Flu and Pneumococcal Vaccine Coverage in Scleroderma Patients Still Need to Be Prompted: A Systematic Review

Systemic sclerosis (scleroderma, SSc) is an autoimmune connective tissue disease characterized by excessive production of collagen and multiorgan involvement. Scleroderma patients are at increased risk of influenza complications and pneumonia; thus, vaccinations are recommended. This systematic review evaluated the influenza and pneumococcus vaccination coverage for SSc patients. We included all studies from Pubmed reporting on influenza and pneumococcal vaccination rate in Scleroderma patients up to May 2021. The 14 studies thus selected identified a suboptimal vaccination rate in autoimmune and SSc patients, ranging from 28 to 59% for the flu vaccine, and from 11 to 58% for the pneumo vaccine in absence of specific vaccination campaigns, variously considering also other variables such as age, gender, vaccination settings, and possible vaccination campaigns. We also considered the reasons for low coverage and the approaches that might increase the vaccination rates. A lack of knowledge about the importance of vaccination in these patients and their doctors underlined the need to increase the awareness for vaccination in this patients’ category. Current guidelines recommend vaccination in elderly people and people affected by particular conditions that widely overlap with SSc, yet autoimmune diseases are not always clearly mentioned. Improving this suboptimal vaccination rate with clear guidelines is crucial for SSc patients and for clinicians to immunize these categories based principally on the pathology, prior to the age. Recommendations by the immunologist and the direct link to the vaccine providers can highly improve the vaccine coverage.

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Implementing a Multidisciplinary Approach to Enhance Compliance With Guideline-Recommended Prechemotherapy Pneumococcal Vaccination in a Military-Based Medical Oncology Practice

Journal of Oncology Practice ◽

10.1200/jop.2016.015602 ◽

2017 ◽

Vol 13 (11) ◽

pp. e966-e971 ◽

Cited By ~ 1

Author(s):

Wilfred Delacruz ◽

Sandra Terrazzino ◽

Michael Osswald ◽

Casey Payne ◽

Brian Haney

Keyword(s):

Pneumococcal Vaccination ◽

Standard Of Care ◽

Baseline Period ◽

Community Acquired Pneumonia ◽

Vaccination Rates ◽

Patients With Cancer ◽

Single Person ◽

Increased Risk ◽

Oncology Practice ◽

Current Guidelines

Purpose: Patients with cancer are at increased risk for invasive pneumococcal disease, including community-acquired pneumonia. Current Advisory Committee on Immunization Practices and National Cancer Comprehensive Network guidelines recommend pneumococcal vaccination for immunocompromised patients, including patients with cancer. Methods: We conducted a quality improvement (QI) project to enhance compliance with pneumococcal vaccination in patients before their chemotherapy. Baseline pneumococcal vaccination rates were gathered from July 2013 to June 2014. We reviewed the current guidelines for pneumococcal vaccinations in patients with cancer with physicians and encouraged them to prescribe the pneumococcal vaccination to patients before therapy. We also recruited our clinic nurse practitioner, who meets all patients for chemotherapy teaching, to prescribe the vaccine to patients younger than 65 years of age. Results: During the baseline period, of the 110 patients younger than 65 years who received chemotherapy, seven (6.4%) received the pneumococcal vaccine. Of the 90 patients (median age, 60 years; range, 20 to 86 years) who received chemotherapy during the study period, 58 were younger than 65 years, of whom three patients were already vaccinated before their diagnosis. Twenty-five (45.5%) patients were vaccinated through our QI project. We have improved our compliance with pneumococcal vaccination by 39% ( P < .001). Conclusion: We have improved compliance with pneumococcal vaccination in patients with cancer receiving chemotherapy in our clinic through a QI project. We found that screening is best accomplished by a single person who is able to screen all patients. This practice is now a standard of care in our clinic.

