Pneumococcal DES must cover all at-risk groups

The pneumococcal vaccination programme should be incentivised in the same way as the influenza programme if large gaps in uptake are to be addressed, say UK researchers.

Currently, the combined influenza and pneumococcal directed enhanced service (DES) covers at-risk patients for the flu jab, but only patients over 65 and children in the pneumococcal programme.

But research has revealed low pneumococcal uptake levels among the at-risk groups not covered by the DES.

Researchers from the Health Protection Agency (HPA) examined pneumococcal uptake levels between 1999 and 2005, using data on 2.9 million patients registered with 413 practices in England and Wales.

Uptake rates were found to be highest in patients with cochlear implants at 69 per cent.

But uptake levels dropped in other groups, with just 36.5 per cent of CHD patients and 34.7 per cent of diabetics vaccinated.

The lowest levels of uptake were seen in patients with sickle cell disease (15.9 per cent), and those with chronic respiratory disease (12.6 per cent).

The researchers concluded there are 'large gaps in pneumococcal vaccine uptake in a number of at-risk populations'.

'These coverage levels are much lower than those observed for influenza vaccination,' the report said.

The researchers point out that pneumococcal vaccinations lack incentivisation.

Dr George Kassianos, RCGP immunisation spokesman and Berkshire GP, said: 'There needs to be more incentives to push the pneumococcal programme just like there are for the influenza programme.'

Epidemiol Infect 2008

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