Department of Health Management and Policy, University of Michigan, United States.
Department of Health Management and Policy, University of Michigan, United States.
Vaccine. 2021 Feb 22;39(8):1333-1338. doi: 10.1016/j.vaccine.2020.11.060. Epub 2021 Jan 23.
The 23-valent pneumococcal polysaccharide vaccine is routinely recommended for adults with diabetes, but little is known about adherence to this recommendation and how vaccination of these adults affects costs related to pneumococcal disease.
We used data from a commercial insurance claims dataset to examine a cohort of non-elderly adults with a new diagnosis of diabetes and adults with no diagnosis of diabetes from 2005 to 2014. We examined rates of pneumococcal polysaccharide vaccination and the relationship between vaccination and pneumococcal disease costs, comparing results for persons with a diagnosis of diabetes and those with no diagnosis of diabetes.
Overall rates of pneumococcal polysaccharide vaccination among adults 30-60 years old were <1%/year. Rates of pneumococcal polysaccharide vaccination were higher for adults with diabetes. Pneumococcal polysaccharide vaccination rates more than doubled from 2.9% per year in 2005 to 6.0% per year in 2014 for adults vaccinated during the same year as their diabetes diagnosis. Using a two-part differences-in-differences model on a propensity-score matched dataset, pneumococcal polysaccharide vaccination may reduce average annual per-person pneumococcal disease costs by $90.54 [95% CI: $183.59, -$2.49, (p = 0.056)] in persons with diabetes from two years before to two years after vaccination.
Non-elderly adults with diabetes have low but rising rates of pneumococcal polysaccharide vaccination. Pneumococcal polysaccharide vaccination has a modest impact reducing overall costs of pneumococcal disease in this population.
23 价肺炎球菌多糖疫苗常用于糖尿病成人，但人们对该建议的遵从性知之甚少，也不知道这些成人接种疫苗如何影响与肺炎球菌病相关的成本。
我们使用商业保险索赔数据集的数据，研究了 2005 年至 2014 年期间患有新发糖尿病的非老年成年患者和无糖尿病诊断的成年患者队列。我们检查了肺炎球菌多糖疫苗接种率以及疫苗接种与肺炎球菌病成本之间的关系，比较了有糖尿病诊断和无糖尿病诊断的患者的结果。
30-60 岁成人肺炎球菌多糖疫苗接种总体率<1%/年。糖尿病患者的肺炎球菌多糖疫苗接种率更高。对于在诊断糖尿病的同一年接种疫苗的成年人，肺炎球菌多糖疫苗接种率从 2005 年的每年 2.9%增加到 2014 年的每年 6.0%，增加了两倍多。使用倾向评分匹配数据集的两部分差分差异模型，肺炎球菌多糖疫苗接种可能会使糖尿病患者在接种疫苗前两年到后两年的人均年度肺炎球菌病成本平均降低 90.54 美元[95%CI：183.59，-2.49，（p=0.056）]。
非老年糖尿病成年患者的肺炎球菌多糖疫苗接种率较低，但呈上升趋势。肺炎球菌多糖疫苗接种对降低该人群肺炎球菌病的总体成本具有适度影响。
