Cobertura y asociación con variables clínicas de la vacunación antineumocócica en la población mayor de 65 años de Tarragona-Valls / Coverage and association with clinical variables of antipneumococcal vaccination of the population over 65 years-old in Tarragona-Valls

Fundamento: En Cataluña, el programa de vacunación antineumocócica(VAN), que incluye a todas las personas mayores de 65años se inició en 1999. Tres años después, analizamos las coberturasvacunales según presencia de factores de riesgo para padecer neumonía.Métodos: Estudio observacional transversal, emplazado en 8Áreas Básicas de Salud (ABS) de Tarragona. Se incluyeron todas laspersonas mayores de 64 años asignados a las 8 ABS participantes(n=11241). Mediante revisión de historias clínicas informatizadas ydel Registro informático de vacunaciones, valoramos en cadapaciente si había recibido la VAN antes de enero de 2002, así comola presencia de enfermedades o factores de riesgo para sufrir neumonía.Resultados: La cobertura vacunal global fue 44,4% (37,1% en65-74 años, 53,9% en 75-84 y 51,5% en 85-99 años). Las mayorescoberturas se dieron entre aquellos con neoplasia activa (56,7%),nefropatía crónica (55,3%), enfermedad pulmonar crónica (54,2%) ycardiopatía crónica (53,5%). Las menores coberturas se observaronen fumadores (38,9%), pacientes enólicos (43,6%) y hepatopatíacrónica (46,5%). La cobertura VAN fue 38,9% (IC 95%: 37,6-40,2)entre las personas sin ningún factor de riesgo, del 47,7% (IC 95%:46,1-49,4) entre aquellos con un factor, y del 52,7% (IC 95%:52,6-54,8) entre aquellos con dos o más factores.Conclusiones: A pesar de una cobertura global aceptable, existenamplios subgrupos de pacientes con alto riesgo que no han recibidola VAN. Los resultados sugieren que, tratando de alcanzar altascoberturas globales, la presencia de factores de riesgo es poco tenidaen cuenta para prescribir o no la VAN

Background: In Catalonia, a polyanccharide pneumococcalvaccine (PPV) programme which includes subjects over 65 yearsold, was started in 1999. Three years later, we study the vaccinecover in relation to the presence of risk factors for pneumonia.Methods: Cross-sectional observational study conducted in 8Basic Health Areas (BHA) of Tarragona. All the subjects over 65years old and assigned to one of the 8 basic health areas participatingin the study were included (n= 11241). Using computerized clinicalrecords and vaccination records we evaluated whether each patienthad received PPV before January 2002, and the presence of diseaseor risk factors for pneumonia.Results: Global vaccination coverage was 44.4% (37.1% in 65-74 years, 53.9% in 75-84 and 51.5% in 85-99 years). The greatestcoverage was recorded in subjects with active neoplasm (56.7%),chronic necropathy (55.3%), chronic lung disease (54.2%) and chroniccardiopathy (53.5%). The least coverage was recorded in smokers(38.9%), alcoholic patients (43.6%) and chronic liver disease(46.5%). AVP coverage was 38.9% (CI 95%: 37.6-40.2) in subjectswithout any risk factors, 47.7% (CI 95%: 46.1-49.4) in those withone factor, and 52.7% (CI 95%:52.6-54.8) in those with two or morefactors.Conclusions: In spite of an acceptable global coverage, there arelarge subgroups of high risk patients who have not received PPV. Theresults suggest that, in an attempt to achieve extended global coverage,the presence of risk factors is largely ignored when deciding whetherto prescribe PPV or not

[Coverage and association with clinical variables of antipneumococcal vaccination of the population over 65 years old in Tarragona-Valls]. / Cobertura y asociación con variables clínicas de la vacunación antineumocócica en la población mayor de 65 anos de Tarragona-Valls.

BACKGROUND: In Catalonia, a polyanccharide pneumococcal vaccine (PPV) programme which includes subjects over 65 years old, was started in 1999. Three years later, we study the vaccine cover in relation to the presence of risk factors for pneumonia. METHODS: Cross-sectional observational study conducted in 8 Basic Health Areas (BHA) of Tarragona. All the subjects over 65 years old and assigned to one of the 8 basic health areas participating in the study were included (n=11241). Using computerized clinical records and vaccination records we evaluated whether each patient had received PPV before January 2002, and the presence of disease or risk factors for pneumonia. RESULTS: Global vaccination coverage was 44.4% (37.1% in 65-74 years, 53.9% in 75-84 and 51.5% in 85-99 years). The greatest coverage was recorded in subjects with active neoplasm (56.7%), chronic necropathy (55.3%). chronic lung disease (54.2%) and chronic cardiopathy (53.5%). The least coverage was recorded in smokers (38.9%), alcoholic patients (43.6%) and chronic liver disease (46.5%). AVP coverage was 38.9% (CI 95%: 37.6-40.2) in subjects without any risk factors, 47.7% (CI 95%: 46.1-49.4) in those with one factor, and 52.7% (CI 95%: 52.6-54.8) in those with two or more factors. CONCLUSIONS: In spite of an acceptable global coverage, there are large subgroups of high risk patients who have not received PPV. The results suggest that, in an attempt to achieve extended global coverage, the presence of risk factors is largely ignored when deciding whether to prescribe PPV or not.