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Uptake of Pneumococcal Vaccines Among U.S. Adults After 2022 Update to Recommendations
Ahuva Averin1, Jeffrey Vietri2, Adriano Arguedas Mohs2
1Avalere Health, Washington, District of Columbia.
Insights
Pneumococcal vaccination uptake remains low, with less than 1 in 7 adults receiving the 20-valent pneumococcal conjugate vaccine post-recommendation changes. Lower rates were observed in at-risk adults under 60, older adults, and those unvaccinated previously.
Area of Science:
- Public Health
- Vaccinology
- Epidemiology
Background:
- Updated U.S. adult pneumococcal vaccination guidelines (Jan 2022) introduced new 15- and 20-valent pneumococcal conjugate vaccines (PCV) and recommended PCV for immunocompetent adults aged 19-64 with specific medical conditions.
- The study aimed to evaluate the adoption of these updated recommendations and identify disparities in vaccine uptake across different adult subgroups.
Purpose of the Study:
- To assess the uptake of updated pneumococcal vaccination recommendations in U.S. adults.
- To identify demographic and clinical subgroups with lower vaccine uptake.
- To inform strategies for improving pneumococcal immunization coverage.
Main Methods:
- Retrospective cohort study utilizing deidentified data from Optum's Clinformatics Data Mart Database.
- Included adults aged ≥65 years and adults aged 19-64 with chronic or immunocompromising conditions.
- Vaccine uptake, including 23-valent pneumococcal polysaccharide vaccine (PPSV23), was estimated using the Kaplan-Meier method over a 21-month follow-up period.
Main Results:
- Overall pneumococcal vaccine uptake was 13.2% (n=6.8 million), with 20-valent PCV being the most common (9.6%).
- 20-valent PCV uptake varied by age and risk factors, highest in younger adults (65-66 years) and lowest in younger at-risk adults (19-49 years).
- Uptake was also influenced by prior vaccination history, with lower rates among those unvaccinated or previously receiving both PCV13 and PPSV23.
Conclusions:
- Fewer than 1 in 7 U.S. adults received the 20-valent PCV within 21 months of updated recommendations.
- Uptake was suboptimal in specific groups: at-risk adults <60 years, adults ≥75 years, and those with no prior pneumococcal vaccination.
- Routine provider assessment of vaccination status and targeted strategies are crucial to enhance uptake of recommended pneumococcal vaccines.
Introduction:
Updated recommendations for adult pneumococcal vaccination in the U.S. (publication date: January 27, 2022) incorporated 2 new vaccines (15- and 20-valent pneumococcal conjugate vaccines), removed 13-valent pneumococcal conjugate vaccine, and called for pneumococcal conjugate vaccine use among immunocompetent adults aged 19-64 years with certain medical conditions. This study assessed uptake of recommendations and disparities in uptake across subgroups of adults.
Methods:
A retrospective cohort design and data from Optum's deidentified Clinformatics Data Mart Database were employed. Study population comprised all adults aged ≥65 years and adults aged 19-64 years with ≥1 chronic (at-risk) or immunocompromising (high-risk) condition. Vaccine uptake (including 23-valent pneumococcal polysaccharide vaccine) was estimated using the Kaplan-Meier method.
Results:
During 21-month follow-up period, 13.2% of adults (n=6.8 million) received pneumococcal vaccine, mostly 20-valent pneumococcal conjugate vaccine (9.6%). By age/risk conditions, 20-valent pneumococcal conjugate vaccine uptake was highest among adults aged 65-66 years (23.8%) and at-risk/high-risk adults aged 60-64 years (12.1%) and lowest among at-risk/high-risk adults aged 19-49 years (4.7%). By immunization history, 20-valent pneumococcal conjugate vaccine uptake was highest among adults with a history of 23-valent pneumococcal polysaccharide vaccine uptake only (15.1%) or 13-valent pneumococcal conjugate vaccine uptake only (10.6%) and lowest among those without prior pneumococcal vaccination (8.7%) or with a history of 13-valent pneumococcal conjugate vaccine + 23-valent pneumococcal polysaccharide vaccine uptake (7.9%).
Conclusions:
Fewer than ∼1 in 7 U.S. adults received 20-valent pneumococcal conjugate vaccine in the first 21 months after the updated recommendations. Uptake was lower among at-risk/high-risk adults aged <60 years, adults aged ≥75 years, and adults without prior pneumococcal vaccination. Routine evaluation of vaccination status by providers and additional strategies to increase uptake of recommend vaccines are warranted.
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