Pneumococcal vaccination coverages among low-, intermediate-, and high-risk adults in Catalonia

ABSTRACT

There is scarce data about pneumococcal vaccination coverages among adults in recent years. We investigated current pneumococcal vaccination coverages in Catalonia, Spain, with a cross-sectional population-based study including 2,033,465 individuals aged 50 y or older assigned to the Catalonian Health Institute at 01/01/2015 (date of survey). A previously validated institutional research clinical Database was used to classify study subjects by their vaccination status for both 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13), to identify comorbidities and underlying conditions, and establish the risk stratum of each individual: High risk stratum: functional or anatomic asplenia, cochlear implants, CSF leaks, or immunocompromising conditions; medium risk stratum: immunocompetent persons with history of chronic cardiac or respiratory disease, liver disease, diabetes mellitus, alcoholism and/or smoking; low risk stratum: persons without high or medium risk conditions. Of the total 2,033,465 study population, an amount of 789,098 (38.8%) had received PPVS23, whereas 5031 (0.2%) had received PCV13. PPSV23 coverages increased largely with increasing age: 4.8% in 50–59 y vs 35.5% in 60–69 y vs 71.9% in 70–79 y vs 79.5% in 80 y or older; p < 0.001). PCV13 coverages also increased with age, although they were very low in all age groups. PPSV23 coverages were 59.2% in high risk stratum, 48.3% in medium risk stratum and 28.1% in low risk stratum (p < 0.001). For the PCV13, uptakes were 1.2%, 0.3% and 0.1% in high, medium and low stratum, respectively (p < 0.001). In conclusion, pneumococcal vaccination coverages in Catalonian adults are not optimal, being especially small for the PCV13 (even in high-risk subjects).

KEYWORDS:

• adults
• coverage
• pneumococcal conjugate vaccine
• pneumococcal polysaccharide vaccine
• pneumococcal vaccination

Disclosure of potential conflicts of interest

No potential conflicts of interest were disclosed.

Funding

This work is supported, in part, by a grant from the “Fondo de Investigación Sanitaria” (FIS) of the ”Instituto de Salud Carlos III” (call 2015) for the “Acción Estratégica en Salud 2013–2016 del Programa Estatal de Investigación Orientado a los Retos de la Sociedad,” framing in the “Plan Estatal de Investigación Científica y Técnica y de Innovación 2013–2016;” code file PI15/01230, cofinanced by the European Union through the “Fondo Europeo de Desarrollo Regional” (FEDER). This work is also funded by a grant from the IDIAP Jordi Gol, Barcelona (grant SIDIAP 13/049). The authors thank Angel Vila-Rovira for his help in the production of this paper..