Pneumococcal vaccination coverage in at-risk internists and factors influencing pneumococcal vaccination

Ceva Wicaksono; Evy Yunihastuti; Sally Aman Nasution; Lugyanti Sukrisman; Eka Ginanjar; Rudy Hidayat; Adityo Susilo; Muhadi Muhadi; Hayatun Nufus; Siprianus Ugroseno Yudho Bintoro; Hermawan Susanto; Asri Ludin Tambunan; Darmadi Darmadi; Hery Djagat Purnomo; Andi Makbul Aman; Mohammad Robikhul Ikhsan; Anggoro Budi Hartopo; Indra Wijaya; Ervita Ritonga; Ahmad Mekah; Selfie Selfie; Wira Gotera; Gede Wira Mahadita; Zen Ahmad; Radiyati Umi Partan; Brilliant V.F.S. Rhomado; Wachid Putranto; Nur Samsu; Muhammad Diah; Azzaki Abubakar; Johana Prihatini; Reinaldo Alexander; Juwanto Wakimin; Dani Rosdiana; Harnavi Harun; Akmal Mufriady Hanif; Linda Wilhelma Ancella Rotty; Cecilia Hendratta; Kuntjoro Yakti; Astried Indrasari; Erwin Erwin; Erwanto Budi Winulyo; Lukman Pura; Abimanyu Abimanyu; Djallalluddin Djallalluddin; Sutiadi Kusuma; Giri Satriya; Suharno Hakim; Andi M.H. Panjaitan; Elfiani Elfiani; Budiman Gunawan; Joko Anggoro; Arif Koswandi; Kurniakin W.S. Girsang; Andreas N.F. Lewai; Erwin A. Pangkahila; Kongko H. Nursetiyanto; Annisa Puspitasari Nachrowi; Dayang Nurbayati; Arfan Sanusi; Fahmi R. Darkuthni; Petrus Irianto; Komariatun Komariatun; Annelin Kurniati; Haeril Aswar; Nelyan H. Mokoginta; Leily D. Pawa; Edwin Ambar; Feliks Duwit; Riswan Riswan

doi:10.1016/j.jvacx.2026.100813

Pneumococcal vaccination coverage in at-risk internists and factors influencing pneumococcal vaccination

Ceva Wicaksono
, Evy Yunihastuti^*
, Sally Aman Nasution
, Lugyanti Sukrisman
, Eka Ginanjar
, Rudy Hidayat
, Adityo Susilo
, Muhadi Muhadi
, Hayatun Nufus
, Siprianus Ugroseno Yudho Bintoro
, Hermawan Susanto
, Asri Ludin Tambunan
, Darmadi Darmadi
, Hery Djagat Purnomo
, Andi Makbul Aman
, Mohammad Robikhul Ikhsan
, Anggoro Budi Hartopo
, Indra Wijaya
, Ervita Ritonga
, Ahmad Mekah

Selfie Selfie, Wira Gotera, Gede Wira Mahadita, Zen Ahmad, Radiyati Umi Partan, Brilliant V.F.S. Rhomado, Wachid Putranto, Nur Samsu, Muhammad Diah, Azzaki Abubakar, Johana Prihatini, Reinaldo Alexander, Juwanto Wakimin, Dani Rosdiana, Harnavi Harun, Akmal Mufriady Hanif, Linda Wilhelma Ancella Rotty, Cecilia Hendratta, Kuntjoro Yakti, Astried Indrasari, Erwin Erwin, Erwanto Budi Winulyo, Lukman Pura, Abimanyu Abimanyu, Djallalluddin Djallalluddin, Sutiadi Kusuma, Giri Satriya, Suharno Hakim, Andi M.H. Panjaitan, Elfiani Elfiani, Budiman Gunawan, Joko Anggoro, Arif Koswandi, Kurniakin W.S. Girsang, Andreas N.F. Lewai, Erwin A. Pangkahila, Kongko H. Nursetiyanto, Annisa Puspitasari Nachrowi, Dayang Nurbayati, Arfan Sanusi, Fahmi R. Darkuthni, Petrus Irianto, Komariatun Komariatun, Annelin Kurniati, Haeril Aswar, Nelyan H. Mokoginta, Leily D. Pawa, Edwin Ambar, Feliks Duwit, Riswan Riswan

