Prevention of community-acquired pneumonia among a cohort of hospitalized elderly: Benefit due to influenza and pneumococcal vaccination not demonstrated

Skull, Sue; Andrews, Ross M.; Byrnes, Graham; Kelly, Heath; Nolan, Terry; Brown, Graham V.; Campbell, Donald

doi:10.1016/j.vaccine.2007.03.015

Cited by 32 publications

(19 citation statements)

References 42 publications

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“…However, JACKSON et al [25] found no reduction in hospitalisation for pneumonia, despite noting significant reductions in immunocompetent patients in the occurrence of both pneumococcal bacteraemia (54%) and all-cause mortality (12%) [26]. A historical cohort study by ANSALDI et al [27] and a casecohort study by SKULL et al [28] also failed to show that vaccination reduced hospital admission for CAP.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of the pneumococcal polysaccharide vaccine in preventing pneumonia in the elderly

et al. 2010

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The objective of our study was to evaluate the effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPV) in preventing hospital admission for communityacquired pneumonia (CAP) in people o65 yrs of age.We conducted a matched case-control study in patients with CAP admitted to five Spanish hospitals. Cases were persons aged o65 yrs admitted to hospital through the emergency department, who presented a clinical and radiological pattern compatible with pneumonia, assessed using established criteria. We matched each case with three control subjects by sex, age (¡5 yrs), date of hospitalisation (¡30 days) and underlying disease. The study period was May 1, 2005 to January 31, 2007. The PPV immunisation status of cases and controls was investigated. Adjusted ORs for vaccination were calculated using logistic regression analysis.A total of 489 cases and 1,467 controls were included in the final analysis. The overall adjusted vaccination effectiveness for all patients was 23.6% (95% CI 0.9-41.0). The adjusted vaccination effectiveness for immunosuppressed patients was 21.0% (95% CI -18.7-47.5).Our results suggest that the PPV may potentially reduce hospitalisations for pneumonia in the elderly and supports vaccination programmes in this age group.KEYWORDS: Case-control study, effectiveness, elderly, pneumococcal polysaccharide vaccine, pneumonia C ommunity-acquired pneumonia (CAP) is an important cause of morbidity and mortality in elderly people and those of any age with underlying diseases [1,2]. In Spain, the overall incidence in adults varies between two and 10 cases per 1,000 persons per yr in all ages and between 14 and 35 per 1,000 persons per yr in persons aged .70 yrs [3,4]. In a Spanish study, the incidence increased dramatically by age in elderly people (9.9/1,000 in people aged 65-74 yrs versus 29.4 in people aged o85 years) [4]. Hospitalisations due to CAP increase with age and may reach 61% for all ages, and 67% in people aged .65 yrs [5,6]. Case-fatality rates may reach 17% in patients aged .75 yrs [5], with higher rates in those with underlying disease [1,3,5]. A substantial proportion of CAP cases requiring hospitalisation are caused by Streptococcus pneumoniae: 30-50% according to most reports [1,[7][8][9][10][11]. Bacteraemic pneumococcal pneumonia, the most severe disease form, accounts for only 10-20% of adult cases of CAP caused by S. pneumoniae, with non-bacteraemic pneumococcal pneumonia being much more frequent [1].The 23-valent pneumococcal polysaccharide vaccine (PPV) has been available in the USA for 25 yrs and is currently licensed in most developed countries. Vaccination is usually recommended for people aged o65 yrs and for high-risk persons aged .2 yrs [1,12,13]. There is a general consensus that observational studies have shown vaccination to be effective in preventing invasive pneumococcal disease [14][15][16]. However, vaccination rates are not high in most countries, partly due to doubts about the vaccine's efficacy and vaccination effectiveness in preventing n...

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Section: Discussionmentioning

confidence: 99%

Effectiveness of the pneumococcal polysaccharide vaccine in preventing pneumonia in the elderly

et al. 2010

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“…The influenza vaccine has been demonstrated to have an additive effect for reducing the rate of pneumonia hospitalization in the elderly [10,26,27]. However, a case-cohort study conducted in Australian hospitals indicated no additive benefit for reducing pneumonia hospitalization among patients who received both the PPV and influenza vaccines compared with those who received only the influenza vaccine [28]. To eliminate the influence of influenza vaccination on pre-vaccination medical service utilization, the participants' 2007 seasonal influenza vaccination status was matched using PSM.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

The 23-valent pneumococcal polysaccharide vaccine is effective in elderly adults over 75 years old—Taiwan's PPV vaccination program

Tsai

Hsieh

Chang

et al. 2015

Vaccine

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“…[6][7][8] The effectiveness of the 23-valent polysaccharide pneumococcal vaccine (PPV23) in preventing pneumonia, the most frequent complication of influenza, has been reported in several studies [9][10][11] although other studies found that PPV23 vaccination was not effective. 12,13 Concomitant use of pneumococcal and influenza vaccines has provided added protection against hospitalization for several diseases, including respiratory illness and death. [14][15][16] After the 2009 influenza pandemic was declared, it was suggested that coadministration of the PPV23 and influenza vaccines might have a greater protective effect in the elderly and high risk groups than programs aimed at just one of these vaccines.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of vaccination with 23-valent pneumococcal polysaccharide vaccine in preventing hospitalization with laboratory confirmed influenza during the 2009-2010 and 2010-2011 seasons

Domı́nguez

Castilla

Godoy

et al. 2013

Human Vaccines & Immunotherapeutics

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Results: 1187 cases and 2328 controls were included. The adjusted estimate of effectiveness of pneumococcal vaccination in preventing influenza hospitalization was 41% (95% cI 8-62) in all patients and 43% (95% cI 2-78) in patients aged ≥ 65 y. The adjusted effectiveness of dual ppV23 and influenza vaccination was 81% (95% cI 65-90) in all patients and 76% (95% cI 46-90) in patients aged ≥ 65 y. The adjusted effectiveness of influenza vaccination alone was 58% (95% cI 38-72).Methods: We conducted a multicenter case-control study in 36 spanish hospitals. We selected patients aged ≥ 18 y hospitalized with confirmed influenza and two hospitalized controls per case, matched according to age, date of hospitalization and province of residence. Multivariate analysis was performed using conditional logistic regression. subjects were considered vaccinated if they had received the pneumococcal or seasonal influenza vaccine ≥ 14 d (or ≥ 7 d for pandemic influenza vaccine) before the onset of symptoms (cases) or the onset of symptoms in matched cases (controls).Conclusions: In elderly people and adults with chronic illness, pneumococcal vaccination may reduce hospitalizations during the influenza season. In people vaccinated with both the influenza and pneumococcal vaccines, the benefit in hospitalizations avoided was greater than in those vaccinated only against influenza.

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Prevention of community-acquired pneumonia among a cohort of hospitalized elderly: Benefit due to influenza and pneumococcal vaccination not demonstrated

Cited by 32 publications

References 42 publications

Effectiveness of the pneumococcal polysaccharide vaccine in preventing pneumonia in the elderly

Effectiveness of the pneumococcal polysaccharide vaccine in preventing pneumonia in the elderly

The 23-valent pneumococcal polysaccharide vaccine is effective in elderly adults over 75 years old—Taiwan's PPV vaccination program

Effectiveness of vaccination with 23-valent pneumococcal polysaccharide vaccine in preventing hospitalization with laboratory confirmed influenza during the 2009-2010 and 2010-2011 seasons

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