Jong Hun Kim1, Byung Chul Chun2, Joon Young Song3, Hyo Youl Kim4, In-Gyu Bae5, Dong-Min Kim6, Young Hwa Choi7, Yoon Hee Jun8, Won Suk Choi9, Seong Hee Kang10, Hyun Hee Kwon11, Hye Won Jeong12, Sae Yoon Kee13, Jian Hur14, Jin Won Chung15, Young Kyung Yoon1, Jang Wook Sohn1, Kyung Sook Yang16, Min Ja Kim17. 1. Division of Infectious Diseases, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. 2. Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea. 3. Division of Infectious Diseases, Department of Internal Medicine, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea. 4. Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea. 5. Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea. 6. Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea. 7. Department of Infectious Diseases, Internal Medicine, Ajou University Hospital, Suwon, Republic of Korea. 8. Department of Internal Medicine, Cheju Halla General Hospital, Jeju-si, Republic of Korea. 9. Division of Infectious Diseases, Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea. 10. Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Republic of Korea. 11. Department of Internal Medicine, Daegu Catholic University, Daegu, Republic of Korea. 12. Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea. 13. Division of Infectious Diseases, Department of Internal Medicine, Sahmyook Medical Center, Seoul, Republic of Korea. 14. Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea. 15. Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea. 16. Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea. 17. Division of Infectious Diseases, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea; The Research Institute of Emerging Infectious Diseases, Korea University, Seoul, Republic of Korea. Electronic address: macropha@korea.ac.kr.
Abstract
BACKGROUND: While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population. METHODS: For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100. RESULTS: We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) -5.8%-51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65-74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4-77.5)] and against NBPP [effectiveness 35.0% (2.3-56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6-98.8) for PPV23-unique serotypes and 81.3% (38.6-94.3) for PPV23 serotypes excluding serotype 3. CONCLUSIONS: This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.
BACKGROUND: While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population. METHODS: For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100. RESULTS: We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) -5.8%-51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65-74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4-77.5)] and against NBPP [effectiveness 35.0% (2.3-56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6-98.8) for PPV23-unique serotypes and 81.3% (38.6-94.3) for PPV23 serotypes excluding serotype 3. CONCLUSIONS: This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.
Authors: Paul S Schulz; Sarah E Moore; Daniel Smith; Jessica Javed; Ashley M Wilde Journal: Open Forum Infect Dis Date: 2022-03-16 Impact factor: 3.835
Authors: Miwako Kobayashi; Jennifer L Farrar; Ryan Gierke; Amadea Britton; Lana Childs; Andrew J Leidner; Doug Campos-Outcalt; Rebecca L Morgan; Sarah S Long; H Keipp Talbot; Katherine A Poehling; Tamara Pilishvili Journal: MMWR Morb Mortal Wkly Rep Date: 2022-01-28 Impact factor: 35.301
Authors: Hannah Lawrence; Harry Pick; Vadsala Baskaran; Priya Daniel; Chamira Rodrigo; Deborah Ashton; Rochelle C Edwards-Pritchard; Carmen Sheppard; Seyi D Eletu; David Litt; Norman K Fry; Samuel Rose; Caroline Trotter; Tricia M McKeever; Wei Shen Lim Journal: PLoS Med Date: 2020-10-23 Impact factor: 11.069