Pneumococcal vaccine: uptake remains low among elderly

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  • Despite data demonstrating the efficacy of 13-valent pneumococcal conjugate vaccine (PCV13) in conjunction with a 23-valent pneumococcal polysaccharide vaccine (PPSV23) series in adults ≥65 y, uptake and related Medicare claims have been persistently low.

Why this matters

  • Clinicians are encouraged to ensure adult patients ≥65 y, especially Medicare (Parts A, B) beneficiaries who are Hispanic/non-Hispanic black, impoverished, and/or free of chronic/immunocompromised disease, routinely initiate and complete the ACIP-recommended vaccination series.
  • Only 2 pneumococcal vaccines are approved for use in adults in the United States: PCV 13 (which was fast-tracked through the FDA because of its benefit over existing treatments) and the PCV23 series.

Study design

  • This study identified vaccination coverage (PCV13/ PPSV23) from September 2009 to 2016 through estimated claims for vaccination among adults aged ≥65 y.
  • Funding: None disclosed.

Key results

  • By 2016, 43.2% Medicare beneficiaries received ≥1 doses PPSV23 and 31.5% received ≥1 doses PCV13.
  • 18.3% patients had at least 1 claim for both PPSV23 and PCV13.
  • Although 2014 recommendations suggest using PCV13 in series with PPSV23, claims by adults ≥65 y have been persistently low.
  • Claims were lower among healthy persons and lower age group (65–69 y).


  • Medicare claims as a proxy for vaccination coverage.

Coauthored with Chitra Ravi, MPharm