A Japanese nationwide survey of 23-valent pneumococcal capsular polysaccharide vaccine (PPSV23) coverage among patients with chronic medical condition aged 50 and older

Figures & data

Table 1. Demographics and Health Characteristics of Japanese aged 50+ respondents with CMCs who vaccinated and unvaccinated the PPSV23 (n = 3,232).

	50–59 (CMC+)					60–64 (CMC+)					65+ (CMC+)
	PPSV23 Vaccinated		PPSV23 Unvaccinated			PPSV23 Vaccinated		PPSV23 Unvaccinated			PPSV23 Vaccinated		PPSV23 Unvaccinated
	13	(%)	969	(%)	p value	36	(%)	1200	(%)	p value	383	(%)	631	(%)	p value
Female	3	(23.1)	429	(44.3)	0.1262	21	(58.3)	549	(45.8)	0.1356	186	(48.6)	284	(45.0)	0.2709
Regularly Consume Alcohol	11	(84.6)	340	(35.1)	0.0002	9	(25.0)	467	(38.9)	0.0909	99	(25.8)	218	(34.5)	0.0038
Regularly Smoking	8	(61.5)	231	(23.8)	0.0017	7	(19.4)	245	(20.4)	0.8866	20	(5.2)	71	(11.3)	0.0011
Exercise	9	(69.2)	228	(23.5)	0.0001	19	(52.8)	406	(33.8)	0.0184	186	(48.6)	294	(46.6)	0.5422
BMI <20	3	(23.1)	143	(14.8)	0.4023	10	(27.8)	197	(16.4)	0.0721	68	(17.8)	91	(14.4)	0.157
History of pneumonia over aged 50	3	(23.1)	46	(4.7)	0.0026	12	(33.3)	70	(5.8)	<0.0001	42	(11.0)	37	(5.9)	0.0033
Flu vaccinated	12	(92.3)	292	(30.1)	<0.0001	20	(55.6)	397	(33.1)	<0.0001	241	(62.9)	248	(39.3)	<0.0001

^※CMC+:Chronic medical conditions, visiting hospital or clinic for treatment of following diseases: Chronic heart disease, Chronic lung disease, Diabetes mellitus, Chronic liver disease, Chronic renal disease, Cancer, etc.

^※Regularly Consume Alcohol: Drinking two and more cup of sake every day, The one cup of sake (180 ml) is almost equivalent to the following amount. One bottle of beer (5% of alcohol, 500 ml), 0.6 cup of shochu (25% of alcohol, 110 ml), 1/4 bottle of wine (14% of alcohol, 180 ml), One cup of whiskey (43% of alcohol, 60 ml), 1.5 canned beer (5% of alcohol, 520 ml)

^※Regularly Smoking: Smoking every day or occasionally

^※Exercise: To exercise more than 30 minutes per time twice a week and it has been continuing for more than 1 year

^※Flu vaccinated: 2017, 2018 vaccinated

^※p value: Calculated by Chi-squared test, Statistical significance was set at p < 0.05 (2-tailed)

Figure 1. Coverage rate of PPSV23 among those having CMCs in each age group (n = 3,232). CMC+: Chronic medical conditions, visiting hospital or clinic for treatment of following diseases: Chronic heart disease, Chronic lung disease, Diabetes mellitus, Chronic liver disease, Chronic renal disease, Cancer, etc.

Figure 2. Coverage rate of PPSV23 among each CMC groups and no-CMC group in aged 65+ (n = 1,712). CMC: Chronic medical conditions, visiting hospital or clinic for treatment of following diseases: Chronic heart disease, Diabetes mellitus, Cancer, Chronic lung disease, Chronic liver disease, Chronic renal disease.

Table 2. Factors associated with PPSV23 vaccination who those having CMCs in aged 65+.

