Vuxen- vaccinations- · Italy acp acp (18 ) Latvia Liechtenstein acp (20 ) Lithuania Luxembourg...

18
Vuxen- vaccinations- program Malin Bengnér Smittskyddsläkare Region Jönköpings län

Transcript of Vuxen- vaccinations- · Italy acp acp (18 ) Latvia Liechtenstein acp (20 ) Lithuania Luxembourg...

Page 1: Vuxen- vaccinations- · Italy acp acp (18 ) Latvia Liechtenstein acp (20 ) Lithuania Luxembourg Malta Netherlands Norway Poland Portugal acp (24 ) Slovakia acp (25 ) Spain Sweden

Vuxen-

vaccinations-

program

Malin Bengnér

Smittskyddsläkare

Region Jönköpings län

Page 3: Vuxen- vaccinations- · Italy acp acp (18 ) Latvia Liechtenstein acp (20 ) Lithuania Luxembourg Malta Netherlands Norway Poland Portugal acp (24 ) Slovakia acp (25 ) Spain Sweden

• Det finns redan nu fler personer >65 år än barn <5 år

• Mellan år 2000 och 2050 kommer antalet personer över 60 år

att fördubblas

• 2050 kommer 20 % av jordens befolkning att vara över 60 år

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Välfärdsutmaningen

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Resistensutmaningen

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Allt viktigare att förebygga infektioner

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Omvärldsspaning

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Pneumococcal Disease: Recommended vaccinations Age

18 19 50 60 64 65 85 >= 86 Austria PCV13 (2 )

Belgium PCV13 (3 ) PCV13 (4

) Bulgaria Croatia Cyprus PPSV23 (8 ) Czech Republic Pnc (10 ) Pnc (11 ) Denmark PPSV23 (12 ) Estonia Finland PCV13+PPSV23 (13 ) France Germany PPSV23 (15 ) Greece PCV13+PPSV23 PCV13+PPSV23 Hungary PPSV23 Iceland PPSV23 (16 ) Ireland PPSV23 (17 ) Italy Pnc (18 ) Latvia Liechtenstein Lithuania Luxembourg PPSV23 (20 ) PCV13+PPSV23 (20 ) Malta PCV Netherlands Norway PPSV23 (22 ) Poland PCV Portugal Romania Slovakia PCV (24 ) Slovenia PPSV23 (25 ) Spain PPSV23 (27 ) Sweden PPSV23

United Kingdom PPSV23

Influenza: Recommended vaccinations Age

18 45 55 59 60 64 >= 65 Austria IIV3 Belgium IIV3 Bulgaria IIV3 (3 ) Croatia IIV3 Cyprus IIV3 (6 )

Czech Republic IIV (8 ) Denmark IIV3 (9 ) Estonia IIV3 (3 ) Finland IIV3 France IIV3 Germany IIV3 (11 ) Greece IIV3 Hungary IIV3 Iceland IIV3 (11 ) Ireland IIV3 (12 ) Italy IIV3 Latvia IIV3 Liechtenstein IIV3 (13 ) Lithuania IIV3 (14 ) Luxembourg IIV3 Malta IIV3 Netherlands IIV3 (15 ) Norway IIV3 Poland IIV3 Portugal IIV3 Romania IIV3 Slovakia IIV3 Slovenia IIV3 (17 ) Spain IIV3 (18 ) Sweden IIV3 United Kingdom IIV3 (13 )

Influensa Pneumokocker

Europa (ECDC)

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Tetanus: Recommended vaccinations Age

18 19 24 25 29 30 45 59 60 65 >= 66 Austria TT (3 ) TT (4 ) Belgium TT (5 ) Bulgaria TT (7 ) Croatia TT TT TT Cyprus TT (7 ) Czech Republic TT (10 ) TT Denmark Estonia TT (7 ) Finland TT (11 ) France TT (12 ) TT TT (13 ) Germany TT (14 ) Greece TT (15 ) Hungary Iceland Ireland Italy TT (19 ) Latvia TT (21 )

Liechtenstein TT (22 ) TT (22 ) TT (22 ) Lithuania

Luxembourg Malta

Netherlands Norway Poland TT (26 ) Portugal TT (27 ) Romania Slovakia TT (28 ) Slovenia TT (29 ) Spain TT (30 ) Sweden United Kingdom

Pertussis: Recommended vaccinations Years

18 19 25 29 45 60 64 65 >= 66

Austria acp (4 ) acp (5 )

Belgium acp (6 )

Bulgaria

Croatia

Cyprus

Czech Republic

acp (9 ) acp

Denmark

Estonia

Finland

France acp (11 )

Germany acp (12 )

Greece acp acp (13 )

Hungary

Iceland

Ireland acp (17 )

Italy acp acp (18 )

Latvia

Liechtenstein acp (20 )

Lithuania

Luxembourg

Malta

Netherlands

Norway

Poland

Portugal acp (24 )

Romania

Slovakia

Slovenia acp (25 )

Spain

Sweden

United Kingdom

acp (29 )

Tetanus Pertussis

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Herpes Zoster: Recommended vaccinations Years

18-49 50 60 64 65 70 74 >= 75

Austria ZOS

Belgium

Bulgaria

Croatia

Cyprus

Czech Republic ZOS ZOS (1 )

Denmark

Estonia

Finland

France ZOS (2 )

Germany

Greece ZOS

Hungary

Iceland

Ireland

Italy ZOS ZOS

Latvia

Liechtenstein

Lithuania

Luxembourg

Malta

Netherlands

Norway

Poland

Portugal

Romania

Slovakia

Slovenia

Spain

Sweden

United Kingdom ZOS

Zoster

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Bältrosvaccination Storbritannien

• Zostavax erbjuds sedan 2013 till alla som fyller 70 resp. 78 år

• Täckningsgrad 24 % i hela gruppen 70-80 år

– men ca 75 % hos 75-åringar

• Skyddseffekt:

– 65 % mot bältros

– 70-88 % mot postherpetisk neuralgi

• Real world data visar bättre skyddseffekt

än den kliniska prövningen

Matthews. Vaccine. 2018;36(46):7105-7111

Amirthalingam. The Lancet. 2018;3:e82-90

Ansaldi. Adv Ther. 2016; 33: 1094–1104

Walker. Vaccine 2018;36(17):2371–7

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Äldrevaccinationsprogram

i Jönköping

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Innehåll

• Influensa

• Pneumokocker (PPV23)

• Bältros (Zostavax)

• Booster difteri, stelkramp, kikhosta

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Målgrupp

• 70-åringar

• Drygt 4 000 70-åringar i Jönköpings län

• Mål att nå 75 % 3 000 personer per år

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Kostnad

• Influensa, pneumokocker, bältros, dTP till 3 000 70-åringar:

– 3,5 miljoner kr/år

• Redan idag ges kostnadsfritt vaccin mot:

– influensavaccin (60 000 doser): 2,6 miljoner kr/år

– pneumokocker (3 000 doser): 550 000 kr/år

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Genomförande

• Skriftlig inbjudan till alla 70-åringar

• Hälsodeklaration fylls i på 1177.se eller på papper

• Sköterska på vårdcentralen skapar ordinationsförslag i Svevac

• Läkare ordinerar

• Vaccination sker i första hand i samband med annat besök på

vårdcentralen eller hälsosamtal

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Informationsmaterial till invånare

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Pilotstudie hösten 2018

• Inbjudan till 50 st 70-åringar

– 33 positiva svar (66 %)

• 13 via webben, 20 på papper

• Praktiska rutiner fungerade väl

• Breddinförande?