^*Corresponding author for this work

Faculty of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction Pneumococcal vaccine is an effective preventive measure to reduce the burden of pneumococcal disease. This vaccine is beneficial for high-risk populations, including elderly healthcare workers and those with comorbidities. However, various studies have demonstrated low vaccination coverage globally. Therefore, we aimed to assess pneumococcal vaccination coverage among at-risk internists and identify its influencing factors. Methods This cross-sectional study is part of the CARMEINA study conducted by the Indonesian Society of Internal Medicine (INASIM) from December 2023 to March 2024. Data was collected from internists at risk of pneumococcal disease recommended for pneumococcal vaccination according to the 2023 Adult Vaccination Recommendation from INASIM. At-risk internist was defined as someone who met the following conditions: (1) over 50 years old; (2) treating immunocompromised patients including patients with malignancy, sickle-cell disease, chronic kidney disease, HIV, primary/secondary immunodeficiency, nephrotic syndrome, patients on long-term immunosuppressants, and transplant recipients; and (3) treating patients with increased risks of pneumococcal disease due to a medical condition. Descriptive analyses and multivariate analysis were performed to identify the medical and demographic profile of pneumococcal vaccination. Results A total of 545 at-risk internists were included in this study. We found that the pneumococcal vaccination coverage among at-risk internists in Indonesia was 11.6% ( n = 63/545). Factors associated with pneumococcal vaccination were: a history of influenza vaccination in the past year (aOR 6.80, 95% CI 3.83–12.08), immunocompromised conditions (aOR 2.95, 95% CI 1.27–6.84), an age of >60 years (aOR 1.99, 95% CI 1.02–3.90), and chronic conditions (aOR 1.88, 95% CI 1.08–3.52). Conclusion Pneumococcal vaccination coverage among at-risk internists in Indonesia is relatively low despite the global burden of pneumococcal disease and adult vaccine recommendations from INASIM. Further targeted interventions are needed in order to improve vaccination coverage, especially among at-risk internists.

Original language	English
Article number	100813
Journal	Vaccine: X
Volume	30
DOIs	https://doi.org/10.1016/j.jvacx.2026.100813
Publication status	Published - Jun 2026

Keywords

Adult immunization
Internist
Pneumococcal vaccine
Vaccination uptake

Access to Document

10.1016/j.jvacx.2026.100813

Cite this

Wicaksono, C., Yunihastuti, E., Nasution, S. A., Sukrisman, L., Ginanjar, E., Hidayat, R., Susilo, A., Muhadi, M., Nufus, H., Bintoro, S. U. Y., Susanto, H., Tambunan, A. L., Darmadi, D., Purnomo, H. D., Aman, A. M., Ikhsan, M. R., Hartopo, A. B., Wijaya, I., Ritonga, E., ... Riswan, R. (2026). Pneumococcal vaccination coverage in at-risk internists and factors influencing pneumococcal vaccination. Vaccine: X, 30, Article 100813. https://doi.org/10.1016/j.jvacx.2026.100813

@article{c30655e1da394c0ea705ef42391b5ed0,

title = "Pneumococcal vaccination coverage in at-risk internists and factors influencing pneumococcal vaccination",

abstract = "Introduction Pneumococcal vaccine is an effective preventive measure to reduce the burden of pneumococcal disease. This vaccine is beneficial for high-risk populations, including elderly healthcare workers and those with comorbidities. However, various studies have demonstrated low vaccination coverage globally. Therefore, we aimed to assess pneumococcal vaccination coverage among at-risk internists and identify its influencing factors. Methods This cross-sectional study is part of the CARMEINA study conducted by the Indonesian Society of Internal Medicine (INASIM) from December 2023 to March 2024. Data was collected from internists at risk of pneumococcal disease recommended for pneumococcal vaccination according to the 2023 Adult Vaccination Recommendation from INASIM. At-risk internist was defined as someone who met the following conditions: (1) over 50 years old; (2) treating immunocompromised patients including patients with malignancy, sickle-cell disease, chronic kidney disease, HIV, primary/secondary immunodeficiency, nephrotic syndrome, patients on long-term immunosuppressants, and transplant recipients; and (3) treating patients with increased risks of pneumococcal disease due to a medical condition. Descriptive analyses and multivariate analysis were performed to identify the medical and demographic profile of pneumococcal vaccination. Results A total of 545 at-risk internists were included in this study. We found that the pneumococcal vaccination coverage among at-risk internists in Indonesia was 11.6\% ( n = 63/545). Factors associated with pneumococcal vaccination were: a history of influenza vaccination in the past year (aOR 6.80, 95\% CI 3.83–12.08), immunocompromised conditions (aOR 2.95, 95\% CI 1.27–6.84), an age of >60 years (aOR 1.99, 95\% CI 1.02–3.90), and chronic conditions (aOR 1.88, 95\% CI 1.08–3.52). Conclusion Pneumococcal vaccination coverage among at-risk internists in Indonesia is relatively low despite the global burden of pneumococcal disease and adult vaccine recommendations from INASIM. Further targeted interventions are needed in order to improve vaccination coverage, especially among at-risk internists.",

