4 years ago

Impact of pneumococcal polysaccharide vaccine on incidence and mortality after pneumonia in adults aged ≥ 60 years – a population-based retrospective cohort study

The 23-valent pneumococcal polysaccharide vaccine (PPV) is recommended for prevention of pneumococcal diseases in adults at risk. Few data exist on time- age- and sex-dependent vaccine effectiveness on outcomes in pneumonia. Methods We performed a population based cohort study including adults ≥ 60 years of age (n=738.927) based on statutory health insurance data 2005-2011. Primary outcomes were all-cause pneumonia incidence and 30-day all-cause mortality. Pneumonia was identified via ICD-10 codes, ambulatory cases validated by antibiotic prescription within 7 days. The effect of PPV within 5 years was analysed after propensity score based matching (three controls per case with PPV vaccination) including comorbidities, care status, age, sex, and influenza vaccination. Evaluations were stratified by age group, sex and time of PPV. Results Two-year incidence of all-cause pneumonia in 213.431 vaccinated individuals was 7501/213.431 (3.51%) versus 23.243/640.293 (3.63%) in matched controls (difference -0.11, 95%CI -0.22—0.002, p=0.046). After sex-dependent analysis, PPV effectiveness on pneumonia incidence was observed only in females (difference -0.15, 95% CI -0.28 - -0.02, p=0.02). 30-day mortality in vaccinated individuals with pneumonia was 1302/7501 (17.36%) versus 4267/22.503 (18.96%) in matched controls (difference -1.60%, 95%CI -2.83—0.38, p=0.011). After analysis according to age group, significant mortality reduction was present only in adults of 60 to 79 years (difference -2.31, 95% CI -3.79 - -0.83, p=0.002). Year of PPV vaccination showed no effect on outcomes. Conclusions The findings support consideration of sex- and age-dependence of PPV effectiveness within further studies.

Publisher URL: www.sciencedirect.com/science

DOI: S1198743X17304561

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.