ABSTRACT
SETTING: Patients aged ⩾ 40 years with a diagnosis of chronic obstructive pulmonary disease (COPD; codes R95, R79 and R91 in the International Classification for Primary Care) registered in primary care clinical records in the Autonomous Community of Madrid, Spain. OBJECTIVE: To assess pneumococcal vaccination coverage in patients with COPD and to analyse factors associated with vaccination uptake. DESIGN: Population-based cross-sectional study in which data were collected in September 2010. RESULTS: We found that 93,797 patients (72.0% men and 28.0% women) had COPD. Overall coverage was 65.5% (67.5% men vs. 60.4% women, P < 0.001). In patients aged 40-59 years, coverage was 19.5%, reaching 75.8% in those aged ⩾ 60 years. In patients aged <60 years, uptake was associated with a higher number of comorbidities and appropriate adherence to seasonal influenza and pandemic vaccination schedules. In patients aged ⩾ 60 years, factors associated with uptake in both sexes were older age and appropriate adherence to seasonal influenza vaccination schedules. Factors associated with uptake in men were concomitant comorbidities and pandemic vaccination. CONCLUSION: Vaccination coverage in individuals aged <60 years with COPD is less than acceptable in Madrid. Coverage was higher in men and in patients with another chronic condition.
Subject(s)
Pneumococcal Infections/prevention & control , Pneumococcal Vaccines/administration & dosage , Practice Patterns, Physicians'/trends , Pulmonary Disease, Chronic Obstructive/therapy , Vaccination/trends , Adult , Age Factors , Aged , Aged, 80 and over , Comorbidity , Cross-Sectional Studies , Female , Guideline Adherence/trends , Health Care Surveys , Humans , Immunization Schedule , Male , Middle Aged , Pneumococcal Infections/diagnosis , Pneumococcal Infections/epidemiology , Practice Guidelines as Topic , Primary Health Care , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Registries , Sex Factors , Spain/epidemiologyABSTRACT
Streptococcus pneumoniae es responsable de una importante morbilidad y mortalidad, afectando especialmente a niños menores de 2 años, mayores de 65 años y adultos inmunocomprometidos o inmunocompetentes con patología de base. Actualmente sólo disponemos de una vacuna de 23 polisacáridos que, aunque eficaz en personas de edad avanzada, presenta importantes limitaciones: no es eficaz en niños menores de 2 años ni en inmunodeprimidos, induce una respuesta inmunológica variable, de poca duración y no confiere memoria inmunológica.Todo ello orientó la investigación hacia nuevas vacunas antineumocócicas conjugadas que inducen memoria inmunológica. Los ensayos clínicos realizados han demostrado su inmunogenicidad y seguridad en niños. Los resultados preliminares del estudio llevado a cabo con la vacuna conjugada heptavalente (PncCRM) demuestran una eficacia del 100 por ciento (IC95 por ciento : 81-100 por ciento) frente a serotipos vacunales, y 89 por ciento frente a todos los neumococos. Esta vacuna ha sido recientemente aprobada por la FDA para la prevención de meningitis y bacteriemia causada por S. pneumoniae en niños menores de 2 años y en aquellos entre 2 y 5 años con alto riesgo de padecer la enfermedad (AU)