keywords = "Adult immunization, Internist, Pneumococcal vaccine, Vaccination uptake",

author = "Ceva Wicaksono and Evy Yunihastuti and Nasution, \{Sally Aman\} and Lugyanti Sukrisman and Eka Ginanjar and Rudy Hidayat and Adityo Susilo and Muhadi Muhadi and Hayatun Nufus and Bintoro, \{Siprianus Ugroseno Yudho\} and Hermawan Susanto and Tambunan, \{Asri Ludin\} and Darmadi Darmadi and Purnomo, \{Hery Djagat\} and Aman, \{Andi Makbul\} and Ikhsan, \{Mohammad Robikhul\} and Hartopo, \{Anggoro Budi\} and Indra Wijaya and Ervita Ritonga and Ahmad Mekah and Selfie Selfie and Wira Gotera and Mahadita, \{Gede Wira\} and Zen Ahmad and Partan, \{Radiyati Umi\} and Rhomado, \{Brilliant V.F.S.\} and Wachid Putranto and Nur Samsu and Muhammad Diah and Azzaki Abubakar and Johana Prihatini and Reinaldo Alexander and Juwanto Wakimin and Dani Rosdiana and Harnavi Harun and Hanif, \{Akmal Mufriady\} and Rotty, \{Linda Wilhelma Ancella\} and Cecilia Hendratta and Kuntjoro Yakti and Astried Indrasari and Erwin Erwin and Winulyo, \{Erwanto Budi\} and Lukman Pura and Abimanyu Abimanyu and Djallalluddin Djallalluddin and Sutiadi Kusuma and Giri Satriya and Suharno Hakim and Panjaitan, \{Andi M.H.\} and Elfiani Elfiani and Budiman Gunawan and Joko Anggoro and Arif Koswandi and Girsang, \{Kurniakin W.S.\} and Lewai, \{Andreas N.F.\} and Pangkahila, \{Erwin A.\} and Nursetiyanto, \{Kongko H.\} and Nachrowi, \{Annisa Puspitasari\} and Dayang Nurbayati and Arfan Sanusi and Darkuthni, \{Fahmi R.\} and Petrus Irianto and Komariatun Komariatun and Annelin Kurniati and Haeril Aswar and Mokoginta, \{Nelyan H.\} and Pawa, \{Leily D.\} and Edwin Ambar and Feliks Duwit and Riswan Riswan",

note = "Publisher Copyright: Copyright {\textcopyright} 2026. Published by Elsevier Ltd.",

