1094Pneumococcal Vaccination Coverage In The Elderly In The United States: Missed Opportunities Continue

Background. All elderly 65 years and older are recommended by the U.S. Advisory Committee on Immunization Practices to receive pneumococcal vaccination, with a coverage goal of 90% per the Healthy People 2020 objectives. This study aimed to provide real-world data on pneumococcal vaccination coverage and factors associated with receiving pneumococcal vaccination in a large U.S. managed care elderly population. Methods. This retrospective observational cohort study included elderly who were 65 years and older from 2008 to 2011 with at least 2-year continuous enrollment in Humana administrative claims database. Descriptive and regression analyses were applied to examine their pneumococcal vaccination coverage. Results. Among the 56,587 elderly cohort, 31.7% were healthy, 30.4% had one, 20.6% had two, and 17.3% had three or more medical conditions. On average, these elderly visited pharmacy 43.6 times, doctor office 21.6 times, outpatient hospital 6.4 times, inpatient hospital 0.6 times and emergency department 11.1 times during the follow up period. Nevertheless, the overall coverage of pneumococcal vaccination was 21.8% after 2 years. The majority of vaccination (77.2%) was received at doctor office and only 9.6% at pharmacy. There were no significant differences in health status and number of chronic medical conditions between the vaccinated and non-vaccinated. Elderly who had primary care physicians, who received influenza or zoster vaccination, or who had increased healthcare encounters were more likely to receive pneumococcal vaccination. Conclusion. Pneumococcal vaccination coverage in US elderly was far below the Healthy People 2020 objective. Findings suggest missed opportunities continue and better interventions needed to improve pneumococcal vaccination during healthcare encounters for the elderly. Disclosures. H. K. Yang, Merck: Employee, Salary C. Shao, Merck: Employee, Salary J. D. Grabenstein, Merck and Co., Inc.: Employee and Shareholder, Salary D. Zhang, Merck: Employee, Salary