For decades, vaccination with the 23-valent polysaccharide pneumococcal vaccine (PPV23) has been available for risk groups aged ⩾2 years to prevent invasive pneumococcal disease (IPD). Recently, a 13-valent pneumococcal conjugated vaccine (PCV13) has been licensed for use in all age groups. PCV13 may induce better protection than PPV23 because of different immunogenic properties. This called for a revision of vaccine recommendations for risk groups. We therefore reviewed literature on risk groups for IPD, and effectiveness and safety of pneumococcal vaccines and supplemented that with information from public health institutes, expert consultations and data on IPD epidemiology. We included 187 articles. We discuss the implications of the heterogenic vulnerability for IPD within and between risk groups, large indirect effects of childhood immunization, and limited knowledge on additional clinical benefits of PCV13 in combination with PPV23 for the Norwegian recommendations. These are now step-wise and consider the need for vaccination, choice of pneumococcal vaccines, and re-vaccination interval by risk group.

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BackgroundEnglish media have reported that many unvaccinated individuals took the COVID-19 vaccine after receiving a phone call from their general practitioner (GP).AimTo determine whether a phone call from GPs to unvaccinated patients at increased risk of severe COVID-19 improves uptake of the COVID-19 vaccine.Design & settingRandomised trial where 202 participants were allocated to receive a phone call from their GP, and 452 participants were allocated to not get the call. 25 GPs at 11 medical centres in Norway took part. Post-trial focus group discussion with 5 GPs.MethodParticipants were sourced from the GPs electronic medical record system, which communicates with the Norwegian Immunisation Registry and can generate a list of the GPs’ unvaccinated patients at increased risk of severe COVID-19.ResultsThe GPs managed to get in touch with 154 (76%) patients allocated to receiving a phone call. At follow-up (average 7.5 weeks), 8.9% in the intervention group and 5.3% in the control group had been vaccinated (OR 1.72; 95% CI 0.90–3.28). Findings from the focus group discussion suggested the timing of the intervention as a likely key reason for its limited success.ConclusionWe observed an increase in the proportion of patients who took the COVID-19 vaccine in the intervention group, but the difference was smaller than anticipated, and may be a chance finding. The effect of this type of intervention will likely vary across contexts and may have proved more effective if a larger proportion of the population were unvaccinated.Trial registration:ClinicalTrials.gov IdentifierNCT05207137

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