Improving Pneumococcus Vaccination Rates Among Patients With Cancer: An ASCO/CDC/CMSS–Sponsored Quality Improvement Project

BACKGROUND: Invasive pneumococcal disease poses a substantial danger to patients with cancer, who experience higher rates of infection, antimicrobial resistance, morbidity, and mortality. Pneumococcal vaccination reduces both cases of pneumonia and hospitalizations in this population. The Advisory Committee on Immunization Practices, National Comprehensive Cancer Network, and American Society of Clinical Oncology recommend vaccination for immunocompromised adults, including those with newly diagnosed cancer prior to chemotherapy. METHODS: As part of the Specialty Societies Advancing Adult Immunization quality improvement initiative, the Kaiser Permanente oncology practice evaluated and improved pneumococcal vaccination rates among patients receiving chemotherapy. Baseline rates were established through workflow review. Three sequential plan-do-study-act cycles were implemented over 3 months targeting a 10% improvement. Interventions included implementing workflow optimization, staff education, and having on-site administration. RESULTS: Vaccination rates increased from 29.5% to 32.8% over 5 months, exceeding the national average of 23% for high-risk adults aged 19 to 64 years. Education for health care practitioners, reminders, and on-site vaccine availability were most effective. The greatest improvement occurred during plan-do-study-act cycle 3 with in-clinic vaccination. No adverse reactions were observed. CONCLUSION: An on-site, team-based vaccination model improved pneumococcal immunization rates. Integrating vaccination into oncology workflows can enhance guideline adherence and protect immunocompromised patients.