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Comparing Interventions Aimed at Improving Influenza Vaccination Coverage Among Vulnerable Populations: A Systematic Review and Meta-Analysis Protocol

10.1101/2021.03.08.21253172 ◽

2021 ◽

Author(s):

Pei Chen Wu ◽

Lyn McPherson ◽

Stephen B Lambert ◽

Peter Wnukowski-Mtonga ◽

Nicholas G Lennox ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Random Effects Models ◽

Vaccination Rates ◽

Concurrent Control ◽

Vaccination Recommendations ◽

Increased Risk ◽

Improvement Interventions ◽

High Risk Populations ◽

Quality Improvement Interventions

ABSTRACTBackgroundInfluenza is a major contributor to global disease burden. Vaccination recommendations specifically target populations at increased risk of serious influenza sequelae. The aim of this study is to conduct a systematic review and meta-analysis to evaluate the effectiveness of different quality improvement interventions to increase vaccination rates in high-risk populations.MethodsRandomized and nonrandomized studies with concurrent control groups will be identified. Interventions to increase vaccination rates will be categorized by strategy type. Overall intervention effects will be calculated using random effects models. Study quality will be assessed using a modified Cochrane Risk of Bias tool.

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Leveraging Interdisciplinary Teams for Pre-Visit Planning to Improve Pneumococcal Immunization Rates Among Internal Medicine Subspecialty Practices

Journal of Primary Care & Community Health ◽

10.1177/21501319211060986 ◽

2021 ◽

Vol 12 ◽

pp. 215013192110609

Author(s):

Rebecca Shafer ◽

Christina Kearns ◽

Maria Carney ◽

Ankita Sagar

Keyword(s):

Registered Nurses ◽

Pneumococcal Vaccination ◽

Vaccination Rate ◽

Emerging Diseases ◽

Interdisciplinary Teams ◽

Immunization Rates ◽

Increased Risk ◽

Control And Prevention ◽

Ready Availability ◽

Ancillary Staff

Background: Despite the ready availability of pneumococcal vaccines and recommendation of vaccination by Center for Disease Control and Prevention (CDC), the immunization rates among adults less than 65 years of age with chronic and immunocompromised conditions remain low. Methods: This interventional (cohort) study aimed to improve the pneumococcal vaccination rate for patients with an increased risk of pneumococcal disease by utilizing a three-pronged approach. This included: (1) clinician education webinar, (2) pre-visit counseling performed by registered nurses, targeted toward patients with upcoming appointments, to address vaccination status, and (3) modified pre-visit interdisciplinary team huddle with clinicians and registered nurses to review which patients are amenable to vaccination at the time of visit and those who may benefit from re-engagement and further motivational interviewing. After the completion of the 10-week intervention, study organizers reviewed the percent of patients with completed pneumococcal vaccinations. Results: In this 10-week rapid cycle initiative, a total of 482 patients were eligible for vaccination. During the intervention phase, 370 patients were contacted and of these 38% of patients were amenable to receiving a vaccine during the pre-visit counseling, 5% were previously vaccinated, 18% were not amenable, and 38% were unreachable prior to visit. This initiative resulted in a 43% increase in the vaccination rate in this cohort. Conclusions: The significant increase in vaccination rate supports the utilization of a framework in the multidisciplinary approach to pre-visit planning in non-primary care specialties and other vaccination efforts, especially emerging diseases such as COVID-19. Future directions of study include the efficacy of telemedicine counseling with a same-day appointment for vaccination, co-location of registered nurses within the practice sites, as well as the use of other ancillary staff (such as medical office assistants) to engage patients in pre-visit planning.

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Improving pneumococcal vaccination rates in pediatric acute lymphoblastic leukemia/lymphoblastic lymphoma.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18666 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18666-e18666

Author(s):

Simone Chang ◽

Alexandra Cheerva ◽

Michael Angelo Huang ◽

Kerry McGowan ◽

Esther E Knapp ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Hematologic Malignancy ◽

