Pneumococcal vaccine lacking in adults with work-related asthma, CDC reports

By John Murphy, MDLinx
Published October 2, 2017

Key Takeaways

Only about half (53.7%) of adults with work-related asthma have ever received a pneumococcal vaccination, a number that falls below the target goal. But that statistic is still better than the vaccination rates for adults whose asthma is not work related, at 35%, and for adults with asthma who have ever worked, at 42%, according to a recent report from researchers at the Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational Safety and Health (NIOSH).

Among adults with work-related asthma—asthma caused or made worse by exposures at work—pneumococcal vaccine rates were lowest among Hispanics (36%), those without health insurance (39%), and adults 18 to 44 years old (42%), NIOSH researchers reported in the American Journal of Preventive Medicine.

All of these vaccination rates are below the Healthy People 2020 target goal of 60%.

“Our study found that the vaccination coverage for pneumococcal disease among adults who have ever worked and have asthma falls short of achieving the coverage public health experts recommend,” said lead author Katelynn Dodd, MPH, an epidemiologist in the Respiratory Health Division at NIOSH.

For this study, NIOSH researchers analyzed data from the 2012–2013 Behavioral Risk Factor Surveillance System Asthma Call-back Survey, which included about 10,000 adults (ages 18 to 64) with asthma from 29 states who had ever held a job, representing an estimated 12 million people. Of the adults with asthma in the study, researchers estimated 15% had work-related asthma, or about 1.8 million people.

“People with work-related asthma are particularly vulnerable to pneumococcal pneumonia,” said NIOSH Director John Howard, MD. “Vaccination is the best way to prevent pneumococcal disease, including pneumonia, and CDC recommends that all adults with asthma, whether work-related or not, get the pneumococcal polysaccharide vaccine.”

Results also showed that adults with work-related asthma were more likely to be vaccinated if they had access to health insurance coverage and preventive care services, the authors noted. In this study, significantly more adults with work-related asthma who had health insurance were vaccinated than those with work-related asthma who didn’t have health insurance (57.5% vs 38.5%). 

In addition to the low vaccine rates noted above, researchers observed that subjects who had used inhaled corticosteroids in the past three months were more likely to get the pneumococcal vaccine compared with those who hadn’t used inhalers. This was true among adults with work-related asthma, with possible work-related asthma, and with non-work-related asthma.

Notably, nearly 68% of those with work-related asthma who had used inhaled corticosteroids had been vaccinated, which exceeded the Healthy People 2020 goal of 60%. “Physicians should continue to offer pneumococcal vaccination to adults with asthma taking inhaled corticosteroids,” the authors advised.

Because community-acquired pneumonia can worsen underlying chronic conditions such as asthma, the researchers called on physicians and health care providers to take further steps to prevent these infections, the researchers noted.

“To increase the number of adults with asthma who are vaccinated against pneumococcal disease, we recommend that healthcare providers verify if their patients who have asthma have received a pneumococcal vaccine and offer the vaccine to those not vaccinated,” said NIOSH’s Katelynn Dodd.

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