Improving Pneumococcal Vaccination in Pediatric Rheumatology Patients

Area of Science:

• Pediatric Rheumatology
• Infectious Disease Prevention
• Immunization Quality Improvement

Background:

• Pediatric rheumatology patients are immunocompromised, increasing their risk of pneumococcal disease.
• Immunosuppressive medications further elevate this risk.
• Low pneumococcal vaccination rates are a concern in this high-risk group.

Purpose of the Study:

• To enhance pneumococcal vaccination rates among pediatric rheumatology patients.
• To implement a quality improvement initiative targeting immunization in a vulnerable population.

Main Methods:

• Interventions included provider education, an immunization algorithm, previsit planning, and electronic reminders.
• Chart reviews and control charts were used to track immunization rates.
• The study included patients aged 2+ with systemic lupus erythematosus and/or on immunosuppressive medication.

Main Results:

• Significant increases in vaccination rates were observed post-intervention.
• 13-valent pneumococcal conjugate vaccine (PCV13) rates rose from 6.7% to 48.4%.
• 23-valent pneumococcal polysaccharide vaccine (PPSV23) rates increased from 8.9% to 28.4%, with combined rates rising from 0% to 23.2%.

Conclusions:

• Pneumococcal vaccination is crucial for systemic lupus erythematosus patients and those on immunosuppressants.
• Simple quality improvement interventions effectively increased vaccination rates.
• The observed improvements in pneumococcal immunization were sustained in this vulnerable patient group.