Pneumococcal vaccination in risk groups – The reality of a family health unit in Portugal

Carolina Pais Neto, Bárbara Duarte Ferreira, Carla Almeida

Keywords: Pneumococcal vaccine; Pneumococcal infection; Prevention; Vaccination; Primary health care

Background:

Pneumococcal disease is an important cause of morbidity and mortality potentially preventable through vaccination. Despite the recommendation for vaccination in adults belonging to increased risk groups for invasive pneumococcal disease (IPD), it remains underused worldwide.

Research questions:

Our aim was to assess the pneumococcal vaccination profile in risk groups within a portuguese Family Health Unit.

Method:

We conducted an observational cross-sectional and descriptive study among adults registered in a portuguese Family Health Unit in July 2023, aged ≥ 65 years or ICPC-2 coding corresponding to risk conditions for IPD, in accordance with the portuguese clinical guidance standard, based on WHO recommendations.

Results:

From the 2463 identified at-risk adults, a representative sample of 333 patients was obtained, 53.8% female and with an mean age of 72 years (minimum = 19; maximum = 97). The pneumococcal vaccination rate was 24.6%, of which 58.5% had incomplete vaccination. The predominant vaccination scheme was the 13-valent conjugate vaccine followed by the 23-valent polysaccharide vaccine (90.3%), with 65% prescribed in primary health care. Vaccination rate varied according to the IPD risk group, being higher in adults with a greater number of risk factors (p = 0.023). There was also a trend towards increased vaccination in the absence of economic insufficiency (p = 0.327) and at higher levels of education (p = 0.413).

Conclusions:

The reduced pneumococcal vaccination coverage in risk groups and the prevalence of incomplete vaccination requires a reflection on prescription and vaccination adherence determinants related to the doctor and the patient, as a means to implement effective measures aimed at improving the quality of pneumococcal vaccination in this population.

Points for discussion:

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