Pneumococcal vaccination in older adults: An initial analysis of social determinants of health and vaccine uptake

Gatwood, Justin; Shuvo, Sohul; Hohmeier, Kenneth C.; Hagemann, Tracy M.; Chiu, Chi‐Yang; Tong, Rachel; Ramachandran, Sujith

doi:10.1016/j.vaccine.2020.06.077

Cited by 48 publications

(27 citation statements)

References 26 publications

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“…In addition, adult vaccination differences have been observed based upon racial and ethnic identity, gender, age groups, and socioeconomic status [12]. Some studies have linked social determinants of health to adult vaccination disparities [13][14][15]. For example, factors such as health literacy, poverty/low socioeconomic status, residential area, and access to information, may be linked to vaccine-related (e.g., pneumococcal) decisions [13].…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have linked social determinants of health to adult vaccination disparities [13][14][15]. For example, factors such as health literacy, poverty/low socioeconomic status, residential area, and access to information, may be linked to vaccine-related (e.g., pneumococcal) decisions [13]. Among adults ages 19-49 years old, 16.3% of whites reported hepatitis A coverage compared to African Americans (11.7%) and Hispanics (13.4%) [11].…”

Section: Introductionmentioning

confidence: 99%

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Identifying Missed Opportunities for Routine Vaccination among People Who Use Drugs

Frew

Schamel

Randall

et al. 2021

IJERPH

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In the US, adult immunization coverage remains low, especially among vulnerable populations, as recent hepatitis A outbreaks have demonstrated. We studied the vaccination history variation among the US adults who use drugs by implementing a community-engaged research survey to identify reported immunization coverage, missed opportunities (MO), and places where immunizations might be delivered. Our analysis of a sample of 1127 participants recruited at community syringe exchanges in three cities identified higher overall vaccination receipt in Los Angeles compared to Atlanta or Las Vegas (e.g., HAV receipt 52.2% LA, 42.1% LV, 41.4% Atlanta). Overall, fewer participants reported having received HAV (45.9%), HBV (47.5%), or influenza (47.6%) vaccines than MMR (57.1%) or Td/Tdap (61.1%). Across sites, HAV receipt was higher for participants incarcerated ≥5 years (54.2% vs. 43.6% for those incarcerated <5 years, 49.4% no incarceration history, p = 0.02). HBV receipt was higher among participants who were not intravenous drug users (56.1% vs. 46.0%, p = 0.03). Additionally, income >$20k predicted higher rates of MMR receipt (67.0% vs. 56.5%, p = 0.009), as did stable housing (62.8% vs. 54.3%, p = 0.01). To address the need to expand vaccine coverage among vulnerable adults, delivering vaccine at sites where persons who use drugs access services, or in correctional facilities, may be warranted.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Identifying Missed Opportunities for Routine Vaccination among People Who Use Drugs

Frew

Schamel

Randall

et al. 2021

IJERPH

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“…2 The 23-valent pneumococcal polysaccharide vaccination (PPSV23) and the 13-valent pneumococcal conjugate vaccine are effective for preventing pneumonia caused by S. pneumoniae strains in older adults aged ≥65 years. 3 4 The following epidemiological determinants have been reported to be associated with coverage of the PPSV23 or the both vaccinations: age, 5 6 sex, 6 7 education, 6 8 income, 9 marital status, 8 household structure, 8 self-rated health, 10 health literacy, 9 smoking, 6 general practitioner, 10 high-risk diseases for pneumonia including diabetes, heart diseases, chronic respiratory…”

Section: Introductionmentioning

confidence: 99%

Social capital and pneumococcal vaccination (PPSV23) in community-dwelling older Japanese: a JAGES multilevel cross-sectional study

