NFID Medical Director Highlights ACIP Rationale for Lowering Age for Pneumococcal Vaccination

The following transcript has been lightly edited for clarity and style.

Patient Care©: Would you discuss the ACIP recommendation that just lowered the age for vaccination against pneumococcal disease from 65 years to 50 years?

Robert Hopkins, Jr, MD: Pneumococcal vaccine recommendations have been in place for many years, targeting all adults aged 65 and older as well as younger adults with chronic health conditions that increase their risk for invasive pneumococcal disease. Despite these longstanding guidelines, vaccination rates remain concerningly low—less than 30% of individuals in risk groups are vaccinated. Compounding this issue are significant racial and ethnic disparities, with African American and Hispanic patients experiencing even lower vaccination rates.

The hope is that transitioning to an age-based recommendation for people aged 50 and older will help close these gaps. This approach aims to address not only racial and ethnic disparities but also the challenges in identifying undiagnosed chronic conditions. Many individuals with heart failure, diabetes, COPD, or other chronic conditions fall into these risk groups but remain undiagnosed. An age-based strategy increases the likelihood of vaccinating these at-risk individuals and, in turn, reduces adverse outcomes while improving overall health outcomes.

It’s critical to continue monitoring vaccination rates, disease incidence, and health outcomes to inform future updates to these recommendations. The landscape of pneumococcal vaccination is evolving, with at least three candidate vaccines currently in development. Over the next three to five years, these advancements will likely lead to refined guidelines aimed at better protecting vulnerable populations.

By adopting an age-based approach and tracking progress, we can work toward more equitable vaccination coverage and improved public health.

Robert J Hopkins, Jr, MD, is the medical director of the National Foundation for Infectious Diseases and professor of internal medicine and pediatrics and director of the division of General Internal Medicine at the University of Arkansas for Medical Sciences, in Little Rock, AK.