The effectiveness of the polysaccharide pneumococcal vaccine for the prevention of hospitalizations due to Streptococcus pneumoniae community-acquired pneumonia in the elderly differs between the sexes: Results from the Community-Acquired Pneumonia Organization (CAPO) international cohort study

Wiemken, Timothy; Carrico, Ruth; Klein, Sabra L.; Jonsson, Colleen B.; Peyrani, Paula; Kelley, Robert; Aliberti, Stefano; Blasi, Francesco; Fernández-González, Ricardo; Lopardo, Gustavo; Ramirez, Julio A.

doi:10.1016/j.vaccine.2014.02.048

Cited by 42 publications

(43 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Three registry-based cohort studies [43,44,46], 3 matched case-control studies [47][48][49], and 4 "case-case studies" using the Broome method [21,[50][51][52] fulfilled this condition. Efficacy against PP was also investigated in a study with a similar case-case design, in which pneumonia cases caused by other pathogens or with no identified pathogen were used as the control group [53]. A large registry-based cohort study from Sweden [69] was excluded because it did not take confounders into account.…”

Section: Ppsv23mentioning

confidence: 99%

Background paper to the updated pneumococcal vaccination recommendation for older adults in Germany

Falkenhorst

Remschmidt

Harder

et al. 2016

Bundesgesundheitsbl

View full text Add to dashboard Cite

are members of the German Standing Committee on Vaccination (STIKO). Bundesgesundheitsblatt -Gesundheitsforschung -Gesundheitsschutz 12 · 2016 1624Tätigkeitsberichte Summary Background and objective The incidence of pneumococcal diseases among adults increases with age. Therefore, Germany's Standing Committee on Vaccination (Ständige Impfkommission, STIKO) has since 1998 recommended vaccination with the 23-valent pneumococcal polysaccharide vaccine (PPSV23) for all people aged ≥60 years. PPSV23 has been the only pneumococcal vaccine licensed for adults until few years ago. Universal pneumococcal vaccination of infants, using a conjugate vaccine, has been recommended by STIKO since 2006. Since then, pneumococcal serotypes contained in conjugate vaccines have declined among cases of pneumococcal disease not only in children, but -through herd protection -also in older adults. The 13-valent pneumococcal conjugate vaccine (PCV13), currently used for most infants in Germany, has now been approved for use in adults as well. Data on the efficacy of PCV13 against clinical endpoints in older adults was published in 2015. For that reason, STIKO investigated whether one of the two vaccines (or the combination of both) should be preferred in order to reduce the burden of pneumococcal diseases in older adults, and at what age the vaccine should be given. Efficacy against invasive pneumococcal diseasesPooled data from 4 randomised controlled trials (RCTs) of PPSV23 in older adults show an efficacy of 73 % against invasive pneumococcal disease (IPD) caused by any serotype (95 % confidence interval [CI], 10-92 %). The IPD cases in these studies were mostly caused by one of the 23 serotypes contained in the vaccine. The efficacy of PCV13 in older adults was investigated in one RCT. Efficacy against IPD by any serotype was 49 % (95 % CI, 21-67 %, modified-intention-to-treat analysis). Efficacy against IPD by the 13 serotypes contained in the vaccine (VT-IPD) was 76 % (95 % CI, 47-90 %). Efficacy against pneumococcal pneumoniaAfter exclusion of 2 RCTs with a high risk of bias, pooled efficacy of PPSV23 against pneumococcal pneumonia (PP) caused by any serotype in the remaining 2 RCTs was 64 % (95 % CI, 35-80 %). In the included observational studies, pooled efficacy ranged from 37 % to 53 %, with broadly overlapping CIs, depending on study type. The efficacy of PCV13 against PP caused by any serotype was 22 % (95 % CI, 2-39 %), and against VT-PP it was 38 % (95 % CI, 14-55 %). Anticipated epidemiological and health economic effectsThe above-mentioned studies do not provide clear evidence of a difference between the two vaccines regarding efficacy against clinical endpoints (IPD, PP) caused by the serotypes contained in the respective vaccine. In the 2015-'16 season, 70 % of IPD cases in people aged ≥60 years were caused by PPSV23 serotypes, but only 30 % by PCV13 serotypes. Because PPSV23 contains all the serotypes in PCV13 (except for serotype 6A), vaccination with PPSV23 confers broader serotype coverage and can thereby prevent ...

