Abstract：
BACKGROUND: In 2020 Australia changed the funded universal older adult pneumococcal vaccination program from use of the 23-valent pneumococcal polysaccharide vaccine (PPV23) at age 65 to the 13-valent pneumococcal conjugate vaccine (PCV13) at age 70 years. We investigated uptake of both PCV13 and PPV23 in older adults before and after the program change.
METHODS: We analysed a national dataset of records of patients attending general practices (GPs). We included regular attendees aged 65 or above in 2020. Cumulative uptake of PCV13 and monthly uptake of PPV23 was compared for the two periods before (January 2019 to June 2020) and after (July 2020 to May 2021) the program change on 1 July 2020, by age groups and presence of comorbid conditions.
RESULTS: Our study included data from 192,508 patients (mean age in 2020: 75.1 years, 54.2 % female, 46.1 % with at least one comorbidity). Before July 2020, for all adults regardless of underlying comorbidities, the cumulative uptake of PCV13 was < 1 % but by May 2021, eleven months after the program changes, cumulative uptake of PCV13 had increased among those aged 70-79 years (without comorbidity: 16.3 %; with comorbidity: 21.1 %) and 80 + years (without comorbidity: 13.5 %; with comorbidity: 17.7 %), but not among those aged 65-69 years (without comorbidity: 1.3 %; with comorbidity: 3 %). Monthly uptake of PPV23 dropped following the program change across all age groups.
CONCLUSIONS: Changes in uptake of PCV13 and PPV23 among those aged 70 + years were consistent with program changes. However, PCV13 uptake was still substantially lower in individuals aged 65-69 years overall and in those with comorbidities.
METHODS: We analysed a national dataset of records of patients attending general practices (GPs). We included regular attendees aged 65 or above in 2020. Cumulative uptake of PCV13 and monthly uptake of PPV23 was compared for the two periods before (January 2019 to June 2020) and after (July 2020 to May 2021) the program change on 1 July 2020, by age groups and presence of comorbid conditions.
RESULTS: Our study included data from 192,508 patients (mean age in 2020: 75.1 years, 54.2 % female, 46.1 % with at least one comorbidity). Before July 2020, for all adults regardless of underlying comorbidities, the cumulative uptake of PCV13 was < 1 % but by May 2021, eleven months after the program changes, cumulative uptake of PCV13 had increased among those aged 70-79 years (without comorbidity: 16.3 %; with comorbidity: 21.1 %) and 80 + years (without comorbidity: 13.5 %; with comorbidity: 17.7 %), but not among those aged 65-69 years (without comorbidity: 1.3 %; with comorbidity: 3 %). Monthly uptake of PPV23 dropped following the program change across all age groups.
CONCLUSIONS: Changes in uptake of PCV13 and PPV23 among those aged 70 + years were consistent with program changes. However, PCV13 uptake was still substantially lower in individuals aged 65-69 years overall and in those with comorbidities.
摘要：
背景：2020年，澳大利亚将资助的老年肺炎球菌疫苗接种计划从65岁时使用23价肺炎球菌多糖疫苗（PPV23）改为70岁时使用13价肺炎球菌结合疫苗（PCV13）。我们调查了计划变更前后老年人对PCV13和PPV23的摄取。
方法：我们分析了参加一般实践（GP）的患者记录的国家数据集。我们包括2020年65岁或以上的常规与会者。在2020年7月1日计划变更之前（2019年1月至2020年6月）和之后（2020年7月至2021年5月）的两个时期，按年龄组和合并症的存在进行了比较PCV13的累积吸收和PPV23的每月吸收。
结果：我们的研究包括来自192,508名患者的数据（2020年的平均年龄：75.1岁，54.2%女性，46.1%，至少有一种合并症）。2020年7月之前，对于所有成年人，无论潜在的合并症如何，PCV13的累积摄入量<1%，但到2021年5月，即计划变更后的11个月，在70-79岁（无合并症：16.3％；合并症：21.1％）和80岁以上（无合并症：13.5％；合并症：17.7％）的人群中，PCV13的累积摄取增加，但不在65-69岁的人群中（无合并症：1.3％；合并症：3％）。在所有年龄组的计划变更后，PPV23的每月摄取下降。
结论：70岁以上人群中PCV13和PPV23摄取的变化与程序变化一致。然而,在65-69岁的总体个体和有合并症的个体中，PCV13的摄取仍然大大降低。
方法：我们分析了参加一般实践（GP）的患者记录的国家数据集。我们包括2020年65岁或以上的常规与会者。在2020年7月1日计划变更之前（2019年1月至2020年6月）和之后（2020年7月至2021年5月）的两个时期，按年龄组和合并症的存在进行了比较PCV13的累积吸收和PPV23的每月吸收。
结果：我们的研究包括来自192,508名患者的数据（2020年的平均年龄：75.1岁，54.2%女性，46.1%，至少有一种合并症）。2020年7月之前，对于所有成年人，无论潜在的合并症如何，PCV13的累积摄入量<1%，但到2021年5月，即计划变更后的11个月，在70-79岁（无合并症：16.3％；合并症：21.1％）和80岁以上（无合并症：13.5％；合并症：17.7％）的人群中，PCV13的累积摄取增加，但不在65-69岁的人群中（无合并症：1.3％；合并症：3％）。在所有年龄组的计划变更后，PPV23的每月摄取下降。
结论：70岁以上人群中PCV13和PPV23摄取的变化与程序变化一致。然而,在65-69岁的总体个体和有合并症的个体中，PCV13的摄取仍然大大降低。