year = "2026",

month = jun,

doi = "10.1016/j.jvacx.2026.100813",

language = "English",

volume = "30",

journal = "Vaccine: X",

issn = "2590-1362",

publisher = "Elsevier Ltd",

}

Wicaksono, C, Yunihastuti, E, Nasution, SA, Sukrisman, L, Ginanjar, E, Hidayat, R, Susilo, A, Muhadi, M, Nufus, H, Bintoro, SUY, Susanto, H, Tambunan, AL, Darmadi, D, Purnomo, HD, Aman, AM, Ikhsan, MR, Hartopo, AB, Wijaya, I, Ritonga, E, Mekah, A, Selfie, S, Gotera, W, Mahadita, GW, Ahmad, Z, Partan, RU, Rhomado, BVFS, Putranto, W, Samsu, N, Diah, M, Abubakar, A, Prihatini, J, Alexander, R, Wakimin, J, Rosdiana, D, Harun, H, Hanif, AM, Rotty, LWA, Hendratta, C, Yakti, K, Indrasari, A, Erwin, E, Winulyo, EB, Pura, L, Abimanyu, A, Djallalluddin, D, Kusuma, S, Satriya, G, Hakim, S, Panjaitan, AMH, Elfiani, E, Gunawan, B, Anggoro, J, Koswandi, A, Girsang, KWS, Lewai, ANF, Pangkahila, EA, Nursetiyanto, KH, Nachrowi, AP, Nurbayati, D, Sanusi, A, Darkuthni, FR, Irianto, P, Komariatun, K, Kurniati, A, Aswar, H, Mokoginta, NH, Pawa, LD, Ambar, E, Duwit, F & Riswan, R 2026, 'Pneumococcal vaccination coverage in at-risk internists and factors influencing pneumococcal vaccination', Vaccine: X, vol. 30, 100813. https://doi.org/10.1016/j.jvacx.2026.100813

TY - JOUR

T1 - Pneumococcal vaccination coverage in at-risk internists and factors influencing pneumococcal vaccination

AU - Wicaksono, Ceva

AU - Yunihastuti, Evy

AU - Nasution, Sally Aman

AU - Sukrisman, Lugyanti

AU - Ginanjar, Eka

AU - Hidayat, Rudy

AU - Susilo, Adityo

AU - Muhadi, Muhadi

AU - Nufus, Hayatun

AU - Bintoro, Siprianus Ugroseno Yudho

AU - Susanto, Hermawan

AU - Tambunan, Asri Ludin

AU - Darmadi, Darmadi

AU - Purnomo, Hery Djagat

AU - Aman, Andi Makbul

AU - Ikhsan, Mohammad Robikhul

AU - Hartopo, Anggoro Budi

AU - Wijaya, Indra

AU - Ritonga, Ervita

AU - Mekah, Ahmad

AU - Selfie, Selfie

AU - Gotera, Wira

AU - Mahadita, Gede Wira

AU - Ahmad, Zen

AU - Partan, Radiyati Umi

AU - Rhomado, Brilliant V.F.S.

AU - Putranto, Wachid

AU - Samsu, Nur

AU - Diah, Muhammad

AU - Abubakar, Azzaki

AU - Prihatini, Johana

AU - Alexander, Reinaldo

AU - Wakimin, Juwanto

AU - Rosdiana, Dani

AU - Harun, Harnavi

AU - Hanif, Akmal Mufriady

AU - Rotty, Linda Wilhelma Ancella

AU - Hendratta, Cecilia

AU - Yakti, Kuntjoro

AU - Indrasari, Astried

AU - Erwin, Erwin

AU - Winulyo, Erwanto Budi

AU - Pura, Lukman

AU - Abimanyu, Abimanyu

AU - Djallalluddin, Djallalluddin

AU - Kusuma, Sutiadi

AU - Satriya, Giri

AU - Hakim, Suharno

AU - Panjaitan, Andi M.H.

AU - Elfiani, Elfiani

AU - Gunawan, Budiman

AU - Anggoro, Joko

AU - Koswandi, Arif

AU - Girsang, Kurniakin W.S.

AU - Lewai, Andreas N.F.

AU - Pangkahila, Erwin A.

AU - Nursetiyanto, Kongko H.

AU - Nachrowi, Annisa Puspitasari

AU - Nurbayati, Dayang

AU - Sanusi, Arfan

AU - Darkuthni, Fahmi R.

AU - Irianto, Petrus

AU - Komariatun, Komariatun

AU - Kurniati, Annelin

AU - Aswar, Haeril

AU - Mokoginta, Nelyan H.

AU - Pawa, Leily D.