Lymphoblastic Leukemia ◽

Pneumococcal Vaccination ◽

Vaccination Rate ◽

Lymphoblastic Lymphoma ◽

Pediatric Acute Lymphoblastic Leukemia ◽

Vaccination Rates ◽

Targeted Interventions ◽

Pediatric All

e18666 Background: Pediatric Acute Lymphoblastic Leukemia/ Lymphoblastic Lymphoma (ALL/LLy) is the most common pediatric cancer. Invasive pneumococcal disease (IPD) is prevalent in this population and the Centers for Disease Control and Prevention recommends pneumococcal vaccination to decrease morbidity and mortality. Despite these recommendations, vaccination rates remain low and the incidence of IPD among children with hematologic malignancy is significantly higher compared to the average pediatric population. An interventional study was designed to improve the vaccination rate and reduce the incidence of IPD in our institution. Methods: A plan-do-study-act (PDSA) model of quality improvement (QI) was used. Chart review at our institute was done for the 6-month period of January 2020 - June 2020 and baseline rates for pneumococcal polysaccharide (PPSV23) vaccination were calculated. Patients were included if they were ≥ 2 years old, diagnosed with ALL/LLy, and undergoing maintenance. A multidisciplinary team performed the root cause analysis. Immunization records were obtained and reviewed and targeted interventions were implemented. The interventions used are outlined in Table. The percentage of pediatric ALL/LLy patients per month in maintenance who received age-appropriate pneumococcal vaccinations was monitored before and after the interventions. Results: Analysis of the 6-month retrospective cohort (n=36) showed a baseline vaccination rate of 5.5%. During the subsequent 6-month phase with interventions, 40 patients were prospectively enrolled. Demographics showed a mean age of 10.2 years (range, 2-21) and a predominantly male (66.7%) cohort. B-cell ALL/LLy comprised the majority (78.9%); the rest included T-cell ALL/LLy and mixed phenotype acute leukemia. As seen in Table, the percentage receiving at least 1 pneumococcal vaccine increased from 5.5% to 84.8% over the first 3 months, this plateaued around 81%. Completion of the series mirrored this and increased to 74.2%. Pre-visit planning and cues proved to be the most helpful interventions. Conclusions: Use of a PDSA model successfully improved pneumococcal vaccination rates in the pediatric ALL/LLy population. We suggest these results can be achieved with planning and implementation of the outlined interventions. [Table: see text]

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Abstract P271: Influenza and Herpes Zoster Vaccination in United States Stroke Survivors: A Nationwide Analysis

Stroke ◽

10.1161/str.52.suppl_1.p271 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Mu Ji Hwang ◽

Setareh Salehi Omran ◽

Saad Mir ◽

Alexander E Merkler ◽

Hooman Kamel ◽

...

Keyword(s):

United States ◽

Herpes Zoster ◽

Influenza Vaccination ◽

Vaccination Rate ◽

Behavioral Risk ◽

Stroke Survivors ◽

Cross Sectional ◽

Vaccination Rates ◽

Increased Risk ◽

Prior Stroke

Introduction: Patients with stroke face an increased risk of contracting influenza and herpes zoster. We compared vaccination rates in stroke survivors versus the general United States population. Methods: We performed a cross-sectional analysis of data from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System, which is an annual, nationally representative, health survey. Respondents are asked about medical conditions and care. We used the most recent years with complete data for influenza (2018) and zoster (2017). We utilized survey procedures to estimate CDC-recommended vaccination rates for influenza (annual vaccination for all) and zoster (one-time vaccination for those at least 50 years old). Multiple logistic regression was used to compare the odds of vaccination in those with and without prior stroke, while adjusting for demographics (including income and health insurance) and comorbidities that may influence vaccination rates (obesity, diabetes, heart disease, cancer, pulmonary disease, and smoking). Results: In 2018, 8,254,136 (3.4%; 95% CI, 3.3-3.5) Americans were stroke survivors. The influenza vaccination rate was 44.4% (95% CI, 42.8-46.2) in stroke survivors and 32.8% (95% CI, 32.5-33.1) otherwise. In unadjusted models, stroke survivors were more likely to have had an influenza vaccination in the past year than those without stroke (OR, 1.6; 95% CI, 1.5-1.8). In 2017, 5,839,186 (5.7%; 95% CI, 5.5-5.9) Americans over 50 years old (i.e., eligible for zoster vaccination) were stroke survivors. The zoster vaccination rate was 30.3% (95% CI, 28.8-32.0) in stroke survivors and 27.6% (95% CI, 27.3-28.0) in those without prior stroke. Stroke survivors were more likely to have had zoster vaccination than those without stroke (OR, 1.14; 95% CI, 1.06-1.23). However, after accounting for demographics and comorbidities, stroke survivors were not more likely to be vaccinated for influenza (OR, 1.01; 95% CI, 0.93-1.10) or zoster (OR, 1.00; 95% CI, 0.90-1.12). Conclusion: Stroke survivors were not vaccinated at higher rates than expected based on demographics and comorbidities, and absolute vaccination rates were low, especially for zoster. Efforts to increase vaccination after stroke may be needed.

