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Liapikou A, Konstantinidis A, Kossyvaki V, Skiadas J, Menegas D, Méndez C, Beavon R, Begier E, Gessner BD, Milionis H, Tsimihodimos V, Baxevanos G, Argiriadou T, Terrovitou C, Toumbis M, Study Group TE, Moses E, Angelos L, Ilias T, Aikaterini P, Valentina S, Iro R, Konstantinos E, Konstantina G, Christos K, Elias L, Thomas T, Georgios D, Evaggelia C, Nikolaos Z, Lampros P, Vasilios I, Elisavet F, Daniil D, Ioanna K, Anastasia C, Eleni T. Pneumococcal serotypes in adults hospitalized with community-acquired pneumonia in Greece using urinary antigen detection tests: the EGNATIA study, November 2017 - April 2019. Hum Vaccin Immunother 2022; 18:2079923. [PMID: 35703733 DOI: 10.1080/21645515.2022.2079923] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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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Affiliation(s)
- Adamantia Liapikou
- Hellenic Thoracic Society (HTS), Infectious Diseases Working Group, Athens, Greece.,6th Respiratory Medicine Department, "Sotiria" Hospital of Chest Diseases, Athens, Greece
| | | | | | | | | | | | - Rohini Beavon
- Pfizer Ltd, Global Vaccines, Medical Development and Scientific/Clinical Affairs (MDSCA), London, United Kingdo
| | - Elizabeth Begier
- Pfizer Inc., Global Vaccines, Collegeville, Pennsylvania, United States of America
| | - Bradford D Gessner
- Pfizer Inc., Global Vaccines, Collegeville, Pennsylvania, United States of America
| | - Haralampos Milionis
- 1st Internal Medicine Department, University Hospital of Ioannina, Loannina, Greece
| | | | - Gerasimos Baxevanos
- Internal Medicine Department, General Hospital of Ioannina G. Hatzikosta, Loannina, Greece
| | - Theodora Argiriadou
- 1st Respiratory Medicine Department, General Hospital of Kavala, Kavala, Greece
| | | | - Michael Toumbis
- Hellenic Thoracic Society (HTS), Infectious Diseases Working Group, Athens, Greece
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Buades J, Losada I, González-Moreno J, Peñaranda M, Vilaplana L, Roda N, Rey A, Rodriguez A, Garau M, de Gopegui ER, Serra A, Saurina J, Payeras A. Evolution, Clinical and Microbiological Characteristics of Invasive Pneumococcal Disease since the Introduction of the Pneumococcal Conjugate Vaccine 13-Valent in Adults over 18 Years Old. Vaccines (Basel) 2021; 9:93. [PMID: 33513726 PMCID: PMC7911783 DOI: 10.3390/vaccines9020093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 11/28/2022] Open
Abstract
Invasive pneumococcal disease (IPD) presents high mortality in the population at risk. The aim of this work is to know the evolution, clinical and microbiological characteristics of IPD in the adult population of Majorca, since the introduction of a public funded program for pneumococcal conjugate vaccine (PCV-13) in the pediatric population in the Balearic Islands in 2016. For this purpose, a retrospective multicenter study was carried out in which all episodes of IPD in adult patients from the four hospitals of the public health system of Majorca were included, comparing the periods between 2012 and 2015 and between 2016 and 2019. Clinical variables, serotypes and antibiotic sensitivity were collected. There were 498 cases of IPD; 56.8% were male with a mean age of 67 (standard deviation: 16). Most infections were bacterial pneumonias (73.7%). Of the total cases, 264 (53%) presented complications. Of the 498 cases, 351 strains were obtained, of which 145 (41.3%) belong to vaccinal serotypes (included in the PCV-13 vaccine) and 206 (58.7%) to non-vaccinal serotypes (not included in the PCV-13 vaccine). The percentage of IPD caused by vaccinal serotypes was lower in the second period (47.8% vs. 34.5%; p = 0.012).
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Affiliation(s)
- Juan Buades
- Internal Medicine Service, Son Llàtzer University Hospital (HUSLL), 07198 Palma, Spain; (I.L.); (J.G.-M.); (A.R.); (A.P.)
| | - Ines Losada
- Internal Medicine Service, Son Llàtzer University Hospital (HUSLL), 07198 Palma, Spain; (I.L.); (J.G.-M.); (A.R.); (A.P.)
- Institute of Health Research of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Juan González-Moreno
- Internal Medicine Service, Son Llàtzer University Hospital (HUSLL), 07198 Palma, Spain; (I.L.); (J.G.-M.); (A.R.); (A.P.)
