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| 8 Adult Pneumococcal Vaccination |
| Description | Specific Indicators | Corresponding Mandatory Objectives | Corresponding National Indicators | Data Sources | Alternative Data Sources | ICD Codes | Analysis Check List | Method of Calculation | Basic Categories | Indicator Comments | Cross-References to Other Sections | References | Acknowledgements | Changes Made
Description | - Total number of people aged 65 years and older, or 18 years and older with a chronic condition, vaccinated for pneumococcal disease relative to the total population aged 65 and older or total population with a chronic condition.
| | Specific Indicators | - Percent of adults age 65 years and older who ever had a pneumonia vaccination
- Percent of adults between 18 and 64 years with a chronic condition who ever had a pneumonia vaccination
- Percent of adults age 65 years and older with a chronic condition who ever had a pneumonia vaccination
| Corresponding Outcomes from the Ontario Public Health Standards (OPHS)
The Ontario Public Health Standards (OPHS) establish requirements for the fundamental public health programs and services carried out by boards of health, which include assessment and surveillance, health promotion and policy development, disease and injury prevention, and health protection. The OPHS consist of one Foundational Standard and 13 Program Standards that articulate broad societal goals that result from the activities undertaken by boards of health and many others, including community partners, non-governmental organizations, and governmental bodies. These results have been expressed in terms of two levels of outcomes: societal outcomes and board of health outcomes. Societal outcomes entail changes in health status, organizations, systems, norms, policies, environments, and practices and result from the work of many sectors of society, including boards of health, for the improvement of the overall health of the population. Board of health outcomes are the results of endeavours by boards of health and often focus on changes in awareness, knowledge, attitudes, skills, practices, environments, and policies. Boards of health are accountable for these outcomes. The standards also outline the requirements that boards of health must implement to achieve the stated results. Link to OPHS
http://www.ontario.ca/publichealthstandards
Outcomes Related to this Indicator | Societal outcome (vaccine preventable diseases): Target coverage rates for vaccine preventable diseases are achieved. Board of Health (vaccine preventable diseases): Target coverage rates for provincially funded immunizations are achieved.
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Corresponding Health Indicator(s) from Statistics Canada and CIHI |
Data Sources
Numerator & Denominator: Rapid Risk Factor Surveillance System (RRFSS)
Original source: Public Health Unit
Distributed by: Public Health Unit
Suggested citation (see Data Citation Notes):
RRFSS [month, year – month, year], Extracted: [month,year]
Survey Questions
RRFSS Questions as of April 2002
I2: Have you EVER had a pneumonia vaccination?
Chronic Condition is defined as follows:
cd1b=1 (ever diagnosed with asthma)
cd1c= 1 (still have asthma)
cd1d=1 (have diabetes)
cd3=1 (cancer)
cd3=2 (liver disease/problem)
cd3=3 (kidney disease/problem)
cd3=4 (heart disease/problem)
cd3=5 (lung disease/problem)
cd3=6 (spleen problem)
cd3=7 (thyroid problem)
cd3=8 (blood disorder)
cd3=9 (immune disorder)
Analysis Check List
| - For RRFSS:
- Denominators with a cell size less than 30 should not be released.
- Numerators with a cell size less than 5 should not be released.
- Weighting – the general household weight will be applied where applicable (this weight compensates for the different probability of being selected, depending upon the number of adults in the household)
- “Don’t know” responses will be analyzed if the cell size is greater than 5.
- “Refused” responses will be analyzed if the cell size is greater than 5.
- The analysis for seasonal variation will use the interview date variable.
- For the age calculation:
- Yrbirth = missing/refused: exclude from age calcuation
- Mbirth = missing/refused: impute 6
- Age =< 18: exclude from data set
Method of Calculation
Number of people aged 65 years and older who ever had a pneumonia vaccination | x 100 |
| total population aged 65 years and older |
Number of adults (18-64 years) who had a chronic condition and had a pneumonia vaccination | x 100 |
| total population (18-64 years) with a chronic condition |
Number of adults (65+) with a chronic condition who had a pneumonia vaccinationation | x 100 |
| total population aged 65 years and older with a chronic condition |
Basic Categories
| - Sex: male, female
- Geographic areas: Health units participating in RRFSS
- Chronic disease = asthma, chronic bronchitis or emphysema, diabetes, heart disease, cancer, or effects of a stroke
Indicator Comments | - This is a supplemental indicator because it is not available for all health units. Pneumococcal immunization coverage data are not available from the OHS or CCHS. Data are only available from the RRFSS through participating health units.
- There are two types of pneumococcal vaccines: conjugate vaccine recommended for children (protects against 7 types of pneumococci) and polysaccharide vaccine recommended for all individuals 65 years of age and older (protects against 23 types of pneumococci). The RRFSS question “Have you EVER had a pneumonia vaccination?” is not specific to the type of vaccine.
- Polysaccharide vaccine is also recommended to all individuals over 5 years of age with the following conditions: asplenia, splenic dysfunction, sickle cell disease, chronic cardiorespiratory disease (except asthma), cirrhosis, alcoholism, chronic renal disease, nephrotic syndrome, diabetes mellitus, chronic CSF leak, HIV infection and other conditions associated with immunosuppression (Hodgkin’s disease, lymphoma, multiple myeloma, induced immunosuppression for organ transplantation).
- Some of these conditions cannot be identified through RRFSS. The chronic conditions included in this indicator provide an estimate of the population for whom the vaccine is recomended.
Cross-References to Other Sections
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References
| Acknowledgements | Lead Author(s) | Dara Friedman, Ottawa Public Health
Katherine Russell (nee Haimes), Ottawa Public Health | Contributing Author(s) | Core Indicators Infectious Disease Subgroup | | CIWG Reviewers | Core Indicators Infectious Disease Subgroup | | External Reviewers | Effie Gournis, Toronto Public Health
Ameeta Mathur, Toronto Public Health
Rachel Savage, Ontario Agency for Health Protection and Promotion |
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Changes Made
Date | Type of Review-Formal Review or Ad Hoc? | Changes made by | Changes | June 2008 | Formal Review | Infectious Disease subgroup of Core Indicators | - Changed name from "Pneumococcal Vaccination"
- Added specific indicators for those with chronic conditions (percent of adults between 18 and 64 years with a chronic condition who ever had a pneumonia vaccination, and percent of adults age 65 years and older with a chronic condition who ever had a pneumonia vaccination)
- Added related outcomes from draft Ontario Public Health Standards
- Updated indicator comments and references
| January 27, 2009 | Formal Review | Infectious Disease subgroup of Core Indicators | - Incorporated reviewer comments.
| | January 30, 2012 | Ad hoc | Sherri Deamond on behalf of CIWG | - Added "Changes Made" and "Acknowledgements" sections
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