CDC: Pneumococcal Vaccination in Adults Save

Streptococcus pneumonia is a leading cause of morbidity and mortality in adults; including patients with autoimmune diseases who are at particular risk.

In 2014, the ACIP recommended routine use of the 13-valent pneumococcal conjugate vaccine (PCV13) in series with the 23-valent pneumococcal polysaccharide vaccine PPSV23 for adults ≥ 65 years, with the goal of providing broader protection by adding the PCV13 recommendation.

A report published in MMWR last week sought to evaluate coverage of these two vaccines both before and after implementation of the 2014 recommendation by analyzing claims for vaccination submitted for reimbursement to the Centers for Medicare & Medicaid Services (CMS). The examined population included persons ≥ 65 years old who were enrolled in Medicare parts A and B between September 19, 2009 and September 18, 2016. 

Using Medicare claims as a proxy for estimating vaccine coverage, they found that 43.2% of Medicare beneficiaries had claims for ≥ 1 dose of PPSV23 (regardless of PCV13 status), 31.5% had claims for ≥ 1 dose of PCV13 (regardless of PPSV23 status), and 18.3% had claims for ≥ 1 dose of each PCV13 and PPSV23. 

They found that implementation of PCV12 and PPSV23 vaccination has not been equal across subgroups and showed that beneficiaries with chronic or autoimmune conditions were more likely to be vaccinated with both vaccines compared to those without these conditions (other factors – older age, white race). While acknowledging the many limitations of a claims-based study, this report reminds us that we can do a better job making sure patients complete the recommended pneumococcal vaccination series.