- Institute of Health Research of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Maria Peñaranda
- Infectious Diseases Section, Hospital Universitario Son Espases (HUSE), 07120 Palma, Spain;
| | - Laia Vilaplana
- Department of Internal Medicine, Hospital de Manacor, 07500 Manacor, Spain; (L.V.); (N.R.)
| | - Nuria Roda
- Department of Internal Medicine, Hospital de Manacor, 07500 Manacor, Spain; (L.V.); (N.R.)
| | - Adelaida Rey
- Internal Medicine Service, Hospital de Inca, 07300 Inca, Spain;
| | - Adrian Rodriguez
- Internal Medicine Service, Son Llàtzer University Hospital (HUSLL), 07198 Palma, Spain; (I.L.); (J.G.-M.); (A.R.); (A.P.)
| | - Margarita Garau
- Microbiology Service, Son Llàtzer University Hospital (HUSLL), 07198 Palma, Spain;
| | | | - Antoni Serra
- Microbiology Service, Hospital de Manacor, 07500 Manacor, Spain;
| | - Juan Saurina
- Microbiology Service, Hospital de Inca, 07300 Inca, Spain;
| | - Antoni Payeras
- Internal Medicine Service, Son Llàtzer University Hospital (HUSLL), 07198 Palma, Spain; (I.L.); (J.G.-M.); (A.R.); (A.P.)
- Institute of Health Research of the Balearic Islands (IdISBa), 07120 Palma, Spain
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Katoh S, Suzuki M, Ariyoshi K, Morimoto K. Serotype Replacement in Adult Pneumococcal Pneumonia after the Introduction of Seven-Valent Pneumococcal Conjugate Vaccines for Children in Japan: a Systematic Literature Review and Pooled Data Analysis. Jpn J Infect Dis 2017; 70:495-501. [PMID: 28367876 DOI: 10.7883/yoken.jjid.2016.311] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Streptococcus pneumoniae is the major causative agent for adult pneumonia. Following the introduction of pneumococcal conjugate vaccines (PCV) for children, serotype replacement has been reported in adult invasive pneumococcal diseases but has not been well studied for cases of pneumococcal pneumonia in adults in Asia. To investigate serotype replacement in adult pneumococcal pneumonia in Japan, we conducted a systematic review of the literature across 5 databases using terms, including pneumococcus, serotype, their synonyms, and derivatives. After the assessment of the identified articles, data on the pneumococcal serotype distribution among adult pneumonia cases were extracted from relevant studies. Twenty-two studies were reviewed, and 4 relevant articles were included in the pooled data analysis. The proportion of the 7-valent PCV (PCV7)-covered serotypes from before and after the introduction of PCV7 for children (-18.1%, p < 0.001) significantly decreased; moreover, the proportions of serotypes covered by PCV13 but not PCV7 (+9.9%, p = 0.003) and those covered by the 23-valent polysaccharide vaccine but not PCV7 (+9.4%, p = 0.007) significantly increased. Serotype replacement occurred in adult cases of pneumococcal pneumonia following vaccination of children with PCV7 in Japan. Further nationwide surveillance is warranted to investigate serotype replacement in the post-PCV13 phase.
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Affiliation(s)
- Shungo Katoh
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University.,Nagasaki University Graduate School of Biomedical Sciences
| | - Motoi Suzuki
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University
| | - Koya Ariyoshi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University.,Nagasaki University Graduate School of Biomedical Sciences.,Department of Infectious Diseases, Nagasaki University Hospital
| | - Konosuke Morimoto
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University.,Department of Infectious Diseases, Nagasaki University Hospital
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Corrigendum. Hum Vaccin Immunother 2016; 12:2478-81. [DOI: 10.1080/21645515.2016.1229033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Payeras A, Peñaranda M, Iñigo A, Garau M, Luis Pérez J, Gallegos C, Riera M. Pneumococcal infections in elderly patients attending hospital since PCV-13 authorization in Spain. Infect Dis (Lond) 2016; 49:71-80. [PMID: 27686179 DOI: 10.1080/23744235.2016.1218044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To study the characteristics and outcomes of pneumococcal infections in patients aged ≥65 years since the authorization of the 13-valent pneumococcal conjugate vaccine (PCV-13) in Spain. METHODS All pneumococcal pneumonias, empyemas or primary bacteraemias treated at two hospitals in Majorca from 2010 to 2015 were included. Clinical variables, serotypes, and antibiotic susceptibility were collected. RESULTS Two hundred and forty-nine pneumonias, 11 primary bacteraemias, and 2 empyemas in 243 patients were studied; 181 (69.1%) men, median age 76 years (range: 66-99). Seven (2.6%) were pneumococcal-vaccinated. Bacteraemia was present in 127 (61.9%) cases and related to a higher severity, p= 0.02, and not having chronic lung disease, p = 0.002. Ninety-seven (37%) episodes involved complications and 30 (11.5%) patients died. Mortality was related with the presence of complications at admission, p < 0.001. Only septic shock was more frequent in patients ≥65 years during the period 2010-2015 compared to the period 2006-2010: 38 of 262 (14.5%) vs. 17 of 212 (8%), p = 0.02. Most infections (57.6%) were due to PCV-13 serotypes but were not related to a worse prognosis. The proportion of PCV-13 serotypes tended to decrease from 61% (non-invasive) and 80% (invasive) in 2010-2011 to 33% and 47% in 2014-2015. The antibiotic susceptibility remained stable. CONCLUSIONS Rates of pneumococcal vaccination in elderly patients with pneumococcal infections were very low. Except for septic shock, the main outcome variables (including mortality) were similar to the ones observed in the period preceding PCV-13 authorization. PCV-13 serotypes were responsible for most infections although they showed a decreasing trend.
