Missed Opportunities in Antipneumococcal Vaccination. Can Something More be Done for Prevention

Abstract Introduction Vaccination is the most effective measure in the prevention of invasive pneumococcal disease (IPD). High-risk patients immunized during medical visits would benefit from the vaccine. Objectives To describe the IPD cases. To assess the most prevalent causative serotypes and to evaluate the missed opportunities for vaccination. Methods This is a descriptive retrospective study of the incidence of IPD cases in Elche during 5 years. The vaccination status and the visits to specialized care prior to disease were reviewed. The effectiveness with the 23-valent pneumococcal vaccine in our population was also calculated. Results Between 2007 and 2011, 181 cases of IPD were notified; the most frequent medical conditions were pneumonia and sepsis, with a mortality rate of 12%. 80% of the causative serotypes are included in the vaccine. More than the half of the cases had at least one of the risk factors for indicating the vaccination. This percentage decreases by 6.2% in cases below 65 years of age with any risk factor. Conclusions After 10 years of introducing the vaccine into the adult immunization schedule the coverage is still low among the patients with risk factors. In our study, 75% of the cases were not vaccinated. Taking in count the vaccine effectiveness for preventing IPD, among the patients attended at the hospital by the specialist prior their IPD, it could have been prevented in the best assumption (85% vaccine effectiveness) 60 IPD cases.