Triptych of the Hermit Saints: pneumococcal polysaccharide vaccines for the elderly

Abstract

Pneumococcal pneumonia is a serious disease with considerable morbidity and mortality in the elderly. Despite adequate antibiotic treatment, the long-term mortality of pneumococcal pneumonia remains high. Preventive measures in the form of vaccination, therefore, are warranted. Twenty-three-valent polysaccharide vaccines have a broad coverage but limited efficacy. Pneumococcal conjugate vaccines have been shown in children to be able to prevent invasive and mucosal pneumococcal diseases. It should be realized that the serotype composition of current pneumococcal conjugate vaccines is not tailored for the elderly, and that replacement disease can occur. Yet, the current 13-valent conjugate vaccine has been shown to protect against infections with vaccine serotypes. Long-term mortality of pneumococcal pneumonia should be included in policy making about the introduction of these vaccines for the elderly.

GheOP3S tool and START/STOPP criteria version 2 for screening of potentially inappropriate medications and omissions in nursing home residents

“…In the investigated population, only one subject received pneumococcal vaccination. The pneumococcal infection in the geriatric population increases the rate of morbidity, mortality, and need for hospitalization, and it represents a significant burden for the medical system . Considering these facts, we need to find a way to increase the number of vaccinated people against Streptococcus pneumoniae in the geriatric population.…”

Rocking Pneumonia and the Boogie Woogie Flu

“…25,27 As indicated above, in a substantial number of patients with community-acquired pneumonia, a causative agent has not been found, so these could also be pneumococcal pneumonia. 17,18 In cases where influenza virus, or any other respiratory virus for that matter, is found, it can be debated whether this infection would be sufficient argument for the classification of viral pneumonia.…”

“…However, even when including sputum cultures, urinary tests, and serotype specific antibodies responses, the aetiological agent responsible for community acquired pneumonia often cannot be established. [16][17][18] Pneumonia poses a significant risk for morbidity and mortality in young children as well as the elderly. In 2008, approximately 156 million children worldwide were affected by pneumonia, with an approximate 1.3 million deaths, accounting for 18% of all deaths of children <5 years old.…”

Vaccines and Senior Travellers

“…Both pneumococcal vaccines are recommended for adults aged less than 65 in the presence of immune-compromising conditions. The antibody response stimulated by PPSV23 is T-cell independent, leading to waning protection over time ( Musher et al, 2010 ; Aliberti et al, 2014 ) and there is no induction of immunological memory ( Rijkers et al, 2018 ). Therefore, booster shots should be recommended in line with recommended intervals.…”