The incidence of lower respiratory tract infections and pneumococcal vaccination status in adults in flemish primary care

ABSTRACT

Pneumococcal vaccination coverage of adults at risk for pneumococcal disease is below recommended levels. There is no observational data on pneumococcal vaccination and the incidence of lower respiratory tract infections in a general adult population. The current study had the objective to explore the incidence of lower respiratory tract infections and the pneumococcal vaccine coverage in function of age, influenza vaccination status and risk status, in Flanders, Belgium. We used data from Intego, ageneral practice-based morbidity registration network in Flanders (Belgium). We gathered data on pneumococcal vaccinations, influenza vaccination (in 2014) and ICPC2-coded diagnoses of pneumonia and acute bronchitis (2015). First, we divided the population into three groups along the risk status for developing apneumococcal infection according to the recommendations for pneumococcal vaccination in adults by the Belgian High Council of Health. 28.6% from our total adult study population are considered the target group for vaccination. Second, we found that the average pneumococcal vaccination coverage in this targeted population was 18.7%. Third, we found asignificantly higher incidence of LRTI in patients previously vaccinated against pneumococcal disease and/or influenza across the majority of subgroups. Pneumococcal vaccination coverage in Flanders is quantitatively low but observed to be qualitatively high in terms of reaching the most at risk population. Our findings are likely to be highly relevant to addressing future vaccination strategies in Flanders.

KEYWORDS:

• Lower respiratory tract infections
• pneumonia
• bronchitis
• pneumococcal vaccination

Availability of data

Intego has no permission form the ethical review board to publish the full database.

Consent for publication

Patients are well informed about Intego through posters in the waiting room of the GP’s. They do not sign an informed consent but can use the opt-out option that is incorporated in the EHR of the GP. Data are pseudonymised and by no means have researchers access to names or contact details of the patients.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics approval and consent to participate

Data were collected from the computers of the participating GPs by a trusted third party. The scientific and ethical review board assesses whether the questions are ethically correct (Ethics Board) and scientifically sound (Scientific Board). They have an advisory function, comparable to a Data Safety Monitoring Board in clinical trials. By this, our procedures are compliant with the law confirmed by decision n° 13.026 of March 19th, 2013 of the Sectoral Committee of Social Security and Health (www.privacycommission.be). The Intego procedures were approved by the ethical review board of the Medical School of the Catholic University of Leuven (no ML 1723).

Authors’ Contributions

BVB, GVP and CM conceived the study idea, SH was responsible for statistical analyses, TDB and BV took the lead in writing the manuscript. All authors discussed the results and contributed to the final manuscript.

Additional information

Funding

The Intego team was funded by the Flemish Agency ‘Zorg en Gezondheid’. TDB and CM received funding from Pfizer, Belgium.