The pneumococcal polysaccharide vaccine (PPV) is offered routinely to individuals aged 2-64 years in England who have certain medical conditions, e.g. those with lung diseases or weakened immune systems (immunosuppression), to protect against infectious diseases (such as pneumonia) caused by the pneumococcus bacterium. The shingles vaccine is offered to older individuals to protect against shingles; however, individuals with immunosuppression are not eligible to receive the shingles vaccine.
Uptake of vaccines is monitored nationally, to check how well each vaccination programme is doing and that individuals at high risk of infection are being protected. However, the current monitoring system has difficulty in counting all individuals who are eligible and ineligible for vaccination, particularly those who have immunosuppression.
This study will use anonymous GP data (medical diagnoses and information on prescribed medicines that affect the immune system) to better quantify how many people are eligible to receive PPV and how many are ineligible to receive shingles vaccination. The proportion of these individuals who receive PPV or shingles vaccine will then be estimated. The results will strengthen our understanding of how well the vaccination programmes for these two vaccines are working and will help inform future campaigns to increase vaccine uptake.
The national immunisation programme in England includes vaccines against pneumococcal disease and against herpes zoster. Pneumococcal polysaccharide vaccine (PPV) is offered to individuals aged 2-64 years in specific clinical risk groups and to all individuals aged 65+ years. The live zoster vaccine is offered to selected older age groups but cannot be given to those with immunosuppression.
National monitoring of vaccine uptake currently involves automatic extraction and uploading of anonymised GP data on vaccine-eligible individuals and their vaccine uptake. Identification of eligible/ineligible individuals for vaccination and their vaccine uptake is based entirely on Read codes, but these codes cannot fully capture specific risk groups such as those with drug-induced immunosuppression.
This study will use anonymised CPRD data (including both medical and drug codes) to better quantify the clinical risk groups for PPV and those ineligible for zoster vaccine and will estimate vaccine uptake in each group. This will provide more robust estimates of PPV uptake in clinical risk groups, and the extent of inadvertent zoster vaccine uptake in the immunosuppressed. As a secondary objective, the proportion inadvertently receiving zoster vaccine who develop varicella-zoster disease after vaccination will also be estimated.
Uptake of pneumococcal polysaccharide vaccine
- Uptake of zoster vaccine
- Vaccine-associated varicella-zoster-virus disease
Helen McDonald - Chief Investigator - London School of Hygiene & Tropical Medicine ( LSHTM )
Helen McDonald - Corresponding Applicant - London School of Hygiene & Tropical Medicine ( LSHTM )
Daniel Grint - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Jemma Walker - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Nick Andrews - Collaborator - Public Health England
Sara Thomas - Chief Investigator - Not from an Organisation
Sara Thomas - Corresponding Applicant - Not from an Organisation
HES Admitted Patient Care