Uptake of 13-Valent Pneumococcal Conjugate Vaccine among US Adults Aged 19 to 64 Years with Immunocompromising Conditions

摘要

The CDC Advisory Committee on Immunization Practices (ACIP) recommended immunization with the recently licensed 13-valent pneumococcal conjugate vaccine (PCV13) for high-risk (immunocompromised) adults aged ≥19 years in 2012. This was in addition to the 23-valent pneumococcal polysaccharide vaccine (PPSV23). Data on vaccine-specific uptake among these individuals were previously unavailable. This retrospective observational study analyzed PCV13 uptake in immunocompromised patients aged 19–64 years. Data were acquired from insurance claims (N = 267,022) and electronic health records (EHR; N = 572,055) from October 2011–October 2016. Descriptive statistics were provided. Demographics were similar across the two database cohorts: mean age 49.7–51.0 years, 57–62% female, and >70% white. Iatrogenic immunosuppression was the most common high-risk category (33.3–44.2%). PCV13 uptake was 7.3% (95% CI: 7.25–7.45) in insurance claims and 9.9% (95% CI: 9.80–9.96) in EHR. Patients with HIV had the highest rate of PCV13 uptake; patients with multiple risk factors were above the mean in both cohorts. A Kaplan-Meier analysis was conducted to include patients lost to follow-up, with 441,657 and 722,071 patients for insurance claims and EHR, respectively. PCV13 uptake was only slightly higher: 9.3% (95% CI: 9.14–9.47) and 13.1% (95% CI: 12.93–13.19) for insurance claims and EHR, respectively. Four years after the ACIP 2012 recommendation, PCV13 uptake in high-risk adults aged19–64 years was low at <15% in all overall analyses. Clinicians caring for these patients should ensure adherence to the ACIP recommendation to minimize the risk of pneumococcal disease.