What can research primary care datasets contribute to routine monitoring of vaccine coverage and uptake?
PHE ePoster Library. McDonald H. Apr 10, 2019; 257506; 15407
Dr. Helen McDonald
Dr. Helen McDonald
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Abstract
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Abstract Background:
Routine monitoring of vaccine coverage extracts primary care data across multiple system providers, limiting complex data extraction and analysis. Research collaborations may offer an opportunity to complement routine uptake monitoring through more detailed identification of people in clinical risk groups for whom vaccination is indicated or contraindicated. This project aimed to explore how routine national estimates of pneumococcal polysaccharide vaccine (PPV) coverage compared to those generated using anonymised primary care research data from the Clinical Practice Research Datalink (CPRD) and detailed diagnostic algorithms for identifying clinical risk groups.
Methods:
: Using CPRD data for practices in England, vaccine uptake was estimated for people aged 2-64 years in clinical risk groups and compared to national estimates. Clinical risk groups were defined using: (1) the routine national monitoring data specification from 2015; (2) an updated data specification generated in collaboration; (3) an enhanced specification using additional GP prescription records to help identify the asthma, diabetes and immunosuppression clinical risk groups; (4) time-updated analyses to refine capture of time-varying clinical conditions.
Results:
: Comparison of algorithms identified differences in clinical risk group definitions, code lists and determining time at risk. Exchange of code search strategies and screening results indicated the potential for mutual improvement of code lists. Immunosuppression was identified as the clinical risk group that would most benefit from coding alignment and from consideration of medication use and time-varying risk.Discussion: Research collaboration can support routine surveillance of PPV uptake including refining the data specification for routine surveillance, validating routine PPV vaccine uptake estimates, and identifying clinical risk groups for whom there may be value in complementary analysis. Funding This research is funded by the National Institute for Health Research Health Protection Research Unit in Immunisation at the London School of Hygiene and Tropical Medicine in partnership with Public Health England.
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