Streptococcus pneumoniae (pneumococcus) remains a significant cause of both mild infections such as otitis media, sinusitis, and bronchitis and more severe manifestations such as bacteremia, pneumonia, and invasive pneumococcal disease. Several key serotypes have been targeted in vaccine development due to their association with increased infectivity. Pneumococcal vaccines are available in two formulations, the unconjugated purified polysaccharide (PPSV) and the conjugated formulation (PCV), which leads to a more robust and prolonged immune response. There have been dramatic reductions in mortality attributed to invasive pneumococcal disease over the past 2 decades due to improved vaccination rates and improved serotype coverage with the existing arsenal of vaccines (PCV13 and PPSV23). Utilizing both conjugate and purified polysaccharide modalities in series has produced greater and lasting immunity. The development of both the PCV15 and the PCV20 vaccines provides an opportunity to use conjugated vaccines against a wider spectrum of pneumococcal serotypes. National guidelines have been updated to incorporate the new pneumococcal vaccines into clinical practice. K E Y W O R D S conjugate vaccine, pneumococcal infections, polysaccharide vaccine, vaccination | 725 EL-BEYROUTY et al.adults 65 years of age or older. 5 The 2010 incidence of IPD for older adults and infants was markedly higher than that of individuals 18-34 years of age (≥65 years: 36.4 cases per 100,000, <1 year: 34.2 cases per 100,000, 18-34 years: 3.8 cases per 100,000). 5Incidence and severity of pneumococcal infection are also heavily impacted by host comorbidities. Underlying health conditions and certain lifestyle factors (Table 1) greatly increase risk. 1,6,7 Surveillance studies have shown that more than half of IPD cases in patients aged 18-64 years of age occurred in those with one or more comorbidities designated as ACIP indications for vaccination. The mortality rate within this group was also doubled when compared to individuals without underlying health conditions. 8 The incidence of pneumococcal infection for adults with hematologic malignancy or HIV is 20 times greater than that of unaffected adults. 1 Despite the importance of vaccinating adults with these comorbidities, individuals with immunocompromising conditions do not benefit as greatly from vaccination as those who are immunocompetent.Gender and race have been implicated in impacting the likelihood of pneumococcal infection as well. One analysis found that rates of IPD were 1.5-2 times higher in males than female patients. 9Black individuals, Native Alaskans, and Native Americans have been shown to be at an increased risk compared with white individuals. 10 Additionally, the incidence of pneumococcal infections is impacted by socioeconomic factors. Developing nations with nutritional deficiencies, lack of exclusive breastfeeding for the first 6 months of life, and lower air quality have higher rates of infection.

The coronavirus disease 2019 (COVID‐19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 has challenged health systems to find innovative ways of delivering patient care while protecting staff from infection with the virus. As the COVID‐19 pandemic has continued to evolve establishing “hot spots” in various areas of the country, clinicians have learned more about caring for these patients. This has required the Department of Pharmacy at Thomas Jefferson University Hospital to constantly update the approach it has taken during this time, and the guidance which is provided for the pharmaceutical care of these patients. Because Philadelphia was in the initial stages of the pandemic within the United States, operations within the Department of Pharmacy at Thomas Jefferson University Hospital needed to be redesigned. This brief report provides an example of the swift changes that were made in the pharmacy practice model at a large academic medical center. Herein we describe the impact of the pandemic on the Department of Pharmacy at Thomas Jefferson University Hospital with a focus on clinical and operations aspects. The areas that will be highlighted in this report represent areas that required rapid and transformational change to the operations and/or clinical care in order to protect the health of pharmacists and allow them to continue to provide the necessary level of patient care.

No abstract

No abstract

No abstract