Related Experiment Video
Updated: Jul 7, 2025
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Pneumococcal Polysaccharide Vaccination (PPSV23) in High-Risk Pediatric Patients With Diabetes
Kelsey Mueller1, Jason Koury1, Preeyaporn Sarangarm1
1Department of Pharmacy, University of New Mexico Hospitals, Albuquerque, NM (KM, JK, PS, RCH, ES).
Insights
Pneumococcal polysaccharide vaccine (PPSV23) uptake was low in high-risk diabetic children, with many missed vaccination opportunities. This highlights a gap in adherence to recommendations for preventing pneumococcal infections in this vulnerable pediatric population.
Area of Science:
- Pediatric Endocrinology
- Immunology
- Public Health
Background:
- The Advisory Committee on Immunization Practices recommends pneumococcal polysaccharide vaccine (PPSV23) after pneumococcal conjugate vaccine (PCV13) for high-risk pediatric patients aged 2-18 years.
- PPSV23 is not routinely recommended for all children, and adherence to recommendations for high-risk groups can be inconsistent.
- Children with type 1 or type 2 diabetes are considered high-risk for pneumococcal infections.
Purpose of the Study:
- To determine the vaccination rates of PPSV23 in high-risk pediatric patients diagnosed with type 1 or type 2 diabetes.
- To identify missed opportunities for PPSV23 vaccination in this population.
- To assess the incidence of invasive pneumococcal infections in relation to vaccination status.
Main Methods:
- A single-center retrospective cohort study was conducted.
- Patients aged 2-18 years with a diabetes diagnosis and at least one healthcare encounter in 2019 were included.
- Primary outcome was PPSV23 vaccination rates; secondary outcomes included missed vaccination opportunities and invasive pneumococcal infection incidence.
Main Results:
- A total of 366 patients were included, with a mean age of 13.3 years; 69.8% were white.
- Only 32 patients (8.7%) had documented PPSV23 vaccination.
- 32 cases of pneumonia were recorded before PPSV23 vaccination, and one case after.
Conclusions:
- PPSV23 vaccination rates were notably low in the studied high-risk diabetic pediatric population.
- Numerous missed opportunities for PPSV23 vaccination were identified.
- The low uptake may stem from PPSV23 not being a universally recommended vaccine for all pediatric patients.
Objective:
The Advisory Committee on Immunization Practices recommends the pneumococcal polysaccharide vaccine (PPSV23) following the pneumococcal conjugate vaccine (PCV13) for pediatric patients aged 2 to 18 years with high-risk medical conditions. The PPSV23 is not a routine immunization for all pediatric patients and children who meet criteria for high-risk conditions may not consistently receive the PPSV23 vaccine, despite current recommendations. The goal of this study was to determine PPSV23 -vaccination rates in the high-risk pediatric patients with type 1 or type 2 diabetes.
Methods:
A single-center retrospective cohort study was conducted. Patients were included if they were 2 to 18 years of age on January 1, 2019, with a diagnosis of diabetes, and had ≥1 encounters within the health care system in 2019. The primary outcome was PPSV23 vaccination rates in the high-risk diabetic pediatric population. Secondary outcomes included identifying missed opportunities for vaccinations and the incidence of invasive pneumococcal infections.
Results:
A total of 366 patients met criteria for study inclusion. Patients had a mean age of 13.3 years and were predominantly white (69.8%). A total of 32 (8.7%) patients had documentation of PPSV23 vaccination. Baseline characteristics were comparable between the two groups. There were 32 cases of pneumonia charted before patients received the PPSV23 and one case reported after patients received the PPSV23 vaccination.
Conclusions:
PPSV23 vaccination rates were low in this high-risk diabetic pediatric group, with many -documented missed opportunities for vaccination. This may be attributed to the vaccine not being a -routinely recommended for all pediatric patients.
Related Concept Videos
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....