并承诺因疫苗型疾病发病率下降而重新审视PCV13的推荐建议。ACIP使用的证据到推荐框架包括对可行性和利益相关者可接受性证据的审查，但文献中尚未发表关于接种者偏好的调查。
2018年3月，对近期开具、接种或推荐成人肺炎球菌疫苗的医生（N = 700）、医师助理（N = 100）、药剂师（N = 100）和执业护士（N = 100）进行了调查。采用对象案例最佳-最差尺度法评估潜在推荐方案中的偏好：保留当时现行的2014年推荐建议且不进行定期重新评估、保留并进行定期重新评估、将PCV13修订为B类（保留PPSV23为A类）、去除PCV13（保留PPSV23为A类）以及同时去除PCV13和PPSV23。
提供者最喜欢的推荐建议是保留2014年推荐建议并进行另一轮计划中的重新评估（52.6%）以及保留当时现行的推荐建议且不进行计划中的重新评估（40.0%）。很少有人倾向于将PCV13改为B类（3.2%）、去除PCV13（3.7%）或同时去除两种肺炎球菌疫苗（0.5%）。
大多数接受调查的接种者倾向于保留2014年推荐建议，要么进行另一轮定期重新评估，要么无限期保留。
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