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Effect of 13-valent pneumococcal conjugate vaccine on hospitalization in older adults

Invasive pneumococcal disease rates have decreased substantially in children and adults since 2010, when use of 13-valent pneumococcal conjugate vaccine in children became the standard of care.

Adults 65 years of age and older receive significant additional protection against all-cause pneumonia and hospitalizations from lower respiratory tract infections (LRTI) when vaccinated with 13-valent pneumococcal conjugate vaccine (PVC13), according to study results published recently in the Journal of the American Medical Association Network Open.

In the US, approximately 50,000 deaths are reported annually among the more than a quarter of a million people hospitalized for pneumonia, despite the high success rate in this century of the PCV13 vaccine in children. Since 2014, the PCV13 vaccine has been recommended for adults 65 years of age or older. Prior to 2014, only the PPV23 vaccine was recommended for this population. Researchers sought to investigate the association between vaccination with the PCV13 in adults aged 65 years older and the incidence of hospitalizations for pneumonia and LRTI in this population.

To accomplish this, they conducted a retrospective study of 192,061 adults within Kaiser Permanente Northern California (56% female; 72% White) born after 1936 who were 65 years of age or older between July 2015 and June 2018, with no history of vaccination with PPV23 or PCV13 before age 65. By 2018, vaccination coverage reached 135,608 (76.9%), and 3488 study participants were hospitalized for pneumonia (with 3766 total pneumonia hospitalizations) and 3846 participants were hospitalized for LRTI (with 4173 total LRTI hospitalizations). The investigators found that PCV13 had an adjusted vaccine effectiveness of 10.0% (95% CI, 2.4-17.0; P =.01) against hospitalized pneumonia and 9.4% (95% CI, 2.1-16.1; P =.01) against hospitalized LRTI.

The researchers concluded, “This study provides evidence that direct PCV13 vaccination of older adults may be associated with broad public health benefit in preventing hospitalizations associated with all-cause pneumonia and LRTI, even in a setting with long-standing PCV13 vaccination of children with very high coverage.”

Study limitations included: 1) the inability isolate the effect of PCV13 due to the inability to account for different possible vaccine sequences (eg, PCV13 before or after PPV23, only PCV13, or multiple doses of PPV23); 2) residual confounding; 3) failure to include individuals born before 1936.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Reference: Hsiao A, Hansen J, Timbol J, et al. Incidence and estimated vaccine effectiveness against hospitalizations for all-cause pneumonia among older US adults who were vaccinated and not vaccinated with 13-valent pneumococcal conjugate vaccine. JAMA Netw Open. 2022;5(3):e221111. doi:10.1001/jamanetworkopen.2022.1111

Source: Pulmonology Advisor

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