Effectiveness of 23-valent pneumococcal polysaccharide vaccine on diabetic elderly

Abstract

Diabetes mellitus is associated with increased risk of pneumonia, and 23-valent pneumococcal polysaccharide vaccine (PPV23) is recommended for prevention of pneumonia. However, the effectiveness of PPV23 remains unclear in the older diabetic patients who usually have compromised immune function.We used data extracted from the Taiwanese National Health Insurance Research Database (NHIRD) from 2000 to 2009 to conduct a population-based retrospective cohort study, comparing the incidence of pneumococcal diseases among PPV23-vaccinated and propensity-score matched PPV23-unvaccinated groups in diabetic elderly. The primary outcome was invasive pneumococcal diseases (IPDs), and the secondary outcomes were medical utilization.PPV23-vaccinated group had reduced risks of IPD (adjusted OR: 0.86, 95% CI: 0.78–0.94), respiratory failure (0.84, 0.77–0.93), and shorter length of hospitalization (−1.27 ± 0.19 days, P value: 0.0012). In flu-vaccinated group, subjects who received PPV23 had reduced risks of IPD, hospitalization, and respiratory failure; had shorter lengths of hospitalization; and less medical costs, than those without receiving PPV23. In not flu-vaccinated group, PPV23 vaccination was associated with reduced risks of IPD and respiratory failure. Receiving both vaccines could bring better protection in IPD, hospitalization, visits of emergency department, and respiratory failure.PPV23 vaccination was effective in prevention of pneumococcal diseases and reduction of medical utilization in diabetic elderly aged 75 and more. Receiving both vaccines resulted in better outcomes than PPV vaccination alone.

COVID-19 vaccination in patients with diabetes mellitus: Current concepts, uncertainties and challenges

“…Likewise, the efficacy of 23-valent pneumococcal polysaccharide vaccine (PPV23) was found to be 84% in people with DM [ 14 ]. The 23-valent pneumococcal polysaccharide vaccination effectively prevented pneumococcal diseases and reduced utilization of medical services in elderly patients with diabetes aged 75 and more [ 15 ]. Furthermore, young and older adults with DM have been shown to mount optimal B-cell response to seasonal influenza vaccine [ 16 ].…”

Multi-disciplinary Consensus Statement Document. Vaccinal Prevention in Adults Patients with Diabetes Mellitus

“…Pneumococcal vaccination efficacy in diabetes patients has also been shown by a retrospective cohort study conducted in approximately 67,000 elderly subjects that, via assessing, across a 9-year period, the Taiwanese National Health Insurance Research Database , reported a reduced risk by 14% of pneumococcal invasive disease onset in the group who received 23-valent pneumococcal vaccine (PPV23) compared with the group not exposed to PPV23 [ 27 ].…”

“…Such a trial reported further benefits associated with Pneumococcal vaccination, since study subjects who received PPV23 experienced an improvement in – clinical and economic – outcomes such as hospitalization, respiratory failure, hospital stay and healthcare costs [ 27 ].…”

“…Influenza vaccination has been shown effective in diabetic patients, resulting in reduced risk of pneumonia, hospitalizations, respiratory failure, as well as shortening hospital stay [ 25 , 27 ].…”

The Pneumococcal Polysaccharide-Tetanus Toxin Native C-Fragment Conjugate Vaccine: The Carrier Effect and Immunogenicity

“…Capsular PS is an important virulence determinant of the encapsulated bacteria and has been used as an antigen for preventive vaccine development [ 4 , 5 ]. However, the PS vaccines elicit weak T cell-independent immune responses without long-term immunological memories, particularly in children and the old [ 6 , 7 ].…”