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Pneumococcal vaccination: uptake and coverage in primary care

Matthew Thalanany, Tarik Derrough

Objectives To assess pneumococcal vaccination coverage achieved in primary care in the Billericay, Brentwood and Wickford area, in order to inform decisions on options to improve pneumococcal vaccination coverage in the future. Study design An audit was set up to evaluate pneumococcal vaccination coverage in patients aged 80 years and over, and those falling in one of theclinical at-risk groups (as defined in August 2003 within the Department ofHealth recommendations). A total of 15 practices at the Billericay, Brentwood and Wickford Primary Care Trust (BBW PCT)were evaluated.Methods The audit was conducted between May and August 2004. Pneumococcal vaccination uptake was assessed by both age-group and clinical risk factor recommendations. Several other factors were also assessed to determine their influence on thelevel of uptake in a given patient population.Results The overall mean vaccine coverage inpatients aged 80 years and over, and patients with a clinical risk factor was found to be 59% and 36%, respectively. In those aged 80 years and over, factors that significantly influenced vaccine uptake werethe presence of a concomitant chronic illness, gender and practice size. Clinical risk patients’ vaccination uptake was also significantly influenced by practice size as well as by the proportion of practiceregistered patients aged 65 years and over.Conclusions The good vaccination coverage achieved in BBW PCT is not typical within the UK. The Department of Health has specifically identified a low level of pneumococcal vaccination uptake in high-risk groups as an important issue, and has asked that measures be put in place by all healthcare professionals and by every PCT to maximise uptake. This audit clearly identifies that smaller= practices are likely to need support to achieve adequate rates.