	65+
	Unadjusted OR	95% CI	p value	Adjusted OR	95% CI	p value
Sex (Ref male)	0.87	0.67–1.12	0.299
Regularly Consume Alcohol	0.66	0.50–0.88	0.004	0.63	0.45–0.88	0.006
Regularly Smoking	0.44	0.26–0.73	0.001	0.56	0.32–1.00	0.048
Exercise	1.08	0.84–1.4	0.560
BMI<20 (Ref BMI ≥20)	1.28	0.91–1.81	0.181
History of pneumonia over aged 50	1.98	1.25–3.14	0.005
Flu vaccinated	2.62	2.02–3.41	<0.001	1.98	1.47–2.67	<0.001
Recommendation by doctor	6.16	4.51–8.4	<0.001	4.09	2.93–5.72	<0.001
Municipal government subsidies and notification	6.52	4.80–8.86	<0.001	5.47	3.95–7.58	<0.001
Chronic heart disease	0.86	0.66–1.12	0.279
Chronic lung disease	1.68	1.08–2.63	0.026	1.56	0.94–2.61	0.086
Chronic renal disease	0.75	0.26–2.16	0.796
Diabetes Mellitus	0.98	0.70–1.36	0.933
Chronic liver disease	1.67	0.72–3.88	0.268
Cancer	0.79	0.50–1.26	0.359

^※Adjusted OR: Factors identified as significantly associated with PPSV23 vaccination were further explored using multivariate logistic regression, with model selection using the stepwise method (α = 0.2), and adjusted OR calculated accordingly

^※OR: Odds ratio.

Table 3. Factors associated with PPSV23 vaccination who those having CMCs in aged 50–59 and 60–64.

	50–59						60–64
	Unadjusted OR	95% CI	p value	Adjusted OR	95% CI	p value	Unadjusted OR	95% CI	p value	Adjusted OR	95% CI	p value
Sex (Ref male)	2.65	0.72–9.68	0.163				0.60	0.31–1.18	0.174
Regularly Consume Alcohol	10.18	2.24–46.17	<0.001	3.67	0.98–13.82	0.054	0.52	0.24–1.12	0.117
Regularly Smoking	5.11	1.66–15.78	0.004				0.94	0.41–2.17	1.000
Exercise	7.31	2.23–23.97	0.001				2.19	1.12–4.25	0.021	1.97	0.89–4.38	0.095
BMI <20 (Ref BMI ≥20)	1.73	0.47–6.37	0.424				1.96	0.93–4.13	0.108
History of pneumonia over aged 50	6.02	1.60–22.62	0.023	5.65	1.08–29.62	0.041	8.07	3.88–16.81	<0.001	2.61	0.89–7.67	0.081
Flu vaccinated	27.82	3.60–214.96	<0.001	4.85	1.22–19.33	0.025	2.53	1.30–4.93	0.007
Recommendation by doctor	642.67	134.90–3061.67	<0.001	126.68	29.99–535.08	<0.001	68.79	28.10–168.38	<0.001	23.48	7.18–76.78	<0.001
Municipal government subsidies and notification	85.69	19.71–372.51	<0.001				30.93	13.79–69.36	<0.001	20.56	8.88–47.62	<0.001
Chronic heart disease	1.26	0.42–3.77	0.783				0.83	0.43–1.61	0.613
Chronic lung disease	2.17	0.47–9.96	0.271				1.19	0.36–3.97	0.738
Chronic renal disease	2.91	0.37–23.17	0.315				4.98	1.09–22.79	0.077	4.45	0.58–33.98	0.150
Diabetes Mellitus	1.92	0.59–6.31	0.284				0.71	0.28–1.86	0.662
Chronic liver disease	6.11	1.29– 28.87	0.057	7.13	0.86–59.13	0.069	1.96	0.45–8.48	0.293
Cancer	1.44	0.18–11.29	0.523				0.38	0.05–2.81	0.508

^※Adjusted OR: Factors identified as significantly associated with PPSV23 vaccination were further explored using multivariate logistic regression, with model selection using the stepwise method (α = 0.2), and adjusted OR calculated accordingly.

^※OR: Odds ratio.

Figure 3. Recommendation of Pneumococcal vaccination to aged 50–64 and 65+ with CMC (Doctor: n = 399). CMC: Chronic medical conditions, visiting hospital or clinic for treatment of following diseases: Chronic heart disease, Chronic lung disease, Diabetes mellitus, Chronic liver disease, Chronic renal disease, Cancer, etc.