Merck & Co, Inc, Rahway, NJ, USA.
Expert Rev Vaccines. 2023 Jan-Dec;22(1):596-607. doi: 10.1080/14760584.2023.2226718.
Adults with chronic or immunocompromising conditions have an elevated risk of invasive pneumococcal disease, yet their pneumococcal vaccination rates remain low.
This retrospective cohort study used the IBM MarketScan® Multi-State Medicaid database to examine pneumococcal vaccination uptake among adults 19-64 years of age with underlying conditions. Gompertz accelerated failure time model was used to examine factors associated with vaccination.
In the study population of 108,159 adults, the vaccination rate was 4.1% after 1 year of follow-up and 19.4% after 10 years. The mean time from initial diagnosis to vaccination was 3.9 years. Adults aged 35-49 and 50-64 years (relative to 19-34) or those receiving an influenza vaccination were more likely to receive a pneumococcal vaccination. Adults with HIV/AIDS were more likely, while adults with chronic heart or lung disease, alcohol or tobacco dependence, or cancer were less likely to be vaccinated than adults with diabetes mellitus. Adults diagnosed by specialists were less likely to be vaccinated than those diagnosed by primary care providers.
The rates of pneumococcal vaccination among adults with Medicaid plans and underlying conditions were well under Healthy People Initiative targets. Insights into factors associated with vaccination can inform efforts to improve vaccination rates among this population.
患有慢性或免疫功能低下疾病的成年人患侵袭性肺炎球菌病的风险较高，但他们的肺炎球菌疫苗接种率仍然很低。
本回顾性队列研究使用 IBM MarketScan®多州医疗补助数据库，调查了患有潜在疾病的 19-64 岁成年人的肺炎球菌疫苗接种情况。采用戈珀特加速失效时间模型来研究与接种相关的因素。
在这项研究的 108159 名成年人中，接种率在随访 1 年后为 4.1%，10 年后为 19.4%。从初次诊断到接种疫苗的平均时间为 3.9 年。与 19-34 岁的成年人相比，35-49 岁和 50-64 岁的成年人（相对于 19-34 岁的成年人）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。患有艾滋病毒/艾滋病的成年人更有可能接种，而患有慢性心脏或肺部疾病、酒精或烟草依赖或癌症的成年人比患有糖尿病的成年人更不可能接种疫苗。由专科医生诊断的成年人比由初级保健提供者诊断的成年人更不可能接种疫苗。
有医疗补助计划和潜在疾病的成年人的肺炎球菌疫苗接种率远低于《健康人民倡议》的目标。了解与接种相关的因素可以为提高这一人群的接种率提供信息。
