PCV13 Vaccination Still Low Among Older Adults, Despite Recommendations

Despites increases in the number of older adults receiving the 13-valent pneumococcal conjugate vaccine (PCV13) after the Advisory Committee on Immunization Practices (ACIP) recommended its routine use in 2014, the numbers remain below the needed amount to reduce the number of cases pneumonia, according to the authors of a recent Centers for Disease Control and Prevention report.

The ACIP estimated that a 60% coverage of older adults with PCV13 would prevent 230 cases of invasive pneumococcal disease and 12,000 cases of community-acquired pneumonia over the lifetime of a single cohort of persons 65 years and older. The estimated benefits resulted in the 2014 recommendation for adding PCV13 to the PPSV23 series.
_______________________________________________________________________________________________________________________
RELATED CONTENT
Study Examines How the Pneumococcal Vaccine Has Affected Rates of Bacteremia
New Study Analyzes the Effectiveness of the Influenza Vaccine in the Elderly Population
_______________________________________________________________________________________________________________________

In the report, the authors analyzed claims for vaccinations submitted for reimbursement to the Centers for Medicare and Medicaid Services (CMS) by beneficiaries who were 65 years of age or older from September 19, 2009 through September 18, 2016. This period covered 5 years before the ACIP recommendations through 2 years after, with the number of beneficiaries enrolled ranging from 23.7 million to 25 million.

Overall, 43.2% of Medicare beneficiaries had claims for at least 1 dose of PPSV23, 31.5% had claims for at least 1 does of PCV13, and 18.2% had claims for at least 1 dose of both PCV13 and PPSV23 by the end of the study period. The highest claims made by beneficiaries for either type of vaccine was among older, white adults, and those with chronic and immunocompromising medical conditions, compared with healthy older adults.

Despite the ACIP recommendations and modest increases in PPSV23 vaccination, the number of claims remained persistently low. The steepest increases in PCV13 uptake occurred in the beginning of the 2015 and 2016 influenza season, which suggested that older adults might be receiving the vaccine when they visit their health care provider for an influenza vaccine.

“Implementation of the National Vaccine Advisory Committee’s standards for adult immunization practice to assess vaccination status at every patient encounter, recommend needed vaccines, and administer vaccination or refer to a vaccinating provider might help increase pneumococcal vaccination coverage and reduce the risk for pneumonia and invasive pneumococcal disease among older adults,” the authors concluded.

—Melissa Weiss

Reference:

Black CL, Williams WW, Warnock R, Pilishvili T, Kim D, Kelman JA. Pneumococcal vaccination among Medicare beneficiaries occurring after the Advisory Committee on Immunization Practices recommendation for routine use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults aged ≥65 years. MMWR Morb Mortal Wkly Rep. 2017; 66:728–733. http://dx.doi.org/10.15585/mmwr.mm6627a4.