title: Pneumococcal vaccination rates in adults in Germany: an analysis of statutory health insurance data on more than 850,000 individuals.
abstract: BACKGROUND
  The German Standing Committee on Vaccination Recommendations (Ständige Impfkommission, STIKO) recommends standard vaccination against pneumococcal infections for all persons aged 60 or older, and for all persons of any age with an increased health risk. It is not known how many persons in the target group in Germany have actually been vaccinated.
  
  
  METHODS
  We used claims data of a German statutory health insurance (Deutsche BKK) to determine pneumococcal vaccination rates, stratified by age and risk, for the one-year period 1 July 2008 to 30 June 2009. The number of influenza vaccinations in the same period was analyzed for comparison. Because pneumococcal vaccination does not need to be performed annually, the calculated rates are an underestimate of the percentage of persons who have been vaccinated. A simulation model was used to correct for persons vaccinated at earlier times. The vaccination rates were estimated on the basis of various scenarios.
  
  
  RESULTS
  Data were obtained on 867 683 persons aged 18 or older. According to an optimistic estimate, the percentage of pneumococcal vaccination in the overall population is 3.75% for persons aged 18-59 and 50.89% for persons aged 60 and above (influenza: 8.80% and 41.15%, respectively). In persons at elevated risk, the rate of vaccination in the presence of at least one risk factor is 12.66% / 54.67% (influenza: 15.66% / 39.96%). In persons with moderate risk, the vaccination rate is 16.02% / 56.75% (influenza: 18.54% / 40.61%); in persons whose elevated risk was high, it is 8.93% / 52.21% (influenza: 7.37%/37.78%). The limitations of this study are the short study period and the inability to define the population at risk unambiguously.
  
  
  CONCLUSIONS
  The rate of pneumococcal vaccination in adults in Germany is too low; at best, it is comparable to that of influenza vaccination. These results should be validated by nationwide monitoring of the pneumococcal vaccination program. For example, questions about pneumococcal vaccination could be included in the GEDA study (German Health Update) that is conducted annually by the Robert Koch Institute.
authors.affiliation: Herescon Gmbh, Hannover, Centre for Health Economics Research Hannover, Hannover, Department of Health Care Management, Deutsche BKK, Wolfsburg.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Theidel
authors.forename: Alexander
authors.initials: A
authors.lastname: Kuhlmann
authors.forename: Anja
authors.initials: A
authors.lastname: Braem
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D032541:Mass Vaccination / Q000706:statistics & numerical data*; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D015995:Prevalence; D018570:Risk Assessment; D017678:Sex Distribution; D055815:Young Adult
chemical_list: D022242:Pneumococcal Vaccines