Background: In Catalonia, a polyanccharide pneumococcal vaccine (PPV) programme which includes subjects over 65 years old, was started in 1999. Three years later, we study the vaccine cover in relation to the presence of risk factors for pneumonia.
Methods: Cross-sectional observational study conducted in 8 Basic Health Areas (BHA) of Tarragona. All the subjects over 65 years old and assigned to one of the 8 basic health areas participating in the study were included (n=11241). Using computerized clinical records and vaccination records we evaluated whether each patient had received PPV before January 2002, and the presence of disease or risk factors for pneumonia.
Results: Global vaccination coverage was 44.4% (37.1% in 65-74 years, 53.9% in 75-84 and 51.5% in 85-99 years). The greatest coverage was recorded in subjects with active neoplasm (56.7%), chronic necropathy (55.3%). chronic lung disease (54.2%) and chronic cardiopathy (53.5%). The least coverage was recorded in smokers (38.9%), alcoholic patients (43.6%) and chronic liver disease (46.5%). AVP coverage was 38.9% (CI 95%: 37.6-40.2) in subjects without any risk factors, 47.7% (CI 95%: 46.1-49.4) in those with one factor, and 52.7% (CI 95%: 52.6-54.8) in those with two or more factors.
Conclusions: In spite of an acceptable global coverage, there are large subgroups of high risk patients who have not received PPV. The results suggest that, in an attempt to achieve extended global coverage, the presence of risk factors is largely ignored when deciding whether to prescribe PPV or not.