Pneumococcal vaccination in elderly care facilities in Japan: A cross-sectional, web-based survey

This study evaluated pneumococcal vaccination status using evaluable data collected from 445 of 1,313 managing directors of elderly care facilities in Japan through an online survey (September 5, 2022-November 25, 2022; UMIN000048747); comparisons were made with the influenza (2021–2022 vaccination only) and coronavirus disease 2019 (COVID-19) vaccination status. Among facilities who kept pneumococcal vaccination records (n = 42), the mean pneumococcal vaccination rate was 31.1%, with the rate being higher for the influenza (93.1%; n = 234) and COVID-19 (94.3%; n = 285) vaccines. Overall, excluding facilities that answered that the corresponding vaccine status at their sites was unknown, the percentage of facilities with high vaccination rates (80% to 100%) was substantially higher for the influenza (80.5%; 351/436) and COVID-19 (89.6%; 396/442) vaccines than for the pneumococcal vaccine (6.5%; 24/370). Multivariable analysis showed that major factors associated with a high pneumococcal vaccination rate (≥15%) were “managing director’s willingness to recommend” and “pneumococcal vaccination request from the residents.” The most common reason for their willingness to recommend the pneumococcal vaccine was that it is an effective disease prevention strategy (83.3%; 65/78) and for their unwillingness to recommend the pneumococcal vaccine was the inability to understand the effectiveness of the vaccine (43.6%; 17/39). In conclusion, there is a need to improve pneumococcal vaccination rates in elderly care facilities in Japan. Strategies such as increasing awareness and encouraging pneumococcal vaccine recommendation among managing directors, especially for residents not eligible for the national subsidy program, and providing regular training on the pneumococcal vaccine for staff and residents are required.
Pneumococcal vaccination rates and factors associated with the vaccination of elderly care facility residents are important for policymakers and academia when considering the development and implementation of vaccination programs and guidelines for the management of residents in these facilities. This study evaluated how many elderly people living in care facilities in Japan got pneumococcal vaccine, comparing it with their rates of getting influenza (2021–2022 vaccination only) and COVID-19 vaccines. The information was collected from managing directors of these facilities through an online survey (September 5, 2022-November 25, 2022). Of the 1,313 managing directors contacted, 445 responded. Among the 42 facilities that had recorded pneumococcal vaccination history of their residents, the average vaccination rate was 31.1%, which was much lower than the rates for influenza (93.1%) and COVID-19 (94.3%) vaccines. Only a small percentage of facilities (6.5%) had high (80% to 100%) pneumococcal vaccination rates, while most had high rates for influenza (80.5%) and COVID-19 vaccines (89.6%). Managing directors recommending the pneumococcal vaccine and residents requesting it were major factors in higher vaccination rates. Most managing directors who recommended pneumococcal vaccine believed it was effective, while those who did not recommend often did not understand its effectiveness. In conclusion, there is a need to increase pneumococcal vaccination rates in elderly care facilities in Japan. Strategies such as raising awareness among managing directors, encouraging them to recommend the vaccine (especially for residents not covered by national subsidy programs), and providing regular training on the vaccine to staff and residents are required.