Providers Prefer Increased Pneumonia, IPD Coverage and Lower Age Recommendation For Pneumococcal Vaccines

Health care providers (HCPs) support a lower age-based recommendation for pneumococcal vaccines, although increased coverage of pneumococcal pneumonia and invasive pneumococcal disease (IPD) in adults 65 years or older was identified as the most important attribute when considering new pneumococcal vaccines.¹

Pneumococcal vaccines have been proven effective at preventing serious disease. | Image Credit: © kittisak | stock.adobe.com

The results, garnered from a non-interventional, cross-sectional survey conducted among HCPs who oftentimes recommend, administer, or prescribe pneumococcal vaccines, can help contribute to the Evidence to Recommendation (EtR) framework that the CDC's Advisory Committee on Immunization Practices (ACIP) uses to evaluate vaccine recommendations.¹

As part of their framework, ACIP formalizes considerations of stakeholder values and preferences, as well as their acceptability of a new vaccine. Given that these providers are usually one of the most important factors in vaccination counseling for patients, this survey was conducted to gauge HCP’s perceptions toward adult pneumococcal vaccinations and quantify their preferences for vaccine attributes.¹

Most survey respondents—340 in total—were male (55.6%), White (85.3%), and practiced in an urban area (82.9%), with an average age of 44.9 years. The respondents were experienced, with an average of 13.5 years in practice.¹

Results indicate that HCPs were around 3 times as likely (OR 2.9; 95% CI, 2.44-3.43) to prefer a pneumococcal vaccine with higher coverage of pneumococcal in adults 65 years and older compared to a vaccine with lesser coverage. Similarly, HCPs were twice as likely (OR 1.92; 95% CI, 1.62-2.27) to prefer a vaccine with higher coverage of IPD for those in this demographic compared to one with decreased coverage.¹

Regarding vaccine evaluation in clinical trials, HCPs significantly preferred a vaccine that has been evaluated in trials among both at-risk/high-risk adults and healthy adults, compared to those with solely healthy adults (OR 1.17; 95% CI, 1.08-1.26). Notably, the most important attributes motivating HCP vaccine decisions were factors associated with disease coverage—including the percentage of coverage of pneumococcal pneumonia and IPD in older adults.¹

HCPs across the board (95.9%) were receptive to the idea of having more approved options for pneumococcal vaccination. During the survey, respondents were shown data demonstrating pneumococcal disease mortality and morbidity by age group; they were then asked about their views on potential changes to ACIP pneumococcal vaccine recommendations. Among respondents, around 91% indicated they would likely or very likely support and implement a recommendation to lower the recommended age for pneumococcal vaccines from ≥65 to ≥50 years of age.¹

These results are especially salient considering recent developments surrounding newly developed pneumococcal vaccines. The STRIDE-8 phase 3 trial evaluated the pneumococcal 21-valent conjugate vaccine, which was effective at protecting adults 16 to 64 years at heightened risk of disease who were vaccine-naive. Earlier this year, the FDA approved the vaccine for the prevention of invasive pneumococcal disease and pneumonia.^2,3

Perhaps most critically, in October the ACIP voted 14-to-1 to expand recommendations for the use of certain pneumococcal vaccines to include ages 50 and older. The recommendation was endorsed by the CDC and is pending final approval by the federal government.⁴

The recommendation aligns with the desires of a vast majority of HCPs who indicated as such in the survey. Multiple factors were cited as benefits of lowering the age-based recommendation, with 73.5% expecting that vaccination rates among at-risk adults would increase and 70.6% predicting that herd immunity would increase. Furthermore, many HCPs believed vaccine uptake would increase in multiple population and age groups, including adults 65 years and older and adults 50 to 64 years.¹

“This research contributes to a better understanding of the preferences and priorities of those involved in making decisions related to adult pneumococcal vaccinations and aligns with the goals of the evidence to recommendation framework of soliciting feedback from the target population to consider in policy making,” the study authors concluded.¹

REFERENCES

1. Mohanty S, Tsai JH, Ning N, et al. Preferences and attitudes of health care providers towards pneumococcal vaccines for adults in the United States. Expert Review of Vaccines. 2024;23(1):966-973. doi:10.1080/14760584.2024.2417393

2. Halpern L. Pneumococcal 21-valent conjugate vaccine generates positive response in adults at increased risk of disease. Pharmacy Times. Published October 21, 2024. Accessed November 7, 2024. https://www.pharmacytimes.com/view/pneumococcal-21-valent-conjugate-vaccine-generates-positive-response-in-adults-at-increased-risk-of-disease

3. Gallagher A. FDA approves V116 for prevention of invasive pneumococcal disease and pneumonia. Pharmacy Times. Published June 18, 2024. Accessed November 7, 2024. https://www.pharmacytimes.com/view/fda-approves-v116-for-prevention-of-invasive-pneumococcal-disease-and-pneumonia

4. Gallagher A. ACIP lowers pneumococcal vaccination recommendation to age 50. Pharmacy Times. Published October 24, 2024. Accessed November 7, 2024. https://www.pharmacytimes.com/view/acip-lowers-pneumococcal-vaccination-recommendation-to-age-50