The Impact of Patients’ Demographics, Insurance Payor and Comorbidities on Pneumococcal Vaccine Uptake in a Resident Community Internal Medicine Clinic

BACKGROUND: National pneumococcal vaccine uptake rates remain well below the Healthy people 2020 target goals. This study aims to assess uptake rates at a residents’ community clinic and to identify factors affecting the likelihood of receiving the vaccine. METHODS: A retrospective chart review was performed utilizing medical records of patients who visited the Internal Medicine clinic between March 1st and July 31st, 2016. Patients were divided into two age groups: age 65 years and above (≥ 65) and those between 19 and 65 years (<65) meeting at least one of ACIP Adult pneumococcal vaccine indications. Four categorical patient demographic variables were assessed: age, ethnicity, primary language, and gender. Indication-specific parameters included: alcoholism, diabetes, heart failure, liver disease, and lung disease. A patient’s insurance payor was considered a categorical variable. Logistic regression analysis was used to examine the univariable and independent multivariable associations of all available parameters. RESULTS: 1,992 patients were included in the study. Overall rate of vaccination in the <65 group was 5% and 16% for ≥ 65. Increasing age was positively associated with vaccination in the younger group, whereas it decreased the odds of vaccination in the older age group. A private insurance payer had a small positive effect on vaccination among the older age group (OR=1.71). A diabetes diagnosis increased the odds of vaccination significantly (11% of patients diagnosed with diabetes vs. 4% of the undiagnosed group were vaccinated). About 26% of those diagnosed with a lung disease were vaccinated, 14% of those not diagnosed with one were vaccinated. CONCLUSION: Age, insurance coverage and specific indications appear to directly influence patient’s likelihood of receiving pneumococcal vaccines, whereas other factors like ethnicity, primary language, and gender had no significant impact. Interventions are actively in place to improve vaccination outcomes with these factors in mind. DISCLOSURES: All authors: No reported disclosures.