PNEUMOCOCCAL VACCINATION STATUS AMONG PULMONARY HYPERTENSION ADULTS AT A REFERRAL ACADEMIC CENTER

SESSION TITLE: Pulmonary Vascular Disease Posters 3 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Pulmonary Hypertension (PH) clinical practice guidelines emphasize the importance of preventive measures including pneumococcal vaccination in order to prevent pneumococcal complications. However, the prevalence and risk factors associated with pneumococcal vaccination in PH patients is largely unknown. We aim to address this literature gap by assessing the prevalence of pneumococcal vaccination and the risk factors associated with vaccine administration among PH patients evaluated at a tertiary outpatient referral care center. METHODS: We conducted an observational cohort study of PH patients evaluated at a tertiary academic hospital referral center in San Antonio, TX from December 2020 through February 2023. We included adult (≥18 years old) patients with history of PH diagnosed by right heart catheterization. We excluded patients who died prior to the end of the observation period or were considered lost to follow up during the observation period. We documented pneumococcal vaccination status (pneumococcal polysaccharide vaccine 23 [PPSV-23]) within 10-years of index date and/or pneumococcal conjugate vaccines 13, 15, or 20 [PCV-13, PCV-15, PCV-20], respectively. Our main outcome was whether PH patients were vaccinated against pneumococcus (prevalence) and the associated risk factors (e.g. demographic, comorbid conditions, etc.) to vaccine administration. RESULTS: We identified 208 patients with PH, and excluded 33 due to death (n=21 [10%]) and lost-to follow up (n=12 [5.8%]), respectively. The prevalence of pneumococcal vaccination was 50.3% (n=88), and a third (35.4%) have received at least one PCV vaccination. A similar proportion of PH patients have received PPSV-23 (n=55 [31.4%]) and PCV-13 (n=59 [33.7%]). There were no differences in age, gender, New York Heart Association group and World Health Organization PH-group 1 status. PH patients with comorbidities (including coronary artery disease, heart failure, chronic lung disease, diabetes mellitus, and chronic kidney disease), and those with Hispanic ethnicity were more likely to be vaccinated against pneumococcus. However, in the multivariate analysis, Hispanic ethnicity (Odds ratio [OR] 2.09, 95%CI 1.08-4.07, p=.029), heart failure (OR 2.33, 95%CI 1.04-5.21, p=.039), chronic lung disease (OR 2.25, 95%CI 1.04-4.90, p=.04), and diabetes mellitus (OR 2.88, 95%CI 1.25-6.67, p=.013) were independently associated with higher vaccination rates. CONCLUSIONS: About half of the PH patients are vaccinated against pneumococcal infection. The patients with the highest rate of vaccine protection were those with Hispanic ethnicity, heart failure, chronic lung disease, and diabetes mellitus. CLINICAL IMPLICATIONS: Vaccine adherence programs can further expand current efforts and identify other PH patients at risk requiring pneumococcal vaccination. DISCLOSURES: No relevant relationships by Hasan Baher No relevant relationships by Rodolfo Estrada No relevant relationships by Marcos Restrepo