Serotype-specific effectiveness of 23-valent pneumococcal polysaccharide vaccine against pneumococcal pneumonia in adults aged 65 years or older: a multicentre, prospective, test-negative design study

Suzuki, Motoi; Dhoubhadel, Bhim Gopal; Ishifuji, Tomoko; Yasunami, Michio; Yaegashi, Makito; Asoh, Norichika; Ishida, M.; Hamaguchi, Sugihiro; Aoshima, Masahiro; Ariyoshi, Koya; Morimoto, Konosuke

doi:10.1016/s1473-3099(17)30049-x

Cited by 150 publications

(153 citation statements)

References 27 publications

Supporting

Mentioning

141

Contrasting

Unclassified

Order By: Relevance

“…An important study of PPV23 in people Ն65 years old has been published since the Cochrane review (72). This study was observational in nature but employed a testnegative design; this reduces several biases and has been found to be similar to RCTs in providing estimates of the effectiveness of seasonal influenza vaccines (73).…”

Section: Current Pneumococcal Vaccination Strategies Provide Poor Promentioning

confidence: 99%

“…This study was observational in nature but employed a testnegative design; this reduces several biases and has been found to be similar to RCTs in providing estimates of the effectiveness of seasonal influenza vaccines (73). The study, carried out in Japan, found that the effectiveness of PPV23 was 27.4% against all pneumococcal CAP and 33.5% against CAP caused by the 23 vaccine serotypes (72). Effectiveness against all-cause pneumonia or mortality was not demonstrated.…”

Section: Current Pneumococcal Vaccination Strategies Provide Poor Promentioning

confidence: 99%

“…PPV-induced antibody levels decline in elderly people over 5 years (86); while they may not decline to the prevaccination baseline, clinical data consistently show reduced protective efficacy over time, suggesting that this decline is relevant and clinically significant (72,88). Similar declines in opsonic function over time were seen in older adults who received PCV13 (89).…”

Section: Pneumococcal Vaccines Are Immunogenic In Older Peoplementioning

confidence: 99%

See 2 more Smart Citations

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

Adler

Ferreira

Gordon

et al. 2017

Clin Vaccine Immunol

View full text Add to dashboard Cite

Immunity to pneumococcal infections is impaired in older people, and current vaccines are poorly protective against pneumococcal disease in this population. Naturally acquired immunity to pneumococcal capsular polysaccharides develops during childhood and is robust in young adults but deteriorates with advanced age. In particular, antibody levels and function are reduced in older people. Pneumococcal vaccines are recommended for people Ͼ65 years old. However, the benefits of polysaccharide and protein-conjugated vaccines in this population are small, because of both serotype replacement and incomplete protection against vaccine serotype pneumococcal disease. In this review, we overview the immune mechanisms by which naturally acquired and vaccine-induced pneumococcal capsular polysaccharide immunity declines with age, including altered colonization dynamics, reduced opsonic activity of antibodies (particularly IgM), and impaired mucosal immunity.

show abstract

Section: Current Pneumococcal Vaccination Strategies Provide Poor Promentioning

confidence: 99%

Section: Current Pneumococcal Vaccination Strategies Provide Poor Promentioning

confidence: 99%

Section: Pneumococcal Vaccines Are Immunogenic In Older Peoplementioning

confidence: 99%

See 1 more Smart Citation

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

Adler

Ferreira

Gordon

et al. 2017

Clin Vaccine Immunol

View full text Add to dashboard Cite

show abstract

“…The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is recommended for the elderly since it lowers the risks of invasive pneumococcal disease [4] and pneumococcal pneumonia. [5] Pneumonia holds 3rd place for cause of death in the elderly [6], and streptococcus pneumoniae is the most dominant causative bacteria, accounting for 17 to 28% in cases of pneumonia in adults [7–9]. In Japan, the PPSV23 has proven to be effective in reducing the incidence of pneumonia in general as well as pneumococcal pneumonia specifically [10].…”

Section: Introductionmentioning

confidence: 99%

Correlation between family physician’s direct advice and pneumococcal vaccination intention and behavior among the elderly in Japan: a cross-sectional study

Higuchi

Narumoto

Goto³

et al. 2018

BMC Fam Pract

View full text Add to dashboard Cite

BackgroundVaccination is an important element of health maintenance in family medicine. The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is highly recommended for the elderly, but its uptake is low in Japan. Primary care system remains under development and preventive services tend to be neglected in the Japanese medical practice. The study aims to investigate the association between family physician’s recommendations for PPSV23 during outpatient care and PPSV23 vaccination intention and behavior in the elderly.MethodWe conducted a cross-sectional study with a questionnaire at a family medicine clinic in a rural area in Japan. The participants were over the age of 65 without dementia who had maintained a continuity with the clinic. The questionnaire inquired PPSV23 vaccination status, family physician’s advice for PPSV23, socio-demographics, and the constructs in the Health Belief Model. We defined those who had had vaccination intention and behavior as “PPSV23 vaccinated group” and those who had no vaccination and uncertainty about being or no intention to be vaccinated in the future as “PPSV23 unvaccinated group.” We used chi-square test for correlation between physician advice and PPSV23 vaccination/intention, univariate and multivariate logistic regression analysis for factors related to the vaccination/intention, and descriptive analysis for reasons for reluctance to the vaccination.ResultsWe analyzed 209 valid responses. There were 142 participants in the PPSV23 vaccinated group and 67 in the PPSV23 unvaccinated group. The PPSV23 vaccination group was more likely to have had their physician’s advice (80.2% vs 21.3%, p < 0.001). Multivariate logistic regression analysis showed a significant association between PPSV23 vaccination and their physician’s recommendation (OR 8.50, 95%CI 2.8–26.0), awareness of PPSV23 (OR 8.52, 95%CI 2.1–35.0), and the perceived effectiveness of PPSV23 (OR 4.10, 95%CI 1.2–13.9). The reasons for reluctance to get vaccinated included lack of understanding of PPSV23, lack of physician’s recommendations, and concerns about side effects of PPSV23.ConclusionFamily physician’s recommendation was positively correlated with PPSV23 vaccination intention and behavior in the elderly. This reinforces the importance of providing preventive services during time-constrained outpatient care, even in medical systems where it is undervalued.Electronic supplementary materialThe online version of this article (10.1186/s12875-018-0841-3) contains supplementary material, which is available to authorized users.

