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      Factors associated with pneumococcal vaccination in elderly people: a cross-sectional study among elderly club members in Miyakonojo City, Japan

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          Abstract

          Background

          Pneumonia is the third leading cause of death in Japan. All elderly people aged 65 years or older are recommended to receive a pneumococcal vaccine. A subsidy for part of the cost of routine pneumococcal vaccination in this age group was introduced in 2014. Factors related to vaccination behavior among elderly adults have not been well reported. The purpose of this study was to investigate factors associated with vaccine uptake among elderly people in Japan.

          Methods

          We conducted a cross-sectional study, using a self-administered questionnaire among elderly club members aged 65 years or older in one city of Japan in April 2017. The participants were selected from among all elderly club members in the study area. Variables extracted from the questionnaire were analyzed using logistic regression analysis.

          Results

          A total of 208 elderly club members participated in the study. The mean age (± SD) was 77.2 (± 5.3) years. The pneumococcal vaccination rate was 53.2%. Logistic regression analysis revealed three variables that had a significant association with pneumococcal vaccination: a recommendation for vaccination from medical personnel (aOR 8.42, 95% CI 3.59–19.72, p <  0.001), receiving influenza vaccination in any of the previous three seasons (aOR 3.94, 95% CI 1.70–9.13, p = 0.001), and perception of the severity of pneumonia (aOR 1.23, 95% CI 1.03–1.48, p = 0.026).

          Conclusions

          Although the pneumococcal vaccination rate in this study was increased compared with previous reports, almost half of study participants had not yet received vaccination. Our findings could be helpful for developing vaccination strategies to increase the vaccine coverage in the elderly population.

          Electronic supplementary material

          The online version of this article (10.1186/s12889-018-6080-7) contains supplementary material, which is available to authorized users.

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          Most cited references 19

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          Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults.

          Pneumococcal polysaccharide conjugate vaccines prevent pneumococcal disease in infants, but their efficacy against pneumococcal community-acquired pneumonia in adults 65 years of age or older is unknown.
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            The Burden and Etiology of Community-Onset Pneumonia in the Aging Japanese Population: A Multicenter Prospective Study

            Background The increasing burden of pneumonia in adults is an emerging health issue in the era of global population aging. This study was conducted to elucidate the burden of community-onset pneumonia (COP) and its etiologic fractions in Japan, the world’s most aged society. Methods A multicenter prospective surveillance for COP was conducted from September 2011 to January 2013 in Japan. All pneumonia patients aged ≥15 years, including those with community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP), were enrolled at four community hospitals on four major islands. The COP burden was estimated based on the surveillance data and national statistics. Results A total of 1,772 COP episodes out of 932,080 hospital visits were enrolled during the surveillance. The estimated overall incidence rates of adult COP, hospitalization, and in-hospital death were 16.9 (95% confidence interval, 13.6 to 20.9), 5.3 (4.5 to 6.2), and 0.7 (0.6 to 0.8) per 1,000 person-years (PY), respectively. The incidence rates sharply increased with age; the incidence in people aged ≥85 years was 10-fold higher than that in people aged 15-64 years. The estimated annual number of adult COP cases in the entire Japanese population was 1,880,000, and 69.4% were aged ≥65 years. Aspiration-associated pneumonia (630,000) was the leading etiologic category, followed by Streptococcus pneumoniae-associated pneumonia (530,000), Haemophilus influenzae-associated pneumonia (420,000), and respiratory virus-associated pneumonia (420,000), including influenza-associated pneumonia (30,000). Conclusions A substantial portion of the COP burden occurs among elderly members of the Japanese adult population. In addition to the introduction of effective vaccines for S. pneumoniae and influenza, multidimensional approaches are needed to reduce the pneumonia burden in an aging society.
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              Vaccines for preventing pneumococcal infection in adults.

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                Author and article information

                Contributors
                as-nz@hotmail.co.jp
                phccys@gmail.com
                dusit.suj@mahidol.ac.th
                nobuhiro@med.miyazaki-u.ac.jp
                nakazato@med.miyazaki-u.ac.jp
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                12 October 2018
                12 October 2018
                2018
                : 18
                Affiliations
                [1 ]ISNI 0000 0001 0657 3887, GRID grid.410849.0, Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, , University of Miyazaki, ; Miyazaki, Japan
                [2 ]ISNI 0000 0004 1937 0490, GRID grid.10223.32, Faculty of Public Health, , Mahidol University, ; Bangkok, Thailand
                [3 ]ISNI 0000 0004 1937 0490, GRID grid.10223.32, Department of Microbiology, Faculty of Public Health, , Mahidol University, ; Bangkok, Thailand
                [4 ]ISNI 0000 0004 1937 0490, GRID grid.10223.32, Department of Epidemiology, Faculty of Public Health, , Mahidol University, ; Bangkok, Thailand
                Article
                6080
                10.1186/s12889-018-6080-7
                6186036
                30314498
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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                Research Article
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                © The Author(s) 2018

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