Pneumococcal polysaccharide vaccination for adults: new perspectives for Europe

Abstract

Vaccination is the only public-health measure likely to reduce the burden of pneumococcal diseases. In 2010, a group of European experts reviewed evidence on the burden of pneumococcal disease and the immunogenicity, clinical effectiveness and cost-effectiveness of vaccination with 23-valent pneumococcal polysaccharide vaccine (PPV23). They also considered issues affecting the future use of PPV23 and pneumococcal conjugate vaccines in the elderly and adults at high risk of pneumococcal disease. PPV23 covers 80-90% of the serotypes responsible for invasive pneumococcal disease in Europe. Primary vaccination and revaccination with PPV23 are well tolerated, induce robust, long-lasting immune responses in elderly adults and are cost effective. Ensuring protection against pneumococcal disease requires monitoring of the changing epidemiology of pneumococcal serotypes causing invasive pneumococcal disease and improving vaccine coverage. In the future, it will be critically important for pneumococcal vaccination recommendations for elderly adults to be based on comparative evaluations of PPV23 and newer pneumococcal conjugate vaccines with regard to their long-term immunogenicity, clinical effectiveness and cost-effectiveness.

Pneumococcal vaccination coverages among low-, intermediate-, and high-risk adults in Catalonia

“…14 Our results do not substantially differ with data observed in the USA during 2013, where pneumococcal vaccination coverage only reached 21.2% among persons aged 18-64 years-old with high-risk conditions but it was 69.5% among the general elderly population (65 y or older). 7,8 In European settings, there is scarce population-based data evaluating pneumococcal vaccination coverages among adults.…”

“…distributed in each country, but these estimates show great disparities in PPSV23 uptakes (with higher levels of vaccine use in countries with age-based recommendations and public reimbursement). 14 Estimates of PPSV23 coverages among elderly populations in Western European countries vary between 20% and 69% in distinct settings (probably reflecting national recommendations and program funding). 5,[14][15][16][17][18][19][20] Considering that the use of the PCV13 in adults has only been approved recently, there is no published data about PCV13 uptakes.…”

“…14 Estimates of PPSV23 coverages among elderly populations in Western European countries vary between 20% and 69% in distinct settings (probably reflecting national recommendations and program funding). 5,[14][15][16][17][18][19][20] Considering that the use of the PCV13 in adults has only been approved recently, there is no published data about PCV13 uptakes. We note that, at present, recommendations for pneumococcal vaccination in adults are not homogeneous in distinct countries, scientific societies and/or clinical guidelines.…”

“…We note that, at present, recommendations for pneumococcal vaccination in adults are not homogeneous in distinct countries, scientific societies and/or clinical guidelines. 6,14,[21][22][23][24][25][26][27] Some countries recommend routine PPSV23 vaccination for all persons 65 y of age, (with or without risk conditions), other countries recommend vaccination starting at a younger age, and others recommend PPSV23 only for at-risk groups. 17,26,27 In addition, there is also heterogeneity for PCV13 recommendations and funding for adults in distinct settings.…”

Factors associated with pneumococcal vaccination among an urban elderly population in China

“…9 In Europe, the published figures between 2005 and 2010 were mostly within the range of 20 to 30% among elderly people, and high coverage rates (over 69%) have been observed in the UK following the initiation of active campaigns in 2003. 16 The 23-PPV vaccine is also recommended for all adults over the age of 65 y in the United States, and more than 75% elderly adults have received the 23-PPV vaccine according to a survey called the Vaccine Safety Datalink project. 17 Other reported rates include 46% in Australia, 18 5.91% in Korea, 14 and 3.2% and 6.5% in Pakistan.…”