Immunizations

Immunization and CKM Health‍

Preventing infection is part of caring for people with cardiovascular, kidney, and metabolic conditions. An illness such as pneumonia, influenza, or RSV can be especially difficult for someone already managing heart disease, diabetes, or kidney disease. Vaccination offers an opportunity to reduce the risk of serious illness while addressing a patient’s other CKM needs.

This section begins with pneumococcal vaccination and will also cover RSV, influenza, COVID-19, shingles, and hepatitis B. These vaccines have different recommendations based on age, health conditions, immune status, and vaccination history. Care teams can use routine CKM visits to review what patients have received, recommend vaccines for which they are eligible, and help them complete any needed doses.

Pneumococcal Vaccination‍

Pneumococcal vaccination is an important part of preventive care for many adults with cardiovascular, kidney, and metabolic conditions. Use CKM visits to review vaccination history, identify patients who are due, and make a plan to administer the vaccine or connect the patient with a vaccination site.

Who Should be Assessed?

  • All adults age 50 and older
  • Adults ages 19–49 with diabetes, chronic heart disease, or chronic renal failure or nephrotic syndrome
  • Adults ages 19–49 with other qualifying conditions or risk factors, including chronic lung disease or cigarette smoking

What does the care team need to do?

  • Review the patient’s vaccination history, including doses given outside the health system
  • Use the current CDC schedule to determine which vaccine is indicated. The recommendation depends on age, risk conditions, and prior pneumococcal vaccines
  • Offer vaccination during the visit when feasible. If it is given elsewhere, establish a way to confirm and document it
  • If a later dose is needed, schedule a reminder before the patient leaves

For adults who have not previously received a pneumococcal conjugate vaccine, current options include PCV20 or PCV21 alone, or PCV15 followed by PPSV23, generally one year later. Patients with a prior pneumococcal vaccination history may need a different schedule. Use CDC’s patient-specific tool rather than assuming an additional dose is needed.

Improvement Opportunities

  • Add pneumococcal vaccination status to diabetes, heart disease, and kidney disease visit planning
  • Build a reliable process for reconciling vaccines received at pharmacies and other health systems
  • Review missed opportunities among eligible patients seen during the year
  • Track vaccination and follow-up by age, condition, payer, race and ethnicity, and geography to identify differences in access and completion
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