Background/Purpose: Pneumococcal vaccination is critical in patients with childhood-onset systemic lupus erythematosus (cSLE) due to their immunocompromised status and increased susceptibility to serious infections. Despite this, our institution’s baseline vaccination rate was 0%. Inadequate documentation compromises patient safety, continuity of care, and may reflect missed vaccination opportunities. A limited on-site vaccine supply further challenged timely administration and follow-up. Our goal was to increase pneumococcal vaccination documentation rates in cSLE patients from 0% to 70% over a 12-month period.

Methods: We conducted a retrospective chart review of cSLE patients seen between February and June 2024. To improve documentation and vaccine delivery, we initiated a Plan-Do-Study-Act (PDSA) cycle. Interventions included the development of a standardized documentation template within the electronic health record (EHR), collaboration with key stakeholders (including clinicians, analysts, and nursing staff), and integration of a consistent vaccination process within our rheumatology clinic.

Results: Fifty pediatric patients with cSLE were included in the initial chart review. Of these, 16 had previously received pneumococcal vaccination, but only 2 had appropriate documentation in the EHR. Following implementation of a standardized documentation process, 59 additional patients were identified with non-protective pneumococcal antibody titers. Among these, 8 patients received appropriate vaccination at Scottish Rite: 6 were vaccinated during their clinic visit, and 2 had received the vaccine within 12 months prior. Our clinic vaccination rate went from a baseline of 0% to 13.5% improvement.

Conclusion: Establishing a clear and structured documentation process significantly enhanced the rate of pneumococcal vaccination and documentation in cSLE patients. Accessible, standardized records improved coordination of care and reduced missed opportunities for immunization. On-site vaccine availability also contributed to improved patient follow-through. Continued PDSA cycles, staff feedback, and outcome monitoring will be essential to sustain and expand these improvements.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/implementation-of-pneumococcal-vaccination-in-patients-with-childhood-onset-systemic-lupus-erythematous/