Center for Observational and Real-World Evidence, Merck & Co., Inc., Rahway, NJ, USA.
Merck & Co., Inc., Rahway, NJ, USA.
Hum Vaccin Immunother. 2023 Dec 31;19(1):2194779. doi: 10.1080/21645515.2023.2194779.
The Centers for Disease Control recommends pneumococcal vaccination for U.S. adults aged 19-64 years with chronic or immunocompromising conditions, however, vaccination coverage is low and regional variations in coverage are rarely studied. This study examined pneumococcal vaccination coverage at the metropolitan statistical area (MSAs) level and identified regional factors associated with pneumococcal vaccination using the combined IBM® Watson Health MarketScan® Commercial and Medicare Supplemental databases. Pneumococcal vaccination coverage, clinical and socioeconomic factors were calculated for each MSA. Ordinary least square and spatial regression models were used to examine factors associated with vaccination. Results indicated that the national pneumococcal vaccination coverage was 13.4% with a large variation across MSAs (0-34%). The spatial error model, model with the best fit, showed that proportions of the population who were ≥50 years of age, received an influenza vaccine, or had health maintenance organization health plans were positively associated with pneumococcal vaccination coverage. In summary, we found that national pneumococcal vaccination coverage was low and there was substantial variation across MSAs. Regional factors identified may help inform interventions to improve pneumococcal vaccination coverage across geographies.
美国疾病控制与预防中心建议对患有慢性或免疫功能低下疾病的 19-64 岁美国成年人进行肺炎球菌疫苗接种，然而，疫苗接种率较低，且区域覆盖率差异很少得到研究。本研究使用 IBM Watson Health MarketScan 商业和 Medicare 补充数据库，在都市区（MSA）层面上检查肺炎球菌疫苗接种覆盖率，并确定与肺炎球菌疫苗接种相关的区域因素。为每个 MSA 计算了肺炎球菌疫苗接种覆盖率、临床和社会经济因素。使用普通最小二乘法和空间回归模型来检验与接种相关的因素。结果表明，全国肺炎球菌疫苗接种覆盖率为 13.4%，MSA 之间差异很大（0-34%）。具有最佳拟合度的空间误差模型表明，≥50 岁的人口比例、接种流感疫苗的比例或拥有健康维护组织健康计划的比例与肺炎球菌疫苗接种覆盖率呈正相关。总之，我们发现全国肺炎球菌疫苗接种覆盖率较低，MSA 之间差异较大。确定的区域因素可能有助于为改善各地理区域的肺炎球菌疫苗接种覆盖率提供信息。
