Pneumococcal and influenza vaccination levels among HIV-infected adolescents and adults receiving medical care in the United States. Adult and Adolescent Spectrum of HIV Disease Project Group.

OBJECTIVE

To assess pneumococcal and influenza vaccination coverage among HIV-infected adolescents and adults receiving medical care in the United States.

DESIGN

Periodic medical record reviews.

SETTING

More than 90 clinics, hospitals, and private medical practices in nine cities.

PATIENTS

HIV-infected individuals aged > or = 13 years were included in the analyses of pneumococcal (n = 9737) and influenza (n = 6161) vaccination coverage.

MAIN OUTCOME MEASURES

Documentation of receipt of pneumococcal and influenza vaccines in medical records during 6-18-month and 12-month periods, respectively.

RESULTS

Overall, 37 and 33% of individuals received pneumococcal and influenza vaccines, respectively. In general, vaccination levels varied little by age group, race/ethnicity, or mode of HIV exposure. Having had at least five medical visits was significantly associated with having received pneumococcal and influenza vaccines [adjusted odds ratio (OR), 1.7 for each]. Having a CD4+ T-lymphocyte count < 200 x 10(6)/l (adjusted OR, 0.8) and being female (adjusted OR, 0.7) were associated with non-receipt of pneumococcal vaccine. Lower pneumococcal vaccination coverage among women was mostly accounted for by pregnancy.

CONCLUSION

Until new, more effective means of preventing pneumococcal disease and influenza become available, efforts should be directed towards improving vaccination levels among HIV-infected individuals.