2021

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ObjectiveInequalities exist between the 23-valent pneumococcal polysaccharide vaccination (PPSV23) rate in each municipality among Japanese older adults. Exploring individual-level and community-level intervenable factors is necessary to improve the vaccination rates. We examined the associations between community-level and individual-level social capital and the PPSV23 vaccination among older Japanese adults using multilevel Poisson regression analyses.DesignCross-sectional study.SettingWe used data from the Japan Gerontological Evaluation Study, conducted between 3 October 2016 and 10 January 2017 in 631 districts, 39 municipalities and 18 prefectures.ParticipantsThe target population comprised persons aged 65 years or older who are physically and cognitively independent (that is, not certified as needing long-term care). Further, 180 021 older adults from 39 Japanese municipalities were enrolled.Primary outcome measureThe primary outcome was the PPSV23 vaccination among the Japanese older adults aged 65 years or older who did not have physical or cognitive disabilities.ResultsAfter adjusting for municipality-, community-, individual-levels effects with multiple imputation, 137 075 individuals who participated in one/more of the civic participation (participation of social groups), social cohesion (social tie), or reciprocity (mutual exchange of social support) were significantly associated with more vaccinations than those without the three social capitals among the 137 075 older adults (13.0% (95% CI 11.0% to 14.9%), 5.0% (95% CI 2.4% to 7.6%) or 33.9% (95% CI23.6% to 44.2%) increase, respectively, p>0.001 for all). The rich (≥+1 SD) community-level civic participation was significantly associated with 3.4% increase [95% CI 0.02% to 6.78%, p<0.05] of the PPSV23 vaccination among the older adults compared to those with the poor or standard one.ConclusionsOlder adults with one/more of the three social capitals at the both levels received more PPSV23 vaccinations than those without those social capitals. Therefore, fostering of those social capitals may improve the inequality of the PPSV23 vaccination rate among older adults in each municipality.

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“…Apart from the broadly discussed effectiveness of PPV23, which is currently recommended for the elderly in many countries, there are reports of low uptake of adult pneumococcal vaccination. 11,12 To address this important cause of morbidity and mortality in older adults in Germany, the National Immunization Technical Advisory Group (STIKO) of the Robert Koch Institute first recommended that all adults 60 years and older receive a dose of PPV23 in 1998.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pneumococcal vaccine uptake and vaccine effectiveness in older adults with invasive pneumococcal disease in Germany

Perniciaro¹,

Linden²

2020

Preprint

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Background - Invasive pneumococcal disease (IPD) in people ≥60 years old is on the rise in Germany. There has been a recommendation for pneumococcal vaccination in this age group since 1998. Methods - We determined the vaccination status of people ≥60 years old with IPD in Germany. We assessed vaccine effectiveness (VE) of the recommended 23-valent polysaccharide vaccine (PPV23). Results - The rate of pneumococcal vaccination in older adults with IPD is low, 26%, with only 16% of people receiving a pneumococcal vaccine within the past 5 years. Age- and sex- adjusted vaccine effectiveness (VE) for PPV23 was 37% (95% confidence interval 12% - 55%). For people vaccinated with PPV23 less than 2 years prior to IPD, VE was -20% (-131% - 34%), between 2-4 years prior to IPD, VE was 56% (20% - 76%), and 47% (17% - 63%) for those vaccinated ≥5 years ago. Excluding serotype 3, overall VE for the remaining serotypes in PPV23 was 63% (49% - 74%). For people receiving PPV23 within the past 2 years, VE against all serotypes except 3 was 49% (12% - 71%); for people vaccinated between 2-4 years prior to IPD 66% (37% - 82%); for those vaccinated ≥5 years ago, 69% (50% - 81%). VE of PPV23 against serotype 3 IPD only was -110% (-198% - -47%). Conclusions - To reduce IPD in older adults in Germany, we must increase the rate of pneumococcal vaccine uptake. For 22/23 serotypes, PPV23 was effective. Serotype 3 remains a major problem.

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Pneumococcal vaccination in older adults: An initial analysis of social determinants of health and vaccine uptake

Cited by 48 publications

References 26 publications

Identifying Missed Opportunities for Routine Vaccination among People Who Use Drugs

Identifying Missed Opportunities for Routine Vaccination among People Who Use Drugs

Social capital and pneumococcal vaccination (PPSV23) in community-dwelling older Japanese: a JAGES multilevel cross-sectional study

Pneumococcal vaccine uptake and vaccine effectiveness in older adults with invasive pneumococcal disease in Germany

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