Stanley E. Grogg, Jan Schultz. Call to Action on Pneumococcal Disease: Review of Vaccination Evidence and Outcomes of Webcast Programs. J Am Osteopath Assoc 2015;115(6_suppl):S6–S25. doi: 10.7556/jaoa.2015.071.
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In 2015, the Advisory Committee on Immunization Practices issued updated recommendations for the use of 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23) to immunize adults aged 19 to 64 years with risk factors and all adults aged 65 years or older. Despite these recommendations, rates of vaccination among adults remain low. Federal and state initiatives have been launched to encourage health care providers to incorporate vaccination screening and recommendations in practice. Several resources are available to improve vaccination rates, including implementing electronic medical records; engaging non-physician staff in assessing vaccination history and administering immunizations; adopting standing order protocols; and implementing strong recommendations to patients regarding needed immunizations. However, even in the face of compelling evidence-based research, implementing changes in practice is challenging. The American Osteopathic Association implemented a 2-part Web program called the Call to Action on Pneumococcal Disease. Although some changes in attitudes and intent to change were demonstrated by this initiative, there were no statistically significant increases in self-reported actual adoption of standing order protocols or increases in adult pneumococcal immunization. Nonetheless, some lessons were learned, and these results support the need for ongoing efforts in this area of medicine.
a Including congestive heart failure and cardiomyopathies.
b Including chronic obstructive pulmonary disease, emphysema, and asthma.
c A second dose of 23-valent pneumococcal polysaccharide vaccine (PPSV23)is recommended 5 years after the first dose for persons with functional or anatomic asplenia and for immunocompromised persons.
d Includes B-(humoral) or T-lymphocyte deficiency, complement deficiencies (particularly C1, C2, C3, and C4 deficiencies), and phagocytic disorders (excluding chronic granulomatous disease).
Source: Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR Morb Mortal Wkly Rep. 2010;59(34):1102-1106.
Source: Centers for Disease Control and Prevention (CDC). Noninfluenza vaccination coverage among adultsUnited States, 2011. MMWR Morb Mortal Wkly Rep. 2013;62(4):66-72.19
Source: Adapted from Increasing appropriate vaccination. Guide to Community Preventative Services website. http://www.thecommunityguide.org/vaccines/index.html. Accessed April 21, 2015
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