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Comparison between cohorts vaccinated and unvaccinated against influenza and pneumococcal infection

Epidemiology and Infection ◽

10.1017/s095026880200780x ◽

2002 ◽

Vol 129 (3) ◽

pp. 515-524 ◽

Cited By ~ 35

Author(s):

B. CHRISTENSON ◽

P. LUNDBERGH

Keyword(s):

Influenza Vaccination ◽

Chronic Diseases ◽

Demographic Data ◽

Pneumococcal Infection ◽

Pneumococcal Vaccination ◽

Vaccination Rate ◽

Elderly Persons ◽

Vaccination Rates ◽

Myocardial Disease ◽

Chronic Lung Diseases

This study characterizes possible confounders that might make cohorts vaccinated and unvaccinated against influenza and pneumococcal infection different at baseline, with the hypothesis that the two cohorts are comparable. The similarity between health and demographic data was analysed by a randomized, multivariant study addressed to 10 000 persons aged 65 years and older in Stockholm County and was carried out in the form of a postal inquiry during the period December 2000 to May 2001. The study-population response rate was 78%. Of these, 66% (5120 persons) had been given at least one influenza vaccination during the 3-year study period (1998–2000), 50% (3780) had received one pneumococcal vaccination and 78% had received both vaccines during the period. The vaccination rate was lower in the age group 65–69 years (60%), compared with elderly cohorts aged over 70 years (67–72%, P<0·001). Elderly persons living in nursing homes or institutions had higher vaccination rates than persons living in their own households (72 vs. 67%). Persons with underlying chronic diseases had higher vaccination rates (71%, P<0·001) than those without underlying chronic diseases. Vaccine recipients had fewer days in hospital, compared with non-recipients. Unvaccinated persons with myocardial disease had nine times more days in hospital than vaccinated persons with myocardial disease. Vaccination against pneumococcal infection had an additional effect with influenza vaccination in reducing hospitalization for chronic lung diseases; influenza vaccination alone did not have this effect. In conclusion, the influenza and pneumococcal-vaccine recipients were older and had significantly more chronic lung and heart conditions than the unvaccinated cohort.

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A Multifaceted Intervention to Improve Influenza, Pneumococcal, and Herpes Zoster Vaccination among Patients with Rheumatoid Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.150984 ◽

2016 ◽

Vol 43 (6) ◽

pp. 1030-1037 ◽

Cited By ~ 16

Author(s):

David W. Baker ◽

Tiffany Brown ◽

Ji Young Lee ◽

Amanda Ozanich ◽

David T. Liss ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Insurance Coverage ◽

Pneumococcal Vaccination ◽

Vaccination Rate ◽

Rate Of Change ◽

System Level ◽

Vaccination Rates ◽

Order Sets ◽

Vaccination History ◽

Patient Outreach

Objective.Vaccination rates for influenza, pneumococcus, and zoster in patients with rheumatoid arthritis (RA) have remained low. Simple electronic or paper reminders have produced only small increases in vaccination rates. We sought to identify a more effective approach to improve vaccination rates.Methods.We conducted a system-level intervention at an academic rheumatology clinic that included electronic reminders with linked order sets, physician auditing and feedback, patient outreach, and optional printed prescriptions for zoster vaccination at an outside pharmacy.Results.We targeted 1255 eligible patients with RA. There was no change in patients’ self-reported influenza vaccination rates, although the baseline self-reported rate was already high and much higher than that documented in the electronic health record. Pneumococcal vaccination rates increased from 28.7% to 45.8%; in regression analysis, the rate of change in pneumococcal vaccination increased by 9.4% per year above baseline trends (95% CI 3.9–15.5, p = 0.002). The rate of zoster vaccination increased from 2.5% to 4.5% overall (p = 0.01) and from 3.0% to 6.6% among patients not receiving biologic therapy that precluded zoster vaccination.Conclusion.Although the intervention improved pneumococcal and zoster vaccination rates, the improvement in pneumococcal vaccination rate was less than expected, and the zoster vaccination rate remained low even for ideal candidates. Likely barriers include lack of familiarity and difficulty using electronic reminders and order sets, uncertainty about the value and safety of recommended vaccines, and uncertainty about patients’ insurance coverage and prior vaccination history. Future interventions should include strategies to address these.

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The importance of sustained compliance with physical distancing during COVID-19 vaccination rollout

10.21203/rs.3.rs-390037/v1 ◽

2021 ◽

Author(s):

Alexandra Teslya ◽

Ganna Rozhnova ◽

Thi Mui Pham ◽

Daphne van Wees ◽

Hendrik Nunner ◽

...

