Improving pneumococcal vaccination coverage among older people in Victoria

Although pneumococcal vaccine is recommended by the National Health and Med ical Research Council and is cost-effective in preventing invasive pneumoco ccal disease, it is the only vaccine on the standard schedule that is not n ationally funded through public health grants to the States. In Victoria, the Department of Human Services has provided free pneumococca l vaccine to people aged 65 years and over since 1998. Pneumococcal vaccination was given in conjunction with the annual influenza vaccination program; 28.5% of the eligible cohort (95% CI, 24.8%-32.1%) re ceived pneumococcal vaccine in 1998, giving an estimated cumulative coverag e of 42% (13.4% had received it in 1997). We expect coverage will continue to increase over time, but revaccination e very five years will present a substantial financial burden; access to vacc ine is critical to improving coverage. Our experience in Victoria suggests that a nationally funded program, admin istered similarly to the influenza vaccination program, would dramatically increase pneumococcal vaccination coverage at a national level.