Some senior citizens may be getting over-vaccinated, according a study by the Department of Health and Human Services' Office of the Inspector General (OIG).
The OIG compared Medicare data on pneumococcal vaccination to the Advisory Committee on Immunization Practices' guidelines, which recommend people 65 and older get the vaccine for pneumonia prevention. Once in a lifetime should be sufficient, but if multiple shots are thought necessary, they should spaced be no less than five years apart, the committee says.
While pneumococcal pneumonia kills about 4,000 Americans annually and all pneumonias kill almost 50,000 -- with seniors being especially vulnerable -- the OIG's findings suggest that the risks of vaccinations administered too frequently may be overlooked.
Of the 4.6 million Medicare beneficiaries receiving one of several varieties of pneumococcal vaccinations between 2007 and 2011, the OIG found that 122,498 had received multiple vaccinations of the same type within five years, and also found 1,191 associated adverse events.
Just over 40 percent of the multiple vaccinations within five years were administered by the same provider -- showing, as the OIG said, that providers could be monitoring patient histories better, especially now that most have digital health records.The "data suggest a need to educate certain providers about repeat vaccinations," the OIG wrote.
Medicare spent about $234 million on pneumococcal vaccinations between 2007 and 2011, which isn't a lot, but there are also consequences from adverse events that may be associated with over-vaccination.
Reviewing the Vaccine Adverse Events Reporting System, the OIG found that of 1,191 adverse events reported by seniors during the time period, 391 resulted in emergency department visits, 42 resulted in hospitalizations and 12 ended up being life-threatening.
The OIG also singled out the prevalence of over-vaccination as an area for focus under the goal of care coordination, one of six priority areas for HHS's national quality improvement strategy.
If the Advisory Committee on Immunization Practices and other bodies are recommending pneumococcal vaccination for all seniors, there may also room for boosting rates of participating. According to the Centers for Disease Control and Prevention, only 62 percent of Americans 65 and older have received a pneumococcal vaccination.