Odysseus Data Services, Inc., 245 First St, Cambridge, MA, USA.
Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ 07033 USA.
Vaccine. 2022 Aug 5;40(33):4856-4863. doi: 10.1016/j.vaccine.2022.06.068. Epub 2022 Jul 6.
The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommends pneumococcal vaccination for adults with chronic or immunocompromising conditions to prevent pneumococcal disease, yet vaccination rates are low and have limited information on regional variation. This study examines factors associated with pneumococcal vaccination in adults with underlying conditions and describes regional variation in vaccination across the U.S.
Using IBM MarketScan Commercial Database and Medicare Supplemental Database, this retrospective cohort study included adults ages 19-64 newly diagnosed with chronic (i.e. diabetes, chronic heart, lung, or liver disease, alcohol or tobacco dependence) or immunocompromising (i.e. cancer, chronic renal disease, organ transplant, HIV/AIDS, and asplenia) conditions in 2013. Adults were followed up until the time of pneumococcal vaccination, death, or December 31, 2019, whichever came first. Cox proportional hazards model was used to examine factors associated with vaccination. Vaccination rate was calculated by metropolitan statistical area (MSA) and visually represented on a U.S. map.
255,330 adults were included. Vaccination rate increased from 6.0% to 21.1% among adults with one year and five years of follow-up, respectively. It took 2.4 years on average for adults to receive vaccination after initial diagnosis. Adults ages 50-64, 35-49 (relative to 19-34) or receiving influenza vaccination were more likely to receive pneumococcal vaccinations. Adults with HIV/AIDS were more likely and those with other conditions were less likely to be vaccinated than those with diabetes. Adults being diagnosed by other providers were less likely to be vaccinated than those diagnosed by primary care providers. Vaccination rate varied largely across MSAs, ranging from 0.0% (Ames, IA; Cheyenne, WY) to 34.0% (Ann Arbor, MI).
Pneumococcal vaccination remains low and most adults with underlying conditions are unvaccinated. Insights into factors associated with vaccination, including regional variability, can help to increase pneumococcal vaccination.
美国疾病控制与预防中心免疫实践咨询委员会建议对患有慢性或免疫功能低下疾病的成年人进行肺炎球菌疫苗接种，以预防肺炎球菌病，但疫苗接种率仍然较低，并且关于区域差异的信息有限。本研究检查了与潜在疾病成年人肺炎球菌疫苗接种相关的因素，并描述了美国各地疫苗接种的区域差异。
本回顾性队列研究使用 IBM MarketScan 商业数据库和 Medicare 补充数据库，纳入了 2013 年新诊断患有慢性（如糖尿病、慢性心脏、肺部或肝脏疾病、酒精或烟草依赖）或免疫功能低下（如癌症、慢性肾病、器官移植、HIV/AIDS 和脾切除）疾病的 19-64 岁成年人。成年人将被随访至肺炎球菌疫苗接种、死亡或 2019 年 12 月 31 日，以先发生者为准。使用 Cox 比例风险模型检查与接种相关的因素。根据都市区（MSA）计算接种率，并在美国地图上直观表示。
共纳入 255330 名成年人。在接受一年和五年随访的成年人中，接种率分别从 6.0%增加到 21.1%。成年人从初次诊断到接种疫苗平均需要 2.4 年。50-64 岁、35-49 岁（相对于 19-34 岁）或接受流感疫苗接种的成年人更有可能接种肺炎球菌疫苗。与患有糖尿病的成年人相比，患有 HIV/AIDS 的成年人更有可能接种疫苗，而患有其他疾病的成年人更不可能接种疫苗。与由初级保健提供者诊断的成年人相比，由其他提供者诊断的成年人更不可能接种疫苗。疫苗接种率在 MSA 之间差异很大，从 0.0%（爱荷华州艾姆斯；怀俄明州夏延）到 34.0%（密歇根州安阿伯）。
肺炎球菌疫苗接种率仍然较低，大多数患有潜在疾病的成年人未接种疫苗。了解与疫苗接种相关的因素，包括区域差异，有助于提高肺炎球菌疫苗接种率。