AU - Ambar, Edwin

AU - Duwit, Feliks

AU - Riswan, Riswan

PY - 2026/6

Y1 - 2026/6

N2 - Introduction Pneumococcal vaccine is an effective preventive measure to reduce the burden of pneumococcal disease. This vaccine is beneficial for high-risk populations, including elderly healthcare workers and those with comorbidities. However, various studies have demonstrated low vaccination coverage globally. Therefore, we aimed to assess pneumococcal vaccination coverage among at-risk internists and identify its influencing factors. Methods This cross-sectional study is part of the CARMEINA study conducted by the Indonesian Society of Internal Medicine (INASIM) from December 2023 to March 2024. Data was collected from internists at risk of pneumococcal disease recommended for pneumococcal vaccination according to the 2023 Adult Vaccination Recommendation from INASIM. At-risk internist was defined as someone who met the following conditions: (1) over 50 years old; (2) treating immunocompromised patients including patients with malignancy, sickle-cell disease, chronic kidney disease, HIV, primary/secondary immunodeficiency, nephrotic syndrome, patients on long-term immunosuppressants, and transplant recipients; and (3) treating patients with increased risks of pneumococcal disease due to a medical condition. Descriptive analyses and multivariate analysis were performed to identify the medical and demographic profile of pneumococcal vaccination. Results A total of 545 at-risk internists were included in this study. We found that the pneumococcal vaccination coverage among at-risk internists in Indonesia was 11.6% ( n = 63/545). Factors associated with pneumococcal vaccination were: a history of influenza vaccination in the past year (aOR 6.80, 95% CI 3.83–12.08), immunocompromised conditions (aOR 2.95, 95% CI 1.27–6.84), an age of >60 years (aOR 1.99, 95% CI 1.02–3.90), and chronic conditions (aOR 1.88, 95% CI 1.08–3.52). Conclusion Pneumococcal vaccination coverage among at-risk internists in Indonesia is relatively low despite the global burden of pneumococcal disease and adult vaccine recommendations from INASIM. Further targeted interventions are needed in order to improve vaccination coverage, especially among at-risk internists.

AB - Introduction Pneumococcal vaccine is an effective preventive measure to reduce the burden of pneumococcal disease. This vaccine is beneficial for high-risk populations, including elderly healthcare workers and those with comorbidities. However, various studies have demonstrated low vaccination coverage globally. Therefore, we aimed to assess pneumococcal vaccination coverage among at-risk internists and identify its influencing factors. Methods This cross-sectional study is part of the CARMEINA study conducted by the Indonesian Society of Internal Medicine (INASIM) from December 2023 to March 2024. Data was collected from internists at risk of pneumococcal disease recommended for pneumococcal vaccination according to the 2023 Adult Vaccination Recommendation from INASIM. At-risk internist was defined as someone who met the following conditions: (1) over 50 years old; (2) treating immunocompromised patients including patients with malignancy, sickle-cell disease, chronic kidney disease, HIV, primary/secondary immunodeficiency, nephrotic syndrome, patients on long-term immunosuppressants, and transplant recipients; and (3) treating patients with increased risks of pneumococcal disease due to a medical condition. Descriptive analyses and multivariate analysis were performed to identify the medical and demographic profile of pneumococcal vaccination. Results A total of 545 at-risk internists were included in this study. We found that the pneumococcal vaccination coverage among at-risk internists in Indonesia was 11.6% ( n = 63/545). Factors associated with pneumococcal vaccination were: a history of influenza vaccination in the past year (aOR 6.80, 95% CI 3.83–12.08), immunocompromised conditions (aOR 2.95, 95% CI 1.27–6.84), an age of >60 years (aOR 1.99, 95% CI 1.02–3.90), and chronic conditions (aOR 1.88, 95% CI 1.08–3.52). Conclusion Pneumococcal vaccination coverage among at-risk internists in Indonesia is relatively low despite the global burden of pneumococcal disease and adult vaccine recommendations from INASIM. Further targeted interventions are needed in order to improve vaccination coverage, especially among at-risk internists.

KW - Adult immunization

KW - Internist

KW - Pneumococcal vaccine

KW - Vaccination uptake

UR - https://www.scopus.com/pages/publications/105036403171

U2 - 10.1016/j.jvacx.2026.100813

DO - 10.1016/j.jvacx.2026.100813

M3 - Article

AN - SCOPUS:105036403171

SN - 2590-1362

VL - 30

JO - Vaccine: X

JF - Vaccine: X

M1 - 100813

ER -

Pneumococcal vaccination coverage in at-risk internists and factors influencing pneumococcal vaccination

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this