Averin Ahuva, Vietri Jeffrey, Mohs Adriano Arguedas, Willis Sarah J, Lonshteyn Alexander, Weycker Derek
Avalere Health, Washington, District of Columbia.
Pfizer, Inc., Collegeville, Pennsylvania.
AJPM Focus. 2025 Jun 25;4(5):100384. doi: 10.1016/j.focus.2025.100384. eCollection 2025 Oct.
Updated recommendations for adult pneumococcal vaccination in the U.S. (publication date: January 27, 2022) incorporated 2 new vaccines (15- and 20-valent pneumococcal conjugate vaccines), removed 13-valent pneumococcal conjugate vaccine, and called for pneumococcal conjugate vaccine use among immunocompetent adults aged 19-64 years with certain medical conditions. This study assessed uptake of recommendations and disparities in uptake across subgroups of adults.
A retrospective cohort design and data from Optum's deidentified Clinformatics Data Mart Database were employed. Study population comprised all adults aged ≥65 years and adults aged 19-64 years with ≥1 chronic (at-risk) or immunocompromising (high-risk) condition. Vaccine uptake (including 23-valent pneumococcal polysaccharide vaccine) was estimated using the Kaplan-Meier method.
During 21-month follow-up period, 13.2% of adults (=6.8 million) received pneumococcal vaccine, mostly 20-valent pneumococcal conjugate vaccine (9.6%). By age/risk conditions, 20-valent pneumococcal conjugate vaccine uptake was highest among adults aged 65-66 years (23.8%) and at-risk/high-risk adults aged 60-64 years (12.1%) and lowest among at-risk/high-risk adults aged 19-49 years (4.7%). By immunization history, 20-valent pneumococcal conjugate vaccine uptake was highest among adults with a history of 23-valent pneumococcal polysaccharide vaccine uptake only (15.1%) or 13-valent pneumococcal conjugate vaccine uptake only (10.6%) and lowest among those without prior pneumococcal vaccination (8.7%) or with a history of 13-valent pneumococcal conjugate vaccine + 23-valent pneumococcal polysaccharide vaccine uptake (7.9%).
Fewer than ∼1 in 7 U.S. adults received 20-valent pneumococcal conjugate vaccine in the first 21 months after the updated recommendations. Uptake was lower among at-risk/high-risk adults aged <60 years, adults aged ≥75 years, and adults without prior pneumococcal vaccination. Routine evaluation of vaccination status by providers and additional strategies to increase uptake of recommend vaccines are warranted.
美国成人肺炎球菌疫苗接种的最新建议（发布日期：2022年1月27日）纳入了2种新疫苗（15价和20价肺炎球菌结合疫苗），取消了13价肺炎球菌结合疫苗，并呼吁在患有某些疾病的19至64岁免疫功能正常的成年人中使用肺炎球菌结合疫苗。本研究评估了这些建议的采纳情况以及不同成年亚组在采纳率上的差异。
采用回顾性队列设计和来自Optum的去识别化临床信息数据集市数据库的数据。研究人群包括所有65岁及以上的成年人以及患有≥1种慢性（风险）或免疫功能低下（高风险）疾病的19至64岁成年人。使用Kaplan-Meier方法估计疫苗接种率（包括23价肺炎球菌多糖疫苗）。
在21个月的随访期内，13.2%的成年人（=680万）接种了肺炎球菌疫苗，主要是20价肺炎球菌结合疫苗（9.6%）。按年龄/风险状况划分，20价肺炎球菌结合疫苗接种率在65至66岁的成年人中最高（23.8%），在60至64岁的有风险/高风险成年人中为12.1%，在19至49岁的有风险/高风险成年人中最低（4.7%）。按免疫接种史划分，20价肺炎球菌结合疫苗接种率在仅接种过23价肺炎球菌多糖疫苗的成年人中最高（15.1%）或仅接种过13价肺炎球菌结合疫苗的成年人中为10.6%，在未接种过肺炎球菌疫苗的成年人中最低（8.7%），或在有13价肺炎球菌结合疫苗 + 23价肺炎球菌多糖疫苗接种史的成年人中为7.9%。
在美国最新建议发布后的前21个月内，每7名成年人中接受20价肺炎球菌结合疫苗接种的不到1人。在年龄小于60岁的有风险/高风险成年人、75岁及以上的成年人以及未接种过肺炎球菌疫苗的成年人中，接种率较低。医疗服务提供者对接种状况进行常规评估以及采取其他策略以提高推荐疫苗的接种率是必要的。
