Pneumococcal vaccination uptake and missed opportunities for vaccination among Canadian adults: A cross-sectional analysis of the Canadian Longitudinal Study on Aging (CLSA)

Abstract

Introduction In Canada, pneumococcal vaccination is recommended to all adults aged ≥65 and those <65 who have one or more chronic medical conditions (CMCs). Understanding vaccine uptake and its determinants among eligible groups has important implications for reducing the burden of pneumococcal disease. Methods Using data from a large national cohort of Canadian residents aged ≥47 years between 2015–2018, we calculated self-reported pneumococcal vaccine uptake among eligible groups, estimated associations between key factors and non-vaccination, assessed missed opportunities for vaccination (MOV) and examined risk factors for MOV. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for relevant associations were estimated through logistic regression. Results 45.8% (95% CI: 45.2–46.5) of 22,246 participants aged ≥65 and 81.3% (95% CI: 80.5–82.0) of 10,815 individuals aged 47–64 with ≥1 CMC reported never having received a pneumococcal vaccine. Receipt of influenza vaccination in the previous year was associated with the lowest odds of pneumococcal non-vaccination (aOR = 0.14 [95% CI: 0.13–0.15] for older adults and aOR = 0.23 [95% CI: 0.20–0.26] for those aged 47–64 with ≥1 CMC). Pneumococcal vaccine uptake was also more likely in case of contact with a family doctor in the previous year (versus no contact), increased with age and varied widely across provinces. Among individuals recently vaccinated against influenza, 32.6% (95% CI: 31.9–33.4) of those aged ≥65 and 71.1% (95% CI: 69.9–72.3) of those aged 47–64 with ≥1 CMC missed an opportunity to get a pneumococcal vaccine. Among individuals who had contact with a family doctor, 44.8% (95% CI: 44.1–45.5) of those aged ≥65 and 80.4% (95% CI: 79.6–81.2) of those aged 47–64 with ≥1 CMC experienced a MOV. Conclusions Pneumococcal vaccine uptake remains suboptimal among at-risk Canadian adults who are eligible for vaccination. Further research is needed to clarify the reasons behind missed opportunities for vaccination and adequately address the main barriers to pneumococcal vaccination.

Age- and sex-specific associations of frailty with mortality and healthcare utilization in community-dwelling adults from Ontario, Canada

“…Hence, monitoring health deficit accumulation by family health teams for patients even in their 20 or 30 s would aid in the efficient delivery of preventative health interventions such as mental health screening, smoking cessation and vaccination. For example, consistent communication with a family physician significantly improves vaccine uptake amongst younger or older adults [ 38 , 39 ], and reduces hospital visits in people with complex health needs [ 40 ]. From a conservative perspective, purposeful assessment of frailty and targeted social and health interventions to reduce the impact of frailty before the age of 60 years is supported through the findings of this study.…”

Vaccination of pneumococcal infection in patients with systemic lupus erythe matosus and antiphospholipid syndrome: experience of 6 years of use

“…На сегодняшний день не известно, в какой степени показатели иммуногенности коррелируют с клинической эффективностью вакцин у больных ИВРЗ. Более того, показано, что корреляции между уровнем поствакцинальных антител и защитой от пневмококковых инфекций значительно варьируют в различных популяциях в зависимости от серотипов возбудителя и локализации инфекций [40] Несмотря на факты, подтверждающие безопасность и достаточную иммуногенность пневмококковых вакцин, охват пневмококковой вакцинацией больных ИВРЗ низок во всех странах (20-32,2%), что отражает недостаточное выполнение национальных и международных рекомендаций [41][42][43].…”

Prevalence, correlates, and drivers of COVID-19 vaccine hesitancy among Canadians.

“…Given that the efficacy of the COVID-19 vaccines significantly wanes after 4–6 months, well over majority of the population is now vulnerable to COVID-19 (re)infection, escalating the risk for novel strains of COVID-19 to evade immunity (Canada House of Commons, 2021; WHO, 2021a). Vaccine hesitancy (i.e., a delay in acceptance or refusal of vaccines despite the availability of vaccination services; MacDonald & Hesitancy, 2015) is a known barrier to vaccine uptake, whether for COVID-19 or other illnesses (Buchan & Kwong, 2016; Sulis et al, 2022). Rates of COVID-19 vaccine hesitancy appear to be increasing across the globe since the start of the pandemic (de Albuquerque Veloso Machado et al, 2021).…”