Pneumococcal and influenza vaccination levels among HIV-infected adolescents and adults receiving medical care in the United States. Adult and Adolescent Spectrum of HIV Disease Project Group.
OBJECTIVE
To assess pneumococcal and influenza vaccination coverage among HIV-infected adolescents and adults receiving medical care in the United States.


METHODS
Periodic medical record reviews.


METHODS
More than 90 clinics, hospitals, and private medical practices in nine cities.


METHODS
HIV-infected individuals aged > or = 13 years were included in the analyses of pneumococcal (n = 9737) and influenza (n = 6161) vaccination coverage.


METHODS
Documentation of receipt of pneumococcal and influenza vaccines in medical records during 6-18-month and 12-month periods, respectively.


RESULTS
Overall, 37 and 33% of individuals received pneumococcal and influenza vaccines, respectively. In general, vaccination levels varied little by age group, race/ethnicity, or mode of HIV exposure. Having had at least five medical visits was significantly associated with having received pneumococcal and influenza vaccines [adjusted odds ratio (OR), 1.7 for each]. Having a CD4+ T-lymphocyte count < 200 x 10(6)/l (adjusted OR, 0.8) and being female (adjusted OR, 0.7) were associated with non-receipt of pneumococcal vaccine. Lower pneumococcal vaccination coverage among women was mostly accounted for by pregnancy.


CONCLUSIONS
Until new, more effective means of preventing pneumococcal disease and influenza become available, efforts should be directed towards improving vaccination levels among HIV-infected individuals.
Wortley
P M
PM
Division of HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, Georgia 30333.
Farizo
K M
KM
D000293:Adolescent; D000328:Adult; D001428:Bacterial Vaccines; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D007252:Influenza Vaccines; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D022242:Pneumococcal Vaccines; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D014611:Vaccination / Q000706:statistics & numerical data*
D001428:Bacterial Vaccines; D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines