title: Pneumococcal Carriage and Vaccine Coverage in Retirement Community Residents.
abstract: OBJECTIVE
  To evaluate pneumococcal immunization in older adults living in retirement communities and to measure nasopharyngeal carriage of Streptococcus pneumoniae to better assess the potential for herd protection from the 13-valent pneumococcal conjugate vaccine (PCV-13) in these settings.
  
  
  METHODS
  Cross-sectional observational study of adults aged 65 and older living in retirement communities to determine coverage with 23-valent pneumococcal vaccine (PPSV-23), coverage with PCV-13 in immuncompromised individuals according to 2012 Advisory Committee on Immunization Practices (ACIP) guidelines, and nasopharyngeal carriage of S. pneumoniae.
  
  
  METHODS
  Two retirement communities in North Carolina.
  
  
  METHODS
  Older adults recruited between December 2013 and April 2014 (N = 21, 64.8% female, mean age 81.4).
  
  
  METHODS
  A survey was used to assess chronic illnesses, immunization history, and potential risk factors for pneumococcal carriage; a chart review was used to confirm immunization history and abstract chronic conditions; and a nasopharyngeal swab was collected and cultured for S. pneumoniae.
  
  
  RESULTS
  Eighty-seven percent of participants reported receiving PPSV-23 since age 65. Of the 16.2% of participants with an immunocompromising condition, only one had received PCV-13. Nasopharyngeal carriage with S. pneumoniae was detected in 1.9% (95% confidence interval = 0.0-3.8%) of participants.
  
  
  CONCLUSIONS
  In this select sample, PPSV-23 coverage was high, but adherence to the ACIP recommendation for PCV-13 in immunocompromised groups was low. Nasopharyngeal carriage of S. pneumoniae was present, although infrequent, suggesting that immunization with PCV-13 could provide an individual benefit and a small degree of herd protection.
authors.affiliation: Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Becker-Dreps
authors.affiliation: Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Kistler
authors.affiliation: Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Ward
authors.affiliation: Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Ley A
authors.initials: LA
authors.lastname: Killeya-Jones
authors.affiliation: Department of Medicine, Center for Applied Genomics and Precision Medicine, Duke University, Durham, North Carolina.
authors.forename: Olga Maria
authors.initials: OM
authors.lastname: Better
authors.affiliation: Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: David J
authors.initials: DJ
authors.lastname: Weber
authors.affiliation: Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Sheryl
authors.initials: S
authors.lastname: Zimmerman
authors.affiliation: Institute for Medical Research, Durham Veterans Affairs Medical Center, Durham, North Carolina.
authors.forename: Bradly P
authors.initials: BP
authors.lastname: Nicholson
authors.affiliation: Infectious Diseases Section, Durham Veterans Affairs Medical Center, Durham, North Carolina.
authors.forename: Chris W
authors.initials: CW
authors.lastname: Woods
authors.affiliation: Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Philip
authors.initials: P
authors.lastname: Sloane
mesh_terms: D000369:Aged, 80 and over; D002353:Carrier State; D003430:Cross-Sectional Studies; D005260:Female; D016852:Housing for the Elderly; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009305:Nasopharynx / Q000382:microbiology*; D009657:North Carolina / Q000453:epidemiology; D022242:Pneumococcal Vaccines; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*; D014611:Vaccination / Q000706:statistics & numerical data*; D018074:Vaccines, Conjugate
chemical_list: D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
keywords: Pneumococcal conjugate vaccine; Pneumococcal polysaccharide vaccine; Streptococcus pneumoniae; geriatrics; retirement