tetano
Editor, Senior Moderator
Vaccine
. 2022 Jul 7;S0264-410X(22)00841-6.
doi: 10.1016/j.vaccine.2022.06.071. Online ahead of print.
Pneumococcal and influenza vaccination coverage among at-risk adults: A 5-year French national observational study
Benjamin Wyplosz[SUP] 1 [/SUP], Jérôme Fernandes[SUP] 2 [/SUP], Ariane Sultan[SUP] 3 [/SUP], Nicolas Roche[SUP] 4 [/SUP], François Roubille[SUP] 5 [/SUP], Paul Loubet[SUP] 6 [/SUP], Bertrand Fougère[SUP] 7 [/SUP], Bruno Moulin[SUP] 8 [/SUP], Didier Duhot[SUP] 9 [/SUP], Alexandre Vainchtock[SUP] 10 [/SUP], Fanny Raguideau[SUP] 11 [/SUP], Joannie Lortet-Tieulent[SUP] 12 [/SUP], Emmanuelle Blanc[SUP] 13 [/SUP], Jennifer Moïsi[SUP] 14 [/SUP], Gwenaël Goussiaume[SUP] 15 [/SUP]
Affiliations
Abstract
Introduction: The risk of developing pneumococcal infections increases with certain chronic conditions and in immunocompromised patients. We aimed to monitor pneumococcal vaccination coverage in at-risk patients and to examine factors associated with pneumococcal vaccination in France.
Material and methods: In this annual cross-sectional study, at-risk patients were extracted between 2014 and 2018 from the National Health Insurance's (NHI) General scheme's claims database with their vaccine reimbursements. Descriptive analyses and a logistic model were performed to assess the influence of healthcare use and medical and demographic factors on pneumococcal vaccination.
Results and discussion: In 2018, 4.5% of 4,045,021 at-risk adults were up to date with their pneumococcal vaccination. During the study period, the number of patients with chronic medical conditions (86% of 4,045,021) increased by 10.1%, but vaccination coverage decreased from 12.9% to 2.9%. The population with immunocompromised status (14% of 4,045,021) increased by 16.2% and vaccination coverage from 10.3% to 18.8%. Influenza vaccination coverage was much higher and stable (around 45.0%). Factors associated with pneumococcal vaccination were: immunocompromised status vs. having a chronic medical condition (odds ratio [OR] 4.72), influenza vaccination (OR 2.36-3.42), hepatitis B vaccination (OR 2.82), DTPolio vaccination (OR 1.52), ≥5 specialist physicians' visits (OR 1.17), and age above 74 (OR 1.12). Pneumococcal vaccine dispensing was extremely low (median of 9per GP,1per specialist over 9 years) despite frequent healthcare visits.
Conclusion: Pneumococcal and influenza vaccination coverage of adults at risk of pneumococcal disease fell well below public health expectations. Invitations for pneumococcal vaccination should be sent by the NHI to high-risk patients. Patient management protocols should include pneumococcal vaccination. Patients with multiple comorbidities are a high-priority population given the large potential health gains offered by pneumococcal vaccination. Commitment of both scientific societies and health authorities is urgently needed to increase vaccination coverage in at-risk populations.
Keywords: Immunocompromised; Influenza; Pneumococcal infection; SNDS; Vaccine.
. 2022 Jul 7;S0264-410X(22)00841-6.
doi: 10.1016/j.vaccine.2022.06.071. Online ahead of print.
Pneumococcal and influenza vaccination coverage among at-risk adults: A 5-year French national observational study
Benjamin Wyplosz[SUP] 1 [/SUP], Jérôme Fernandes[SUP] 2 [/SUP], Ariane Sultan[SUP] 3 [/SUP], Nicolas Roche[SUP] 4 [/SUP], François Roubille[SUP] 5 [/SUP], Paul Loubet[SUP] 6 [/SUP], Bertrand Fougère[SUP] 7 [/SUP], Bruno Moulin[SUP] 8 [/SUP], Didier Duhot[SUP] 9 [/SUP], Alexandre Vainchtock[SUP] 10 [/SUP], Fanny Raguideau[SUP] 11 [/SUP], Joannie Lortet-Tieulent[SUP] 12 [/SUP], Emmanuelle Blanc[SUP] 13 [/SUP], Jennifer Moïsi[SUP] 14 [/SUP], Gwenaël Goussiaume[SUP] 15 [/SUP]
Affiliations
- PMID: 35811205
- DOI: 10.1016/j.vaccine.2022.06.071
Abstract
Introduction: The risk of developing pneumococcal infections increases with certain chronic conditions and in immunocompromised patients. We aimed to monitor pneumococcal vaccination coverage in at-risk patients and to examine factors associated with pneumococcal vaccination in France.
Material and methods: In this annual cross-sectional study, at-risk patients were extracted between 2014 and 2018 from the National Health Insurance's (NHI) General scheme's claims database with their vaccine reimbursements. Descriptive analyses and a logistic model were performed to assess the influence of healthcare use and medical and demographic factors on pneumococcal vaccination.
Results and discussion: In 2018, 4.5% of 4,045,021 at-risk adults were up to date with their pneumococcal vaccination. During the study period, the number of patients with chronic medical conditions (86% of 4,045,021) increased by 10.1%, but vaccination coverage decreased from 12.9% to 2.9%. The population with immunocompromised status (14% of 4,045,021) increased by 16.2% and vaccination coverage from 10.3% to 18.8%. Influenza vaccination coverage was much higher and stable (around 45.0%). Factors associated with pneumococcal vaccination were: immunocompromised status vs. having a chronic medical condition (odds ratio [OR] 4.72), influenza vaccination (OR 2.36-3.42), hepatitis B vaccination (OR 2.82), DTPolio vaccination (OR 1.52), ≥5 specialist physicians' visits (OR 1.17), and age above 74 (OR 1.12). Pneumococcal vaccine dispensing was extremely low (median of 9per GP,1per specialist over 9 years) despite frequent healthcare visits.
Conclusion: Pneumococcal and influenza vaccination coverage of adults at risk of pneumococcal disease fell well below public health expectations. Invitations for pneumococcal vaccination should be sent by the NHI to high-risk patients. Patient management protocols should include pneumococcal vaccination. Patients with multiple comorbidities are a high-priority population given the large potential health gains offered by pneumococcal vaccination. Commitment of both scientific societies and health authorities is urgently needed to increase vaccination coverage in at-risk populations.
Keywords: Immunocompromised; Influenza; Pneumococcal infection; SNDS; Vaccine.