Pneumococcal vaccination of the elderly during visits to acute care providers: Who are vaccinated?

- We used a large population dataset to determine pneumococcal vaccination in the elderly.
- We describe factors associated with vaccination of the elderly during visits to acute care.
- Many elderly visited acute care but few received the pneumococcal vaccine.
- Acute care visits are associated with increased receipt of pneumococcal vaccine.
- Increased pneumococcal vaccination occurs during influenza season and long inpatient stays.

ObjectiveMany elderly remain unvaccinated against invasive pneumococcal disease yet frequently visit acute care providers where they have an opportunity to receive the pneumococcal vaccine. We describe factors associated with pneumococcal vaccination in adults aged 65 years and older during visits to acute care providers.MethodThe study included all elderly aged 65 years of age and older enrolled in a health insurance registry in a large Canadian city in 2009. Pneumococcal vaccination status was determined using a vaccination administrative database. Unvaccinated elderly were linked to ambulatory and inpatient care databases to determine acute care visits. Logistic regression was used to determine odds ratios for vaccination during a first visit to an acute care provider in 2009.ResultsOf 53,249 unvaccinated elderly, 23,574 presented to at least one acute care provider in 2009. Acute care visits were significantly associated with receipt of pneumococcal vaccine (11.0% vs. 7.8%, risk adjusted odds ratio [OR] = 1.53; 95% confidence interval [CI] = 1.44,1.62), particularly ambulatory care visits during influenza season (OR = 4.36; 95% CI = 2.86,6.66) and inpatient visits with lengths of stay > 14 days (OR = 7.71, 95% CI = 4.41,13.47).ConclusionAcute care visits were associated with greater pneumococcal vaccine uptake for the elderly during the annual influenza season and long hospital stays.