{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T08:58:12Z","timestamp":1771145892461,"version":"3.50.1"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pfizer Pharma GmbH"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Pneumococcal vaccination is recommended by the German Standing Committee on Vaccination (STIKO) for infants, elderly 60+ years and patients at risk. In 2016, a sequential pneumococcal vaccination schedule (conjugate vaccine followed by polysaccharide vaccine 6\u201312 months later) supplemented this recommendation for immunocompromised patients \u22652 years of age. Previous research showed low pneumococcal vaccination rates (pnc-VR) in this vulnerable group. Moreover, no evidence is available on adherence to the newer sequential schedule. This study aimed to analyze the development of pnc-VRs in immunocompromised patients and rates of sequential vaccinations according to the STIKO recommendations.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Using a representative health claims database, we assigned incident immunocompromised patients \u22652 years of age to one of two successive cohorts to observe trends over time: cohort A (first diagnosis of immunocompromised condition between 01\/2013 and 12\/2014), and cohort B (first diagnosis between 01\/ 2015 and 12\/2017). Pnc-VR within two years after first diagnosis and cumulative pnc-VR was compared among both cohorts. In cohort B, we assessed sequential pnc-VR within 15 months of the first vaccination. For additional analyses, patients were stratified by age, gender and immunocompromising condition.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Cohort A and B comprised 193,521 and 289,279 patients, respectively. Overall pnc-VR increased over time from 4.3% (cohort A; 95%-confidence interval: 4.3%-4.4%) to 6.0% (cohort B; 5.9%-6.1%), with highest pnc-VRs in men \u226560 years (11.3%: 11.1%-11.6%) and HIV patients (15.2%: 13.1%-17.4%). Cumulative pnc-VRs in cohort B were higher in any quarter following diagnosis when compared with cohort A. Overall sequential pnc-VR in cohort B was 4.0% (3.7%-4.3%), with a higher rate observed in patients aged 16\u201359 (6.8%: 6.0%-7.7%) vs. patients aged \u226560 years (3.1%: 2.8%-3.4%).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>While some improvements were seen over time, pnc-VRs remain very low in immunocompromised patients, as did sequential vaccination rates. Current recommendations to protect immunocompromised patients from pneumococcal infections are not being sufficiently implemented.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0265433","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T17:27:17Z","timestamp":1647970037000},"page":"e0265433","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Pneumococcal vaccination rates in immunocompromised patients in Germany: A retrospective cohort study to assess sequential vaccination rates and changes over time"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2721-110X","authenticated-orcid":true,"given":"Ralf","family":"Sprenger","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"H\u00e4ckl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nils","family":"Kossack","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Schiffner-Rohe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Wohlleben","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christof","family":"von Eiff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"pone.0265433.ref001","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s41479-020-00074-3","article-title":"Etiology of community-acquired pneumonia in adults: a systematic review","volume":"12","author":"S Shoar","year":"2020","journal-title":"Pneumonia (Nathan)"},{"key":"pone.0265433.ref002","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/s15010-021-01605-w","article-title":"Shift in bacterial etiology from the CAPNETZ cohort in patients with community-acquired pneumonia: data over more than a decade","volume":"49","author":"DCW Braeken","year":"2021","journal-title":"Infection"},{"key":"pone.0265433.ref003","author":"IQTIG\u2013Institut f\u00fcr Qualit\u00e4tssicherung und Transparenz im Gesundheitswesen, Berlin","year":"2020","journal-title":"Qualit\u00e4tsreport"},{"key":"pone.0265433.ref004","doi-asserted-by":"crossref","first-page":"e0253118","DOI":"10.1371\/journal.pone.0253118","article-title":"Eiff C von, et al. 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(Schutzimpfungs-Richtlinie\/SI-RL)"},{"key":"pone.0265433.ref015","author":"Robert Koch-Institut","journal-title":"Neuerungen in den aktuellen Empfehlungen der St\u00e4ndigen Impfkommission (STIKO) am RKI f\u00fcr 2016\/2017"},{"key":"pone.0265433.ref016","author":"Robert Koch-Institut","journal-title":"Epidemiologisches Bulletin 34\/2020"},{"key":"pone.0265433.ref017","author":"U Braeter","journal-title":"Pneumokokkenimpfung bei GKV-Versicherten im Altersbereich 60 bis 64 Jahre\u2014Regionalisierte Analyse zur Umsetzung der Empfehlungen der St\u00e4ndigen Impfkommission anhand bundesweiter vertrags\u00e4rztlicher Abrechnungsdaten"},{"key":"pone.0265433.ref018","author":"Robert Koch-Institut (RKI)","journal-title":"Epidemiologisches Bulletin des Robert Koch-Instituts Ausgabe 44\/2019"},{"key":"pone.0265433.ref019","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1186\/s12913-019-4263-2","article-title":"Impact of a guideline-based best practice alert on pneumococcal vaccination rates in adults in a primary care setting","volume":"19","author":"C McAdam-Marx","year":"2019","journal-title":"BMC Health Serv Res"},{"key":"pone.0265433.ref020","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12913-018-3861-8","article-title":"Burden of community-acquired pneumonia, predisposing factors and health-care related costs in patients with cancer","volume":"19","author":"N Schmedt","year":"2019","journal-title":"BMC Health Serv Res"},{"key":"pone.0265433.ref021","first-page":"743","article-title":"Pneumococcal vaccination rates in adults in Germany: an analysis of statutory health insurance data on more than 850,000 individuals","volume":"110","author":"U Theidel","year":"2013","journal-title":"Dtsch Arztebl Int"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0265433","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T17:27:49Z","timestamp":1647970069000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0265433"}},"subtitle":[],"editor":[{"given":"Alfred S.","family":"Lewin","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,3,22]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0265433","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,22]]}}}