show abstract

Section: Ppsv23mentioning

confidence: 99%

Background paper to the updated pneumococcal vaccination recommendation for older adults in Germany

Falkenhorst

Remschmidt

Harder

et al. 2016

Bundesgesundheitsbl

View full text Add to dashboard Cite

show abstract

“…37 Interestingly, a nested case-control study suggested that PPV23 protected elderly patients from hospitalisation due to pneumococcal CAP, especially female patients, and future studies should consider the impact of gender. 38 …”

Section: Prevention Of Pneumococcal Infections -Vaccinationmentioning

confidence: 99%

Review: Current and new generation pneumococcal vaccines

Feldman

Anderson

2014

Journal of Infection

175

170

View full text Add to dashboard Cite

“…The second was a retrospective nested case-control study of a population-based cohort from the largest Israeli healthcare provider assessing the effectiveness of PPV23 in preventing invasive pneumococcal disease and, subsequently, its effectiveness in preventing hospital-treated CAP in 23,952 participants [23]. The third known as the Community-Acquired Pneumonia Organization (CAPO) cohort study was a multicenter, international-nested case-control study of the CAPO database that assessed the effectiveness of PPV23 in preventing hospitalizations due to pneumococcal CAP among the elderly who were hospitalized for CAP and whether it differs by gender [24].…”

Section: The Influence Of Pneumococcal Vaccines On Cap Outcomes In Elmentioning

confidence: 99%

“…CAP was defined as a new pulmonary infiltrate within 24 h of hospitalization in the presence of an existing sign or symptom of pneumonia, with no history of hospitalization during the two weeks prior to admission [24]. Pneumococcal CAP cases were patients with CAP and S. pneumoniae identified from the blood, bronchoalveolar lavage, sputum, or by urinary antigen test [24]. Controls were patients with CAP without S. pneumoniae identified in any clinical sample [24].…”

Section: The Capo Studymentioning

confidence: 99%

“…Pneumococcal CAP cases were patients with CAP and S. pneumoniae identified from the blood, bronchoalveolar lavage, sputum, or by urinary antigen test [24]. Controls were patients with CAP without S. pneumoniae identified in any clinical sample [24]. A patient was considered vaccinated with PPV23 prior to CAP hospitalization if it was documented in their medical record [24].…”

Section: The Capo Studymentioning

confidence: 99%

See 1 more Smart Citation

The Influence of Influenza and Pneumococcal Vaccines on Community-Acquired Pneumonia (CAP) Outcomes Among Elderly Patients

Gubbins

2015

Curr Infect Dis Rep

View full text Add to dashboard Cite

Elderly are at high risk for hospitalization for community-acquired pneumonia (CAP), especially due to Streptococcus pneumoniae, and seasonal influenza viruses. Data suggest PPV23's influence on various CAP-related outcomes among the elderly may depend upon how many years have elapsed since they received this vaccine. PPV23's protection against invasive pneumococcal disease and CAP hospitalizations are often limited to moderately ill elderly, who are less than 75 years old, or female. PCV13 demonstrates broad protection against a variety of CAPs, but ultimately, its influence on their outcomes among the elderly may be limited by herd immunity from PCV7 use. Influenza vaccine's indirect protective effect against all-cause and non-invasive pneumococcal CAP in the elderly is difficult to ascertain. The use of both PPV23 and influenza vaccine shortens length of stay in hospitalized elderly with CAP, but whether that benefit would be realized in the presence of herd immunity is unknown.

show abstract

The effectiveness of the polysaccharide pneumococcal vaccine for the prevention of hospitalizations due to Streptococcus pneumoniae community-acquired pneumonia in the elderly differs between the sexes: Results from the Community-Acquired Pneumonia Organization (CAPO) international cohort study

Cited by 42 publications

References 14 publications

Background paper to the updated pneumococcal vaccination recommendation for older adults in Germany

Background paper to the updated pneumococcal vaccination recommendation for older adults in Germany

Review: Current and new generation pneumococcal vaccines

The Influence of Influenza and Pneumococcal Vaccines on Community-Acquired Pneumonia (CAP) Outcomes Among Elderly Patients

Contact Info

Product

Resources

About