Validity of self-reported pneumococcal vaccination status in the elderly in Spain
Department of Preventive Medicine and Epidemiology, Hospital Clínic, Barcelona, Spain. Vaccine
(Impact Factor: 3.62).
06/2009; 27(34):4560-4. DOI: 10.1016/j.vaccine.2009.05.057
The objective of this study was to evaluate the validity of information reported by the elderly on 23-valent pneumococcal polysaccharide vaccine (23vPPV) vaccination status. A cross-sectional, observational study was carried out in patients aged >or=65 years admitted to five Spanish hospitals. Data on 23vPPV vaccination history were obtained through interview of the patient or close relative and review of written medical information. The validity of the patient self-report was compared to the written medical information by calculation of the sensitivity, specificity, concordance, positive predictive value (PPV) and negative predictive value (NPV). A total of 2484 patients were initially included of whom 1814 patients (73%) responded about their vaccination status. The global sensitivity of the patient self-report was 0.74 and the specificity 0.95. The PPV was 0.92, the NPV 0.84 and the concordance 87. Vaccination cards and centralized vaccination registries in primary health care centres and hospitals should be potentiated in order to ensure that neither more nor less vaccinations are administered than are necessary.
Available from: PubMed Central
- "Third, the self-reported vaccination status by the OP or his/her caregiver was estimated as the measure of the outcome variable. Again, while some studies have demonstrated the validity of self-report vaccination among various OP populations [57-59], the question arises as to whether these study populations were rural and extremely poor as well. A study should therefore be conducted to verify if the validity of self-reporting remains applicable in our case. "
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ABSTRACT: Immunization is one of the most effective ways of preventing illness, disability and death from infectious diseases for older people. However, worldwide immunization rates are still low, particularly for the most vulnerable groups within the elderly population. The objective of this study was to estimate the effect of the Oportunidades -an incentive-based poverty alleviation program- on vaccination coverage for poor and rural older people in Mexico.
Cross-sectional study, based on 2007 Oportunidades Evaluation Survey, conducted in low-income households from 741 rural communities (localities with <2,500 inhabitants) of 13 Mexican states. Vaccination coverage was defined according to three individual vaccines: tetanus, influenza and pneumococcal, and for complete vaccination schedule. Propensity score matching and linear probability model were used in order to estimate the Oportunidades effect.
12,146 older people were interviewed, and 7% presented cognitive impairment. Among remaining, 4,628 were matched. Low coverage rates were observed for the vaccines analyzed. For Oportunidades and non-Oportunidades populations were 46% and 41% for influenza, 52% and 45% for pneumococcal disease, and 79% and 71% for tetanus, respectively. Oportunidades effect was significant in increasing the proportion of older people vaccinated: for complete schedule 5.5% (CI95% 2.8-8.3), for influenza 6.9% (CI95% 3.8-9.6), for pneumococcal 7.2% (CI95% 4.3-10.2), and for tetanus 6.6% (CI95% 4.1-9.2).
The results of this study extend the evidence on the effect that conditional transfer programs exert on health indicators. In particular, Oportunidades increased vaccination rates in the population of older people. There is a need to continue raising vaccination rates, however, particularly for the most vulnerable older people.
Available from: Fortunato D'Ancona
- "The majority of the literature presented influenza vaccination coverage, with a few papers presenting vaccination coverage for other vaccines such as pneumococcal, hepatitis B, and tetanus vaccines. (Bader and Egler 2004, 2009; Beytout et al. 2004; Blank et al. 2009; de Miguel 2006; del Corro et al. 2009; Gavazzi et al. 2007; Kwong et al. 2007; Leggat et al. 2009; Montrieux et al. 2002; Nielsen et al. 2009; Noakes et al. 2006; Pebody et al. 2008; Sammarco et al. 2004; Schenkel et al. 2008; Stuck et al. 2007; van Houdt et al. 2009) We were unable to identify published literature that discussed a comprehensive adult vaccine schedule and adult vaccine financing in developed countries. To determine the denominator, we used the International Monetary Fund’s (2009) classification of advanced economies (N = 33). "
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While many countries have robust child immunization programs and high child vaccination coverage, vaccination of adults has received less attention. The objective of this study was to describe the adult vaccination policies in developed countries.
From 2010 to 2011, we conducted a survey of 33 advanced economies as defined by the International Monetary Fund. The survey asked about national recommendations for adults for 16 vaccines or vaccine components, funding mechanisms for recommended adult vaccines, and the availability of adult vaccination coverage estimates.
Thirty-one of 33 (93.9 %) advanced economies responded to the survey. Twelve of 31 (38.7 %) reported having a comprehensive adult immunization schedule. The total number of vaccines or vaccine components recommended for adults ranged from one to 15 with a median of 10. Seasonal influenza (n = 30), tetanus (n = 28), pneumococcal polysaccharide (n = 27), and hepatitis B (n = 27) were the most frequently recommended vaccines or components.
Approximately two-thirds of survey respondents do not have a comprehensive adult vaccine schedule, and most do not measure vaccination coverage. We found that a funding mechanism is available for most recommended adult vaccines.
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ABSTRACT: Since 1997, the Advisory Committee on Immunization Practices has recommended the 23-valent pneumococcal polysaccharide vaccine (PPSV23) for nonelderly adults with certain medical conditions. In 2008, the Committee added asthma and cigarette smoking to the list of indications for PPSV23 vaccination. Using data from the 2009 National Health Interview Survey, the authors assessed PPSV23 uptake in people with established and new indications. To identify factors independently associated with receiving PPSV23, they used multivariable logistic regression and predictive marginal analyses. In 2009, a total of 35.2 million adults 18-64 years of age (18.6%) had established PPSV23 indications; adding asthma and smoking to the list of indications increased the high-risk population to 71.6 million people (37.9%). Overall, 26.1% of people with established indications for PPSV23 and 17.4% of people with any indication (those previously established, as well as asthma and smoking) had received the vaccine; overall coverage among persons 50-64 years of age was significantly higher than that among persons 18-49 years of age (34.6% vs. 16.7%; P < 0.001) and for all specific indications except cancer. For persons who had asthma or who smoked but had no other indications, rates of coverage were 12.3% and 8.5%, respectively. In persons who had established indications, being older, white, and unemployed and having more physician visits, a prior hospitalization, a regular physician, and health insurance were independently associated with PPSV23 receipt. PPSV23 uptake varies substantially by age and indication but remains low overall, with approximately 59 million unvaccinated high-risk working-age adults. Effective strategies to increase pneumococcal vaccination coverage among at-risk groups are needed.
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