Table 1. Definitions of primary variables used in analysis.

Variable	Definition
Age	Age at hospital admission for IPD, as documented in electronic medical record
Gender	Gender as documented in electronic medical record
Homeless or unstable housing	No fixed address OR identified as homeless OR under-housed OR couch surfing OR living in tents OR shelters as documented in electronic medical record
Substance use
Heavy alcohol use	Current alcohol use disorder OR alcohol use that exceeds low-risk guidelines, as documented in electronic medical record
Injection drug use	Injection drug use as documented in electronic medical record
Cocaine	Cocaine use described in chart notes OR detected on toxicological screen within last year, as per electronic medical record
Methamphetamine	Methamphetamine use described in chart notes OR detected on toxicological screen within last year, as per electronic medical record
Cannabis	Cannabis use described in chart notes OR detected on toxicological screen within last year, as per electronic medical record
Opioids	Illicit opioid use described in chart notes OR detected on toxicological screen within last year, as per electronic medical record
Tobacco smoking	Recent tobacco smoking (within previous year) described in chart notes, as per electronic medical record
Co-morbidities
HCV	Hepatitis C virus infection described in chart notes or laboratory records, as per electronic medical record
HIV	HIV infection described in chart notes or laboratory records, as per electronic medical record
Lung disease	Co-morbid lung disease described in chart notes, as per electronic medical record
Cardiovascular disease	Co-morbid cardiovascular disease described in chart notes, as per electronic medical record
Renal disease	Co-morbid renal disease described in chart notes, as per electronic medical record
Diabetes	Co-morbid diabetes mellitus described in chart notes, as per electronic medical record
IPD presentation
Pneumonia	Pneumococcal pneumonia as documented in electronic medical record
Meningitis	Pneumococcal meningitis as documented in electronic medical record
Level of care
Hospital admission	Admission to hospital for IPD, as documented in electronic medical record
Length of stay in hospital	Number of days calculated from date of hospital admission (within Island Health) for IPD to date of death or discharge.
ICU admission	Admission to ICU during hospital stay for IPD, as documented in electronic medical record
Outcome
In-hospital death	Death during hospital admission for IPD, as documented in electronic medical record
Immunization
Previous pneumococcal vaccination	Previous pneumococcal vaccination within the last 5 years as documented in electronic medical record or electronic Public Health Information System

Abbreviations: HCV, hepatitis C virus; ICU, intensive care unit; IPD, invasive pneumococcal disease