Invasive pneumococcal disease epidemiology and effectiveness of 23-valent pneumococcal polysaccharide vaccine in Alaska Native adults

Molecular Characterization of Streptococcus pneumoniae Serotype 12F Isolates Associated with Rural Community Outbreaks in Alaska

“…While antimicrobial chemoprophylaxis is likely to be useful in the management of small, short-lived, closed-population outbreaks (27), vaccine options might be a more useful alternative in community outbreaks, which are likely to be of longer duration and involve larger populations (7,28). The 23-valent pneumococcal vaccine has reasonable efficacy against 12F IPD in healthy adults but is not likely to be useful for infants or the very elderly (29,30). Information on current levels of 12F disease might be important for encouraging immunization with polysaccharide vaccine, but prevention options for the very old and the very young are still limited.…”

Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid)

“…22 Moreover, PPV23 has also been assessed in 3 further studies. [23][24][25] In recent years, the age indication for PCV13 was first extended from subjects aged 5 y to include those aged 50 y, and subsequently further extended to include all ages based on comparative immunogenicity data, including also the 18-64 y age group. 26 In the comparison of opsonophagocytic activity (OPA) titres between subjects 60-64 y of age, vaccinated either with PCV13 or PPV23, superiority was demonstrated for PCV13 with 9 of 12 common serotypes and noninferiority for the remaining 3, whereas the comparison between younger subjects only immunized with PCV13 and subjects in the 60-64 y age group vaccinated with PCV13 demonstrated consistently higher titres in younger vaccines.…”

“…22 Singleton et al found 100% (95% CI 78-100%) vaccine efficacy against IPD in the 20-39 y age group and 73% (95% CI < 0-96%) in the 40-54 y age group. 25 Hechter et al did not find a significant level of protection against pneumococcal bacteraemia, but did find significant levels of protection against hospitalisation for all-cause pneumonia (hazard ratio 1.18; 95% CI 1.02-1.37; p D 0.03) in the population overall and in patients without chronic obstructive pulmonary disease (COPD; hazard ratio 1.21; 95% CI 1.02-1.43; p D 0.03) but not in patients with COPD. 24 The efficacy data for PCV13 in the elderly age group were published recently and showed 75% efficacy against IPD due to vaccine serotypes, 45% efficacy against the first episode of community-acquired pneumonia (CAP) due to vaccine serotypes and 45% against non-invasive CAP due to vaccine serotypes.…”

Vaccine-Preventable Infectious Respiratory Diseases in the Elderly

“…The updated recommendations ( ３ ) in 2010 include the following changes from 1997 ACIP recommendations: 1) the indications for which PPV23 vaccination is recommended include smoking (12) and asthma (13,14) , and 2) routine use of PPV23 is no longer recommended for Alaska natives or American Indians aged below 65 years unless they have medical or other indications for PPV23 (15) .…”