Pneumococcal vaccination at 65 years and vaccination coverage in at-risk adults: A retrospective population-based study in France

Age (> 50 years) is a risk factor for pneumococcal disease, but is not an indication for vaccination in France, by contrast to influenza. In 2018, the pneumococcal vaccine coverage rate (VCR) was 4.5% in adults at-risk, in contrast to the influenza VCR, which was 43.6%. We aimed to assess pneumoc...

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Veröffentlicht in:	PloS one Jg. 20; H. 8; S. e0329703
Hauptverfasser:	Wyplosz, Benjamin, Grenier, Benjamin, Roche, Nicolas, Roubille, François, Loubet, Paul, Sultan, Ariane, Fougère, Bertrand, Fernandes, Jérôme, Duhot, Didier, Moulin, Bruno, Raguideau, Fanny, Blanc, Emmanuelle, Goussiaume, Gwenael
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States Public Library of Science 11.08.2025 Public Library of Science (PLoS)
Schlagworte:	Adult Adults Age Aged Aged, 80 and over Algorithms Asthma Biology and Life Sciences Chronic illnesses Chronic obstructive pulmonary disease Cochlear implants Comorbidity Demographic aspects Diabetes Dosage and administration Drug dosages Female France - epidemiology Geriatry and gerontology Health aspects HIV Human health and pathology Human immunodeficiency virus Humans Immunology Infectious diseases Influenza Influenza Vaccines Influenza, Human - epidemiology Influenza, Human - prevention & control Kidney diseases Life Sciences Liver diseases Lung diseases Male Medicine and Health Sciences Middle Aged Patients People and places Pneumococcal infections Pneumococcal Infections - epidemiology Pneumococcal Infections - prevention & control Pneumococcal vaccine Pneumococcal Vaccines - administration & dosage Pneumococcal Vaccines - therapeutic use Pneumonia Polysaccharides Population Population studies Prevention Pulmonology and respiratory tract Retrospective Studies Risk Factors Santé publique et épidémiologie Schedules Transplants & implants Vaccination - statistics & numerical data Vaccination Coverage - statistics & numerical data Vaccines Vaccinology Young Adult France
ISSN:	1932-6203, 1932-6203
Online-Zugang:	Volltext
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Zusammenfassung:	Age (> 50 years) is a risk factor for pneumococcal disease, but is not an indication for vaccination in France, by contrast to influenza. In 2018, the pneumococcal vaccine coverage rate (VCR) was 4.5% in adults at-risk, in contrast to the influenza VCR, which was 43.6%. We aimed to assess pneumococcal and influenza VCR in 2020 in the entire French population and factors associated with a higher VCR (including the age of 65 years). We retrospectively included all adults covered by the National Health Service in 2020 and identified patients at-risk using validated algorithms. We assessed VCRs by analysing pneumococcal vaccines reimbursed between 2009 and 2020 (13-valent pneumococcal conjugate vaccine [PCV13] and 23-valent polysaccharide vaccine [PPSV23]), and influenza vaccines reimbursed between September 2020 and March 2021. In 2020, we identified 7,336,769 adults at risk (median age: 67.0 years): 84.2% had comorbidities and 24.5% were immunocompromised. The overall pneumococcal VCR (PCV13 + PPSV23) was 9.9% and the seasonal influenza VCR was 51.1%. The variable associated with the highest odds of VCR was an "age ≥65 years" for influenza (odds ratio [OR] 4.14), but not for pneumococcal vaccination (OR 1.02). In patients with comorbidities, pneumococcal VCR did not significantly increase between those aged 18-65 years and those aged > 65 years (7.2% to 9.4%), and even decreased from 20% to 17.9% in patients with immunodeficiencies. In contrast, influenza VCR increased significantly from 35.5% to 67.9% (OR 3.55) in patients with comorbidities, and from 27.3% to 71.2% (OR 5.57) in those with immunodeficiencies. In France, pneumococcal VCR did not increase above 65 years of age (OR 1.02), by contrast to influenza VCR (OR 4.14) that increased significantly, suggesting that an age-based recommendation for pneumococcal vaccination will probably benefit to VCR in at-risk, elderly population.
Bibliographie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: BW received Payments from for lectures from Pfizer, Sanofi, Lilly, GSK, for meetings from Pfizer. BG and FR are employees of Heva, the CRO which received payments from Pfizer to conduct the study. NR received institutional grants, consulting fees, honoraria for lectures from Chiesi, GSK, Pfizer, consulting fees and honoraria for lectures from AstraZeneca, Sanofi, Teva, consulting fees from Austral and Biosency, honoraria for lectures, from Zambon, MSD, Menarini and support for meetings from Chiesi, AstraZeneca, GSK. FRoub received honoraria for lectures from Astra Zeneca, Servier, Boehringer, Astra Zeneca, Vifor, Bayer, Pfizer, Novartis, Servier, Novonordisk, Air liquid, Abbott, QuidelOrtho, Newcard, MSD, BMS, Sanofi, Alnylam, Zoll, Implicity, GSK, BMS, consulting fees from Abbott, Air liquide Bayer, Pfizer, support for travel from Novartis, Boehringer-Ingelheim, participates in an advisory board for Carmat, fiduciary role for Boehringer-Ingelheim, Vifor Pharma, Novartis, medical writting from Pfizer. PL received consulting fees from Pfizer, GSK, Sanofi, honoraria for lecture from Pfizer, GSK, Sanofi, Moderna, MSD, Support for attending meeting from Pfizer, Astrazeneca, MSD, Sanofi, GSK. AS received Grants from VIATRIS, SERVIER, Consulting fees from PFIZER, SANOFI, LILLY, SERVIER, ASTRA, DEBEX, NOVARTIS, URGO, honoraria for lectures from PFIZER, SANOFI, LILLY, SERVIER, ASTRA, DEBEX, NOVARTIS, ABOTT, MSD. BF received Consulting fees from Sanofi, AstraZeneca, Pfizer, GSK, honoraria for lectures from Sanofi, AstraZeneca, Pfizer, GSK, CSL Seqirus, Participation on a Data Safety Monitoring Board or Advisory Board for Pfizer. JF received Grants from Astra ZENECA ASTELLAS Pharma ABBVIE JANSSEN BMS, Consulting fees from Astra ZENECA ASTELLAS Pharma ABBVIE JANSSEN BMS, honoraria for lectures from Astra ZENECA ASTELLAS Pharma ABBVIE JANSSEN BMS. DD received honoraria for lecture from Pfizer, BM received honoraria for lecture from Pfizer. EB and GG are employees from Pfizer and may hold stock options. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0329703