Pneumococcal Vaccination in Bronchiectasis
Patients with Bronchiectasis (BE) are â€œat riskâ€ of pneumococcal disease. National guidelines recommend routine pneumococcal vaccination (PV) in all with respiratory disease or those >65yrs. Re-vaccination advice has varied and recall programs are not routine. Patients who are unsure of their re-vaccination schedule may miss re-vaccination risking pneumococcal disease.
Hypothesis: Patients with bronchiectasis may not be receiving revaccination according to current guidelines.
Methods: Single-centre prospective questionnaire study of vaccination, pneumonia rates and patient knowledge of pneumococcal vaccine at a UK specialist centre for adult bronchiectasis patients.
Results: Data on the first 81 patients recruited are presented. Mean age was 65yrs (M:F ratio was 29:52). 95% received PV; only 3 patients hadn't received PV with 2 additional patients unsure of PV status. Only 6 patients reported having received written information on PV or revaccination. 28 pts were either not told revaccination schedules or could not recall this (15 patients told vaccination once per lifespan, 23 told revaccinate every 10yrs, 12 pts told every 5 years, remainder included yearly or 3 yearly). Only 12% reported an expected PV revaccination date. 43 patients self-reported a prior episode of pneumonia. We confirmed pneumonia from secondary care radiology in 9 patients (11.1%). Primary care records were provided in 20 of 62 requests to date.
Conclusions: Self-reported and confirmed episodes of pneumonia are common in BE. Pneumococcal vaccination (PV) is frequently administered in BE patients but patients receive limited written information and are unclear about re-vaccination. Clear guidance/Automated recall may help improve this.