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.

本研究通过线上调查（2022年9月5日—2022年11月25日；UMIN000048747），从日本1313家养老机构的运营管理者中回收445份有效数据，以此评估肺炎球菌疫苗接种情况，并将其与流感疫苗（仅统计2021-2022年度接种）、新型冠状病毒肺炎（Corona Virus Disease 2019，COVID-19）疫苗的接种情况进行对比。在留存有居民肺炎球菌疫苗接种记录的42家机构中，肺炎球菌疫苗平均接种率为31.1%，显著低于流感疫苗（93.1%；n=234）与COVID-19疫苗（94.3%；n=285）的接种率。整体而言，排除回答本机构对应疫苗接种情况不明的机构后，高接种率（80%~100%）机构占比方面，流感疫苗组为80.5%（351/436）、COVID-19疫苗组为89.6%（396/442），均远高于肺炎球菌疫苗组的6.5%（24/370）。多变量分析显示，与高肺炎球菌疫苗接种率（≥15%）相关的主要因素为“运营管理者的推荐意愿”与“居民提出的肺炎球菌疫苗接种诉求”。运营管理者愿意推荐肺炎球菌疫苗的最常见原因为“这是有效的疾病预防策略”（83.3%；65/78）；而不愿推荐的最常见原因为“无法理解该疫苗的有效性”（43.6%；17/39）。综上，日本养老机构的肺炎球菌疫苗接种率有待提升。需采取一系列策略以改善现状，包括提升运营管理者对肺炎球菌疫苗的认知、鼓励其推荐疫苗接种（尤其针对不符合国家补贴计划资格的居民），以及为机构员工与居民定期开展肺炎球菌疫苗相关培训。养老机构居民的肺炎球菌疫苗接种率及其相关影响因素，对于政策制定者与学术界制定并推行此类机构的居民管理疫苗接种计划与指南而言，具有重要参考价值。本研究评估了日本养老机构居住老年人的肺炎球菌疫苗接种情况，并将其与流感疫苗（仅统计2021-2022年度接种）、COVID-19疫苗的接种率进行对比。研究数据通过线上调查从养老机构的运营管理者处收集，调查时间为2022年9月5日至2022年11月25日。在联系的1313位运营管理者中，共回收445份有效回复。在留存有居民肺炎球菌疫苗接种记录的42家机构中，平均接种率为31.1%，远低于流感疫苗（93.1%）与COVID-19疫苗（94.3%）的接种率。仅6.5%的机构肺炎球菌疫苗接种率处于高区间（80%~100%），而多数机构的流感疫苗（80.5%）与COVID-19疫苗（89.6%）接种率处于该高区间。运营管理者推荐肺炎球菌疫苗以及居民提出接种诉求，是提升疫苗接种率的主要相关因素。多数推荐肺炎球菌疫苗的运营管理者认为该疫苗可有效预防疾病，而不愿推荐的管理者则常因无法理解疫苗的有效性而拒绝。综上，日本养老机构的肺炎球菌疫苗接种率有待提升，需采取包括提升运营管理者认知、鼓励其推荐疫苗接种（尤其针对不符合国家补贴计划资格的居民）、为员工与居民定期开展疫苗相关培训在内的一系列策略。