13-Valent Pneumococcal Conjugate Vaccine Utilization in the Primary Care Setting

Introduction: The Centers for Disease Control and Prevention (CDC) began recommending a one-time dose of 13-valent pneumococcal conjugate vaccine (PCV13), Prevnar 13®, for adults 65 years and older in September 2014. A detailed immunization schedule also exists for PCV13 in the elderly based on previous pneumococcal vaccinations that may complicate adherence.

Objectives: To assess the utilization and adherence of PCV13 vaccine in adults ≥ 65 years old in three clinics in accordance with updated CDC recommendations for PCV13 immunization.

Study Design: This ongoing study is a retrospective chart review examining the percentage of elderly patients who qualify for and receive the recommended PCV13 vaccination among three sample outpatient clinics in the greater Winston Salem area.

Methods: Inclusion criteria for the study include: Adults ≥ 65 years old seen by a medical group-associated primary care physician (PCP) for a Medicare annual wellness visit within the month of February 2015. Patients < 65 years old, not seen for a Medicare annual wellness visit or deceased upon review were excluded.

Primary endpoints are the percentage of patients who received prescriptions for PCV13 vaccine as well as percentage of patients with documented administration of PCV13 vaccine. Secondary endpoints of 23-valent pneumococcal polysaccharide vaccine (PSV23) administration and adherence to CDC pneumococcal immunizations schedule will be assessed. Descriptive analysis will be used for all comparisons.

Results: Preliminary results from one clinic suggest 50% of patients have received prescriptions for PCV13; however, only 10% were addressed and documented during the patient's Medicare annual wellness visit. Remainder of patients received prescriptions for PCV13 at other medical office visits. Thirty two percent of patients have documented administration dates in the electronic medical record.

Conclusions: Based on preliminary results, there appears to be a discrepancy with documentation habits for PCV13 prescribing and administration. Full study conclusions anticipated in February 2016.