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Affiliation(s)
- Antoni Payeras
- a Infectious Diseases Unit, Internal Medicine Department , Hospital Son Llàtzer , Palma de Mallorca , Spain
| | - Maria Peñaranda
- a Infectious Diseases Unit, Internal Medicine Department , Hospital Son Llàtzer , Palma de Mallorca , Spain
| | - Antonio Iñigo
- b Microbiology Department , Hospital Son Espases , Palma de Mallorca , Spain
| | - Margarita Garau
- b Microbiology Department , Hospital Son Espases , Palma de Mallorca , Spain
| | - José Luis Pérez
- b Microbiology Department , Hospital Son Espases , Palma de Mallorca , Spain
| | - Carmen Gallegos
- b Microbiology Department , Hospital Son Espases , Palma de Mallorca , Spain
| | - Melchor Riera
- a Infectious Diseases Unit, Internal Medicine Department , Hospital Son Llàtzer , Palma de Mallorca , Spain
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Esposito S, Bonanni P, Maggi S, Tan L, Ansaldi F, Lopalco PL, Dagan R, Michel JP, van Damme P, Gaillat J, Prymula R, Vesikari T, Mussini C, Frank U, Osterhaus A, Celentano LP, Rossi M, Guercio V, Gavazzi G. Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid). Hum Vaccin Immunother 2016; 12:1777-94. [PMID: 27135390 PMCID: PMC4964839 DOI: 10.1080/21645515.2016.1150396] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 01/19/2016] [Accepted: 02/01/2016] [Indexed: 12/27/2022] Open
Abstract
Rapid population aging has become a major challenge in the industrialized world and progressive aging is a key reason for making improvement in vaccination a cornerstone of public health strategy. An increase in age-related disorders and conditions is likely to be seen in the near future, and these are risk factors for the occurrence of a number of vaccine-preventable diseases. An improvement in infectious diseases prevention specifically aimed at adults and the elderly can therefore also decrease the burden of these chronic conditions by reducing morbidity, disability, hospital admissions, health costs, mortality rates and, perhaps most importantly, by improving the quality of life. Among adults, it is necessary to identify groups at increased risk of vaccine-preventable diseases and highlight the epidemiological impact and benefits of vaccinations using an evidence-based approach. This document provides clinical practice guidance on immunization for adults in order to provide recommendations for decision makers and healthcare workers in Europe. Although immunization is considered one of the most impactful and cost-effective public health measures that can be undertaken, vaccination coverage rates among adults are largely lower than the stated goal of ≥ 95% among adults, and stronger efforts are needed to increase coverage in this population. Active surveillance of adult vaccine-preventable diseases, determining the effectiveness of the vaccines approved for marketing in the last 5 y, the efficacy and safety of vaccines in immunocompromised patients, as well as in pregnant women, represent the priorities for future research.
