Pneumococcal infections are responsible for an important morbi-mortality, that can be prevented by pneumococcal vaccination (PV). Thus, PV is recommended for selected patients judged at increased risk of serious complications. Yet, despite clear guidelines-supported indications and a full reimbursement, PV coverage remains low in France in the different targeted populations.

To evaluate the feasibility and efficacy of a large mailing campaign, targeted to selected eligible patients, in term of vaccine coverage, compared to an “usual care” control cohort.

Patients living in the “Loire-Vendée-Océan” Territorial Health Community, aged 65 years or older, suffering from diabetes, chronic heart disease or respiratory diseases and with no PV pharmacy delivery documented in the previous 2 years, were identified from the nominative regional compulsory health insurance data. In October 2022, after a specific information to the general practionners (GP) about the intervention, incentive mails were sent to all eligible patients, asking them to discuss about PV with their GP. PV coverage was assessed at 6 months, using the anonymized national health insurance data. 7472 patients were included in the intervention cohort, and were compared to 25897 patients sharing the same clinical features, living in the same county but outside the studied area, that constituted an “usual care” control cohort.

During the study period, PV vaccine coverage, defined as the delivery of at least one dose of PV per patient, increased by 9.5 points (from 13.8% to 23.3%) in the intervention group, and by 1.9 points (from 16.3% to 18.2%) in the usual care group (P<0.001) (Figure 1). In subgroups, patients suffering from chronic heart disease or diabetes, that demonstrate a lower PV coverage at baseline, benefited the most from the intervention.

This pilot study demontrated that a targeted mailing campaign to pneumococcal vaccine eligible patients, is a feasible and effective intervention to improve vaccine coverage. A larger scale program is planned at regional level.