The epidemiologic and biologic basis for classifying older age as a high-risk, immunocompromising condition for pneumococcal vaccine policy

Grant, Lindsay R.; Slack, Mary; Yan, Qi; Trzciński, Krzysztof; Barratt, Jane; Sobczyk, Elizabeth; Appleby, James C.; Cané, Alejandro; Jódar, Luis; Istúriz, Raúl; Gessner, Bradford D.

doi:10.1080/14760584.2021.1921579

Cited by 17 publications

(13 citation statements)

References 123 publications

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“…Regarding the outcome, we found a statistically significant increase in mortality with advancing age, reaching 42.7% at ≥ 65 years, reflecting the high IPD risk conditions among the elderly with waning immunocompetence. 2 , 32 Conversely, as expected, children had a higher cure rate (89.7%). 27 , 28 Crude associations of higher mortality with comorbidity status and number of comorbid conditions were not observed in our study, which may be related to the high proportion of missing data on comorbidities (20.2%) and on outcome status (25.9%) in this study.…”

Section: Discussionsupporting

confidence: 77%

Chronic medical conditions associated with invasive pneumococcal diseases in inpatients in teaching hospitals in São Paulo city: Estimating antimicrobial susceptibility and serotype-coverage of pneumococcal vaccines

Kfouri¹,

Brandileone

Sáfadi

et al. 2023

The Brazilian Journal of Infectious Diseases

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Section: Discussionsupporting

confidence: 77%

Chronic medical conditions associated with invasive pneumococcal diseases in inpatients in teaching hospitals in São Paulo city: Estimating antimicrobial susceptibility and serotype-coverage of pneumococcal vaccines

Kfouri¹,

Brandileone

Sáfadi

et al. 2023

The Brazilian Journal of Infectious Diseases

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“…Thus, these results suggest that in addition to the targeted population with recognized risk factors for CAP (older age and certain medical conditions), direct vaccination of PCV13 in the overall adult population might be beneficial. However, in line with recent recommendations from the US Advisory Committee on Immunization Practices, 41 the key adult groups to target for PCV immunization remain older adults due to immunosenescence, 42 beginning around the age of 50 years and accelerating afterward, and younger adults with underlying risk factors for pneumococcal disease.…”

Section: Discussionmentioning

confidence: 94%

Pneumococcal serotypes in adults hospitalized with community-acquired pneumonia in Greece using urinary antigen detection tests: the EGNATIA study, November 2017 – April 2019

Liapikou

Konstantinidis

Kossyvaki³

et al. 2022

Human Vaccines & Immunotherapeutics

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Greece introduced a 13-valent pneumococcal conjugate vaccine (PCV13) into the infant national immunization program in 2010 (3 + 1 schedule until June 2019). Since 2015, PCV13 has been recommended for adults aged 19–64 years with comorbidities and adults ≥65 years sequentially with 23-valent pneumococcal polysaccharide vaccine (PPSV23). We examined pneumococcal serotype distribution among Greek adults aged ≥19 years hospitalized with community-acquired pneumonia (CAP) during November 2017-April 2019. This was an interim analysis of EGNATIA, a prospective study of adult hospitalized CAP in the cities of Ioannina and Kavala. Pneumococcus was identified using cultures, BinaxNow®, serotype-specific urinary antigen detection assays (UAD-1/2). Our analysis included overall 482 hospitalized CAP patients (mean age: 70.5 years; 56.4% male). 53.53% of patients belonged to the highest pneumonia severity index (PSI) classes (IV-V). Pneumococcus was detected in 65 (13.5%) patients, with more than half (57%) of cases detected only by UAD. Approximately two-thirds of pneumococcal CAP occurred in those aged ≥65 years (n = 40, 8.3% of CAP). More than half of pneumococcal CAP (n = 35, 53.8%) was caused by PCV13 serotypes. Most frequently detected PCV13 serotypes were 3, 19A, 23F, collectively accounting for 83% of PCV13 vaccine-type (VT) CAP and 6% of all-cause CAP. Overall, 82.9% of PCV13 VT CAP occurred among persons with an indication (age/risk-based) for PCV13 vaccination. Even with a mature PCV13 childhood immunization program, a persistent burden of PCV13 VT CAP exists in Greek adults. Strategies to increase PCV13 (and higher-valency PCVs, when licensed) coverage in adults should be implemented to reduce the disease burden.

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“…Adult pneumococcal disease incidence increases substantially after 50 years of age, as does associated mortality. In addition to age as a risk factor, smoking and certain medical conditions, including immunocompromising conditions, also increase the risk for pneumococcal infection and are associated with potentially increased morbidity and mortality [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

PCV13 Vaccination of Adults against Pneumococcal Disease: What We Have Learned from the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA)

et al. 2022

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The Community-Acquired Pneumonia immunization Trial in Adults (CAPiTA) evaluated older adult pneumococcal vaccination and was one of the largest vaccine clinical trials ever conducted. Among older adults aged ≥65 years, the trial established 13-valent pneumococcal conjugate vaccine (PCV13) efficacy in preventing first episodes of bacteremic and nonbacteremic pneumococcal vaccine serotype (VT) community acquired pneumonia (CAP), and of vaccine serotype invasive pneumococcal disease (VT-IPD). Since the publication of the original trial results, 15 additional publications have extended the analyses. In this review, we summarize and integrate the full body of evidence generated by these studies, contextualize the results in light of their public health relevance, and discuss their implications for the assessment of current and future adult pneumococcal vaccination. This accumulating evidence has helped to better understand PCV13 efficacy, serotype-specific efficacy, efficacy in subgroups, the interpretation of immunogenicity data, and the public health value of adult PCV vaccination.

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The epidemiologic and biologic basis for classifying older age as a high-risk, immunocompromising condition for pneumococcal vaccine policy

Abstract: The epidemiologic and biologic basis for classifying older age as a high-risk, immunocompromising condition for pneumococcal vaccine policy, Expert Review of Vaccines,

Cited by 17 publications

References 123 publications

Chronic medical conditions associated with invasive pneumococcal diseases in inpatients in teaching hospitals in São Paulo city: Estimating antimicrobial susceptibility and serotype-coverage of pneumococcal vaccines

Chronic medical conditions associated with invasive pneumococcal diseases in inpatients in teaching hospitals in São Paulo city: Estimating antimicrobial susceptibility and serotype-coverage of pneumococcal vaccines

Pneumococcal serotypes in adults hospitalized with community-acquired pneumonia in Greece using urinary antigen detection tests: the EGNATIA study, November 2017 – April 2019

PCV13 Vaccination of Adults against Pneumococcal Disease: What We Have Learned from the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA)

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