Eight years of active proposal of pneumococcal 23-valent polysaccharide vaccine: survey on coverage rate among elderly and chronic patients.
BACKGROUND
Streptococcus pneumoniae, lancet-shaped, gram-positive, facultative anaerobic organisms, are common inhabitants of the respiratory tract and may be isolated from the nasopharynx of 5% to 70% of healthy adults.


OBJECTIVE
The aims of the study were to estimate the vaccination coverage for pneumococcal 23-valent polysaccharide vaccine and to assess the impact its introduction in the Italian region of Puglia, where a program to provide this vaccination has been operative since 2000.


METHODS
Estimation of the coverage for pneumococcal 23-valent polysaccharide vaccine was implemented by a 2-step study consisting of data collection from local health unit vaccination registers between 2000 and 2008 in Puglia and of a cluster sampling study among general practitioners to validate routine data collected during the first step. Moreover, hospitalization for invasive pneumococcal diseases was studied.


RESULTS
From 2000 to 2004, among individuals > or =65 years, the overall coverage rate estimated by routine data amounted to 26.3%; between 2005 and 2007, annual coverage rates did not exceed 8%/year. Between 2002 and 2007, the overall coverage rate estimated by interviewing general practitioners was 46.6% (95% confidence interval: 39.9-53.4). The coverage rate in chronic patients by routine data was approximately 23%, whereas the rate provided by general practitioners was 17.6% (95% confidence interval: 12.5-22.8). From 2001 to 2007, hospitalization data did not show a reduction in invasive pneumococcal disease trends among the elderly population in Puglia.


CONCLUSIONS
The results of this study demonstrate the need for improving vaccine coverage and implementing new immunization strategies and practices.
Martinelli
Domenico
D
Section of Hygiene, Department of Medical and Occupational Science, University of Foggia, Viale Pinto, Foggia, Italy.
Tafuri
Silvio
S
Caputi
Giovanni
G
Fortunato
Francesca
F
Reggio
Paolo
P
Germinario
Cinzia
C
Prato
Rosa
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007558:Italy; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D014611:Vaccination; D055815:Young Adult
C414006:23-valent pneumococcal capsular polysaccharide vaccine; D022242:Pneumococcal Vaccines