show abstract

“…PPA23'ün ≥65 yaşındaki erişkinlerde TGP'ye karşı etkililiğinin değerlendirildiği bir çalışmada, tüm pnömokok pnö-monilerine karşı (%27.4) ve PPA23 serotiplerine karşı (%33.5) düşük ya da orta derecede bir etkisinin olduğu gösterilmiştir (48). Topluma dayalı bir olgu kontrol çalışmasında PPA'nın <55 yaşındaki erişkinlerde İPH'yi önlemede %85-90 etkin olduğu, ancak yaş arttıkça PPA'nın etkinliğinin azaldığı göste-rilmiştir (49).…”

Section: Polisakarid Pnömokok Aşısıunclassified

Pneumococcal Vaccine as One of the Immunization Coverage Targets For Adulthood Vaccines: A Consensus Report of the Study Group For Adult Immunization of the Turkish Society of Clinical Microbiology and Infectious Diseases

Şenol¹,

Azap²,

Erbay³

et al. 2018

Klimik Dergisi

View full text Add to dashboard Cite

Pneumococcal diseases, including pneumonia with or without bacteremia, remain an important cause of morbidity and mortality in adults, especially among the elderly and those with certain medical conditions, including immunocompromising conditions all over the world. Two pneumococcal vaccines are currently licensed for adults in Turkey, 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23). PPSV23 has been available for many years for use in adults. A 7-valent pneumococcal conjugate vaccine (PCV7) included in the Expanded Programme on Immunization for use in infants and children in 2008, and thereafter PCV13 replaced PCV7 in 2011. Recently, the Ministry of Health of Turkey accepted risk groups for vaccine-preventable diseases, and implemented their immunization schedules in accordance with the decisions of Immunization Advisory Committee, including adult pneumococcal vaccination greatly compatible with those of updated U.S. Advisory Committee on Immunization Practices (ACIP) recommendations such as PCV13 for selected high-risk adults and for all adults ≥65 years of age. Furthermore, surveillance of invasive pneumococcal disease has already been included as part of the Surveillance of Vaccine-Preventable Invasive Bacterial Diseases announced that would be started soon in Turkey. In this consensus report prepared by Study Group for Adult Immunization of the Turkish Society of Clinical Microbiology and Infectious Diseases, relevant literature ÖzetPnömokok hastalıkları, bakteriyemik olan ya da olmayan pnömoni başta olmak üzere, özellikle yaşlılarda ve immün sistemi zayıfla-tan durumlar gibi birtakım sağlık sorunları olan erişkinlerde, tüm dünyada önemli bir morbidite ve mortalite nedeni olmaya devam etmektedir. Ülkemizde 13 valan konjuge pnömokok aşısı (KPA13) ve 23 valan polisakarid pnömokok aşısı (PPA23) olmak üzere eriş-kinler için ruhsatlandırılmış iki aşı vardır. PPA23 erişkinlerde yıl-lardır kullanılmaktadır. 2008'de 7 valan konjuge pnömokok aşısı (KPA7) çocuklarda kullanılmak üzere Genişletilmiş Bağışıklama Programı'na alınmıştır; daha sonra 2011'de KPA7 yerini KPA13'e bırakmıştır. Yakınlarda Sağlık Bakanlığı'nca, Bağışıklama Danışma Kurulu kararları doğrultusunda, aşıyla önlenebilir hastalıklar açı-sından risk grupları kabul edilmiş ve bunlara uygulanması gereken, aralarında erişkinlerde pnömokok aşılamasının da bulunduğu aşı şemaları yürürlüğe konulmuştur. Bu şemalar, pnömokok aşıları yö-nünden, KPA13'ün hem yüksek risk altındaki erişkinlere hem de ≥65 yaşındaki tüm erişkinlere uygulanması gibi ABD'deki güncel Advisory Committee on Immunization Practices (ACIP) önerileriy-le büyük ölçüde örtüşmektedir. Ayrıca, yakınlarda yayımlanan bir genelgeyle ülkemizde de başlatılacağı açıklanan invazif pnömokok hastalıkları sürveyansı, Aşıyla Önlenebilir İnvazif Bakteriyel Hastalıkların Sürveyansı programının kapsamına alınmıştır. Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği Erişkin Bağışıkla-ması Çalışma Grubu'nca hazırlanan bu uzlaşı raporun...

show abstract

Serotype-specific effectiveness of 23-valent pneumococcal polysaccharide vaccine against pneumococcal pneumonia in adults aged 65 years or older: a multicentre, prospective, test-negative design study

Cited by 150 publications

References 27 publications

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

Pneumococcal Capsular Polysaccharide Immunity in the Elderly

Correlation between family physician’s direct advice and pneumococcal vaccination intention and behavior among the elderly in Japan: a cross-sectional study

Pneumococcal Vaccine as One of the Immunization Coverage Targets For Adulthood Vaccines: A Consensus Report of the Study Group For Adult Immunization of the Turkish Society of Clinical Microbiology and Infectious Diseases

Contact Info

Product

Resources

About