Single age cohort health risk distribution of pneumococcal disease among US adults in 2022

Background Pneumococcal Disease (PD) is associated with significant health and economic burden in the US. The Advisory Committee on Immunization Practices (ACIP) recommends pneumococcal vaccination for adults with immunocompromised conditions and chronic medical conditions who are at increased risk of PD. This study examines the distribution of PD risk conditions among US adults by single age cohorts, based on the ACIP classification of conditions. Methods A retrospective observational study was conducted among individuals enrolled in US IBM@ MarketScan Commercial Claims and Encounters (CCAE) in 2022. The risk of PD (low-risk (LR), moderate-risk (MR), and high-risk (HR) of PD) among adults aged ≥ 18 years was classified using International Classification of Diseases, Clinical Modification version 10 (ICD-10-CM) and Current Procedural Terminology version 4 codes, based on a 5-year lookback period among individuals with continuous enrollment. Risk distributions were summarized by single-year age cohort, and the clinical conditions comprising the MR and HR categories were described. Supplementary analyses summarized risk distributions using broader age categories, and sensitivity analyses assessed the impact of using a shorter 2-year lookback period and removing the continuous enrollment requirement. Results The study population included more females (52.2%) than males (47.8%) and was more likely to be aged 18–49 years (55.5%) and living in the South region (44.9%). Most adults were classified as LR (58.4%), followed by MR (28.1%) and HR (13.5%). While the LR and MR groups were predominantly aged 18–49 years, the HR group was primarily aged 50–64 years and female. Chronic lung disease and chronic heart disease were the most prevalent MR conditions, and cancer was the most prevalent HR condition. Sensitivity analyses showed similar age-related patterns, although the primary analysis classified higher proportions of adults as MR or HR than analyses using a 2-year lookback period or the full sample without the continuous enrollment requirement. Conclusions This study addresses an evidence gap by providing descriptive single-age cohort estimates of pneumococcal disease risk distribution among commercially insured US adults. These estimates may support future modelling analyses, contextualize age-specific risk patterns, and inform hypothesis generation regarding pneumococcal disease risk across adult age groups. Clinical trial Not applicable.