Changes in pneumococcal vaccine coverage in the Canadian Longitudinal Study on Aging (CLSA): An analysis based on the 2018-2021 follow-up 2 survey.

Pneumococcal vaccine coverage among eligible adults aged 65 years and older was 56.8% during 2018-2021.

• 56.8% (95% CI: 55.8-57.7%) of eligible study participants aged 65 years and older reported having received the pneumococcal vaccine when surveyed between 2018-2021.
• This is based on n = 10,530 participants in this age group.
• This coverage level remains well below Canada's national target of 80% to be achieved by 2025.
• Data were drawn from the CLSA second follow-up visit (FUP2; 2018-2021), a nationally representative cohort launched in 2011.

Pneumococcal vaccine coverage among adults aged under 65 years with at least one chronic medical condition was 19.3% during 2018-2021.

• 19.3% (95% CI: 18.1-20.5%) of those aged <65 years with at least 1 chronic medical condition reported having received the pneumococcal vaccine.
• This is based on n = 4,055 participants in this group.
• This coverage level is substantially lower than among older adults aged 65 and over.
• Pneumococcal vaccination is recommended for individuals with chronic medical conditions due to their high risk of invasive pneumococcal disease.

Pneumococcal vaccine coverage among adults aged 65 and older increased by only approximately 2% between 2015-2018 and 2018-2021.

• 28.4% of participants aged 65 years and older reported being newly vaccinated compared to three years prior (FUP1; 2015-2018).
• Despite this new vaccination uptake, the net change in overall coverage was only approximately 2% over the three-year period.
• The authors previously reported pneumococcal vaccination estimates for 2015-2018, enabling this comparison.
• No changes in overall coverage were observed among those under the age of 65 with underlying conditions, where 11% reported being newly vaccinated.

Males, rural residents, and individuals in certain provinces reported lower pneumococcal vaccination rates.

• Sociodemographic disparities in vaccination coverage were identified through cross-sectional analysis stratified by sociodemographic characteristics.
• The analysis covered participants across Canadian provinces, with provincial-level variation in vaccination rates observed.
• Rural residency was associated with lower vaccination rates compared to urban residency.
• Male sex was associated with lower vaccination rates compared to female sex.

Receipt of influenza vaccination in the previous 12 months was associated with higher odds of being newly vaccinated for pneumococcal disease in both age groups.

• Logistic regression was used to identify factors associated with being newly vaccinated for pneumococcal disease as reported during FUP2 compared with FUP1.
• Higher odds of being newly vaccinated were observed among individuals who reported having received influenza vaccination in the previous 12 months in both the ≥65 years and <65 years with CMC groups.
• Contact with a family doctor in the previous 12 months was also included as a covariate in the analysis.
• The association between influenza vaccination and pneumococcal vaccination suggests a potential role for healthcare contact and provider recommendation in driving pneumococcal vaccine uptake.

Canada's national pneumococcal vaccination target of 80% coverage is to be achieved by 2025, and current coverage falls substantially short of this goal.

• The national target of 80% coverage by 2025 applies to eligible groups including older adults and individuals with chronic medical conditions.
• Coverage among adults aged 65 and older (56.8%) and among those under 65 with CMC (19.3%) both fall well below the 80% target.
• The slow rate of increase (approximately 2% over three years in the 65+ group) suggests the target is unlikely to be met by 2025 at the current pace.
• Pneumococcal vaccination is recommended for older adults and individuals with chronic medical conditions due to the high risk of invasive pneumococcal disease in these groups.