Vaccination coverage: PPV (pneumonia and meningitis) - WMCA

These data describe pneumococcal polysaccharide vaccine (PPV) uptake for the survey year, for those aged 65 years and over. ## Rationale Vaccination coverage is the best indicator of the level of protection a population will have against vaccine preventable communicable diseases. Coverage is closely related to levels of disease. Monitoring coverage identifies possible drops in immunity before levels of disease rise. Pneumococcal disease is a significant cause of morbidity and mortality. Certain groups are at risk for severe pneumococcal disease, these include young children, the elderly and people who are in clinical risk groups². Pneumococcal infections can be non invasive such as bronchitis, otitis media or invasive such as septicaemia, pneumonia, meningitis. Cases of invasive pneumococcal infection usually peak in the winter during December and January. The pneumococcal polysaccharide vaccine (PPV) protects against 23 types of Streptococcus pneumoniae bacterium. It is thought that the PPV is around 50 percent to 70 percent effective at preventing more serious types of invasive pneumococcal infection².Since 1992 the 23 valent PPV has been recommended for people in the clinical risk groups and since 2003, the PPV vaccination programme has expanded to include immunisation to all those aged 65 years and over in England¹ This indicator was judged to be a valid and an important measure of public health and was therefore included in the public health outcomes framework. Inclusion of these indicators will encourage the continued prioritisation and evaluation and the effectiveness of the PPV vaccination programme and give an indication of uptake at an upper tier Local Authority level. The vaccination surveys measure the proportion of eligible people that have received PPV at any time and the proportion that received PPV during the previous year, providing an opportunity to assess the delivery of the immunisation programme¹ ¹ Pneumococcal Polysaccharide Vaccine (PPV) coverage report, England, April 2013 to March 2014 [online]. 2015 [cited 2015 Mar]. Available from URL: [https://www.gov.uk/government/publications/pneumococcal-polysaccharide-vaccine-ppv-vaccine-coverage-estimates ] ² Pneumococcal infections, NHS Choices [online]. 2013 [cited 2013 Dec]. Available from URL: [http://www.nhs.uk/conditions/vaccinations/pages/pneumococcal-vaccination.aspx] ## Definition of numerator UKHSA provided UTLA level data. Clinical commissioning group (CCG) data is available from [https://www.gov.uk/government/collections/vaccine-uptake#ppv-vaccine-uptake] ## Definition of denominator Number of adults aged 65 years and over. Data from 2013 to 2014 are now available at source at a local authority level. Data prior to 2013 to 2014 were collected at a PCT level and converted to LA level for inclusion in PHOF using the criteria as defined below: Denominators for local authorities are estimated from denominators for PCTs. Denominators for PCTs include all people registered with practices accountable to the PCT, and no data are available to provide resident-based figures. Denominators for local authorities are estimated as follows: 1. (For local authorities that have exactly the same boundary as a PCT, the PCT figure is used as it is the only estimate available for the residents of the PCT and local authority. 2. For local authorities whose boundary is contained wholly within a single PCT, but is not equal to the whole PCT, the LA denominator is estimated as a proportion of the PCT figure, with the exceptions of Isles of Scilly, City of London, Rutland, Cornwall, Hackney and Leicestershire (see below). 3. For local authorities whose boundaries include all or part of more than one PCT, the local authority denominator is estimated by aggregating the appropriate proportions of the denominators for the PCTs whose boundaries include part of the local authority. The appropriate proportions in cases ii and iii are defined according to the resident population (in the appropriate age group) in the calendar year overlapping most of the period of the indicator value (or the most recent available): resident population by Lower Layer Super Output Area were extracted and used to calculate the population resident in every LA PCT overlapping block. To calculate the denominator, each LA PCT overlap is calculated as a proportion of the PCT resident population, and then multiplied by the denominator for the PCT. A LA may overlap several PCTs: the appropriate portions of all the PCTs’ denominators are aggregated to give the denominator estimate for the LA. Expressed as an equation the denominator is calculated as follows: DenominatorLA = ∑ (DenominatorPCT × n/N) summed over all PCTs overlapping the LA where: DenominatorLA = Estimated denominator in the LA n = Population resident in the LA-PCT overlapping block N = Population resident in the PCT DenominatorPCT = Denominator in the PCT For Isles of Scilly, City of London and Rutland, no indicator data are presented (prior to 2013 to 2014), as the local authority makes up a very small proportion of the PCT, and estimates for the LAs based on the PCT figures are unlikely to be representative as they are swamped by the much larger local authority within the same PCT. The estimates for Cornwall, Hackney and Leicestershire local authorities are combined data for Cornwall and Isles of Scilly, City of London and Hackney, and Leicestershire and Rutland respectively in order to ensure that all valid PCT data are included in the England total. Denominators for Cornwall and Isles of Scilly, City of London and Hackney, and Leicestershire and Rutland are not combined for the 2019 to 2020 annual local authority level data." ## Caveats The pneumococcal vaccine uptake collection is a snapshot of GP patients vaccinated currently registered at the time of data extraction. The proportion of GP practices who provided data for the surveys are available from the uptake reports. Data will exclude patients who have received the vaccine but have subsequently died, patients who have since moved, or patients that are vaccinated but have not had their electronic patient record updated by the time of data extraction. Data for local authorities prior to 2013 to 2014 have been estimated from registered PCT level indicators. While the majority of patients registered with practices accountable to a PCT tend to be resident within that PCT, there are, in some PCTs, significant differences between their resident and registered populations. Therefore the estimates for LAs may not always accurately reflect the resident population of the local authority (LA). Please note that the PCT response rate should be checked for data completeness as this will have a knock on effect to the LA values.