Keyword(s):

Vaccination Coverage ◽

Vaccine Coverage ◽

Transmission Model ◽

Cumulative Number ◽

Vaccination Rates ◽

Contact Rates ◽

Health Authorities ◽

Public Health Authorities ◽

Vaccination Campaigns ◽

The Impact

Abstract Mass vaccination campaigns against SARS-CoV-2 are under way in many countries with the hope that increasing vaccination coverage will enable reducing current physical distancing measures. Compliance with these measures is waning, while more transmissible virus variants such as B.1.1.7 have emerged. Using SARS-CoV-2 transmission model we investigated the impact of the feedback between compliance, the incidence of infection, and vaccination coverage on the success of a vaccination programme in the population where waning of compliance depends on vaccine coverage. Our results suggest that the combination of fast waning compliance, slow vaccination rates, and more transmissible variants may result in a higher cumulative number of infections than in a situation without vaccination. These adverse effects can be alleviated if vaccinated individuals do not revert to pre-pandemic contact rates, and if non-vaccinated individuals remain compliant with physical distancing measures. Both require convincing, clear and appropriately targeted communication strategies by public health authorities.

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COVID-19 Vaccination Rates in a Cohort Study of Patients With Mental Illness in Residential and Community Care

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.805528 ◽

2021 ◽

Vol 12 ◽

Author(s):

Victor Mazereel ◽

Tom Vanbrabant ◽

Franciska Desplenter ◽

Johan Detraux ◽

Livia De Picker ◽

...

Keyword(s):

Mental Illness ◽

Logistic Regression ◽

Care Center ◽

Psychosocial Care ◽

Vaccination Rate ◽

Vaccine Uptake ◽

Negative Consequences ◽

Vaccination Rates ◽

People With Mental Illness ◽

Increased Risk

Background: Patients with mental illness are at increased risk for COVID-19-related morbidity and mortality. Vaccination against COVID-19 is important to prevent or mitigate these negative consequences. However, concerns have been raised over vaccination rates in these patients.Methods: We retrospectively examined vaccine uptake in a large sample of Belgian patients admitted to or residing in a university psychiatric hospital or community mental health care setting between 29th of March 2021 and 30th of September 2021 in the Flanders Region. All patients were offered vaccination. Descriptive statistics were used to analyse the data. Logistic regression was used to examine factors associated with vaccine uptake.Results: 2,105 patients were included in the sample, of which 1,931 agreed to be vaccinated, corresponding with a total vaccination rate of 91.7%. Logistic regression showed an effect of the diagnosis “other disorders” (OR = 0.08, CI = 0.005–0.45), age (OR = 1.03, CI = 1.02–1.04) and residing in the psychosocial care center (OR = 0.50, CI = 0.32–0.80) on vaccination status.Conclusion: Vaccine uptake among people with mental illness is high and comparable to the general population, when implementing a targeted vaccination program.

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How Large Fraction of A Population Must be Vaccinated before A Disease is Controlled?

10.21203/rs.3.rs-1218033/v2 ◽

2022 ◽

Author(s):

Robin Halamicek ◽

Dirk W Schubert ◽

Fritjof Nilsson

Keyword(s):

Vaccine Coverage ◽

Large Fraction ◽

Vaccine Dose ◽

Vaccination Rate ◽

Basic Reproduction Ratio ◽

Mathematical Equation ◽

Reproduction Ratio ◽

Vaccination Rates ◽

Crucial Question ◽

Modelling Study

Abstract The ongoing Covid-19 pandemic has already caused more than 5 million casualties despite hard restrictions and relatively high vaccine coverage in many countries. The crucial question is therefore, how large vaccination rate and how severe restrictions are required to terminate the spread of the decease, assuming that the vaccine efficiency and the basic reproduction ratio (R0) are known? To answer this question, a mathematical equation was applied to visualize the required vaccination level as function of vaccine efficiency, restriction efficiency and basic reproduction ratio (R0). In addition to the modelling study, Covid-19 data from Europe was collected during 19/11-26/11 (2021) to assess the relation between vaccination rate and incidence. The analysis indicates that a vaccination rate of ~92% (2 doses) is required to stop Delta (B.1.617.2) without severe restrictions, under conditions like those in Europe late November 2021. A third vaccine dose, improved vaccines, higher vaccination rates and/or stronger restrictions will be required to force Omicron (B.1.1.529) to expire without infecting a large fraction of the population.

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