Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
PLoS One. 2022 Oct 14;17(10):e0275923. doi: 10.1371/journal.pone.0275923. eCollection 2022.
In Canada, pneumococcal vaccination is recommended to all adults aged ≥65 and those <65 who have one or more chronic medical conditions (CMCs). Understanding vaccine uptake and its determinants among eligible groups has important implications for reducing the burden of pneumococcal disease.
Using data from a large national cohort of Canadian residents aged ≥47 years between 2015-2018, we calculated self-reported pneumococcal vaccine uptake among eligible groups, estimated associations between key factors and non-vaccination, assessed missed opportunities for vaccination (MOV) and examined risk factors for MOV. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for relevant associations were estimated through logistic regression.
45.8% (95% CI: 45.2-46.5) of 22,246 participants aged ≥65 and 81.3% (95% CI: 80.5-82.0) of 10,815 individuals aged 47-64 with ≥1 CMC reported never having received a pneumococcal vaccine. Receipt of influenza vaccination in the previous year was associated with the lowest odds of pneumococcal non-vaccination (aOR = 0.14 [95% CI: 0.13-0.15] for older adults and aOR = 0.23 [95% CI: 0.20-0.26] for those aged 47-64 with ≥1 CMC). Pneumococcal vaccine uptake was also more likely in case of contact with a family doctor in the previous year (versus no contact), increased with age and varied widely across provinces. Among individuals recently vaccinated against influenza, 32.6% (95% CI: 31.9-33.4) of those aged ≥65 and 71.1% (95% CI: 69.9-72.3) of those aged 47-64 with ≥1 CMC missed an opportunity to get a pneumococcal vaccine. Among individuals who had contact with a family doctor, 44.8% (95% CI: 44.1-45.5) of those aged ≥65 and 80.4% (95% CI: 79.6-81.2) of those aged 47-64 with ≥1 CMC experienced a MOV.
Pneumococcal vaccine uptake remains suboptimal among at-risk Canadian adults who are eligible for vaccination. Further research is needed to clarify the reasons behind missed opportunities for vaccination and adequately address the main barriers to pneumococcal vaccination.
在加拿大，建议所有 65 岁及以上的老年人和 65 岁以下患有一种或多种慢性疾病（CMCs）的人接种肺炎球菌疫苗。了解合格人群中疫苗接种率及其决定因素对于降低肺炎球菌疾病负担具有重要意义。
使用 2015-2018 年期间年龄在 47 岁及以上的加拿大居民的大型全国队列数据，我们计算了合格人群中自我报告的肺炎球菌疫苗接种率，估计了关键因素与未接种疫苗之间的关联，评估了错失接种机会（MOV）的情况，并检查了 MOV 的危险因素。通过逻辑回归估计了相关关联的调整后优势比（aOR）和 95%置信区间（CI）。
45.8%（95%CI：45.2-46.5）的 22246 名 65 岁及以上的参与者和 81.3%（95%CI：80.5-82.0）的 10815 名患有≥1 种 CMC 的 47-64 岁的个体报告从未接种过肺炎球菌疫苗。去年接种流感疫苗与肺炎球菌非接种的可能性最低相关（对于老年人，aOR=0.14[95%CI：0.13-0.15]；对于患有≥1 种 CMC 的 47-64 岁的个体，aOR=0.23[95%CI：0.20-0.26]）。在过去一年中与家庭医生有过接触的人也更有可能接种肺炎球菌疫苗（与没有接触相比），随着年龄的增长，疫苗接种率也有所提高，并且在各省之间差异很大。在最近接种流感疫苗的人群中，32.6%（95%CI：31.9-33.4）的 65 岁及以上的人和 71.1%（95%CI：69.9-72.3）的患有≥1 种 CMC 的人错过了接种肺炎球菌疫苗的机会。在与家庭医生有过接触的人群中，44.8%（95%CI：44.1-45.5）的 65 岁及以上的人和 80.4%（95%CI：79.6-81.2）的患有≥1 种 CMC 的人经历了错失接种机会。
在有资格接种疫苗的加拿大高危成年人中，肺炎球菌疫苗接种率仍然不理想。需要进一步研究以阐明错失接种机会的原因，并充分解决肺炎球菌疫苗接种的主要障碍。
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