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Affiliation(s)
- Susanna Esposito
- Pediatric Highly Intensive Care Unit, University of Milan, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Stefania Maggi
- CNR - Institute of Neuroscience, Aging Branch Center for Research, Padua, Italy
| | - Litjan Tan
- Immunization Action Coalition, St Paul, MN, USA
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, IRCCS San Martino-IST University Teaching Hospital, Genoa, Italy
| | | | - Ron Dagan
- Pediatric Infectious Disease Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | | | - Pierre van Damme
- Vaccine & Infectious Disease Institute, Antwerp University, Wilrijk, Belgium
| | | | - Roman Prymula
- Department of Social Medicine, Faculty of Medicine, Charles University, Sokolska, Hradec Kralove, Czech Republic
| | - Timo Vesikari
- Vaccine Research Center, Tampere University Hospital, Tampere, Finland
| | - Cristina Mussini
- Clinic of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - Uwe Frank
- Division of Infection Control and Hospital Epidemiology, Department of Infectious Diseases, Heidelberg University, Heidelberg, Germany
| | | | | | - Marta Rossi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Valentina Guercio
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Gaetan Gavazzi
- University Clinic of Geriatric Medicine, University Hospital of Grenoble, and GREPI University of Grenoble-Alpes, Grenoble, France
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Isturiz R, Webber C. Prevention of adult pneumococcal pneumonia with the 13-valent pneumococcal conjugate vaccine: CAPiTA, the community-acquired pneumonia immunization trial in adults. Hum Vaccin Immunother 2016; 11:1825-7. [PMID: 26076136 PMCID: PMC4514202 DOI: 10.1080/21645515.2015.1043502] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The aging of the world population is expected to be accompanied by increased pneumococcal pneumonia in older adults. To address this, the Community-Acquired Pneumonia immunization Trial in Adults (CAPiTA), a large, randomized, placebo-controlled trial conducted to assess the 13-valent pneumococcal conjugate vaccine (PCV13) in adults ≥65 years, found statistically significant vaccine efficacy for first episodes of vaccine-type community-acquired pneumonia (VT-CAP; 46%), nonbacteremic/noninvasive VT-CAP (45%), and VT invasive pneumococcal disease (75%), along with an acceptable safety profile. Study results were presented to the US Advisory Committee on Immunization Practices in June 2014, which subsequently recommended sequential PCV13 and 23-valent pneumococcal polysaccharide vaccination for adults ≥65 years. Thus, appropriate protection of adults at risk for pneumococcal CAP will include vaccination with PCV13.
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Affiliation(s)
- Raul Isturiz
- a Pfizer Vaccine Research ; Collegeville , PA , USA
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Payeras A, Arrizabalaga M. Vacuna neumocócica: «El camino del progreso no es ni rápido ni fácil». Med Clin (Barc) 2016; 146:203-4. [DOI: 10.1016/j.medcli.2015.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 12/03/2015] [Indexed: 10/22/2022]
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Klett-Tammen CJ, Krause G, Seefeld L, Ott JJ. Determinants of tetanus, pneumococcal and influenza vaccination in the elderly: a representative cross-sectional study on knowledge, attitude and practice (KAP). BMC Public Health 2016; 16:121. [PMID: 26846202 PMCID: PMC4743086 DOI: 10.1186/s12889-016-2784-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 01/26/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Severity and incidence of vaccine-preventable infections with influenza viruses, s. pneumoniae and c. tetani increase with age. Furthermore, vaccine coverage in the elderly is often insufficient. The aim of this study is to identify socio-economic and knowledge-, attitude- and practice- (KAP)-related determinants of vaccination against influenza, pneumococcal disease and tetanus in the older German population. METHODS We analysed data from a German nationally representative questionnaire-based KAP-survey on infection prevention and hygiene behavior in the elderly (n = 1223). We used logistic regressions to assess impacts of socio-demographic- and KAP-related variables on vaccine uptake in general and on tetanus-, influenza- and pneumococcal vaccination. To generate KAP-scores, we applied factor analyses and analysed scores as predictors of specific vaccinations. RESULTS A low rated personal health status was associated with a higher uptake of influenza vaccine whereas place of residence within Germany strongly impacted on pneumococcal vaccination. For tetanus and influenza vaccination, the strongest single vaccination predictor was attitude-related, i.e., the perceived importance of the vaccine (OR = 18.1, 95 % CI = 4.5-71.8; OR = 23.0, 95 % CI = 14.9-35.3, respectively). Pneumococcal vaccination was mostly knowledge-associated, i.e., knowing the recommendation predicted uptake (OR = 17.1, 95 % CI = 9.5-30.7). Regarding the generated KAP-scores, the practice-score reflecting vaccine related behavior such as having a vaccination record, was predictive for all vaccines considered. The knowledge-score was associated with influenza (OR = 1.3, 95 % CI = 1.0-1.6) and pneumococcal vaccination (OR = 1.2, 95 % CI = 1.0-1.5). Uniquely for influenza vaccination, the attitude-score was linked to vaccine uptake (OR = 1.1, 95 % CI = 1.0-1.1). CONCLUSIONS Our results indicate that predictors of vaccination uptake in the elderly strongly depend on vaccine type and that scores of KAP are useful and valid to condense information from numerous individual KAP-variables. While awareness for vaccinations against influenza and tetanus is fairly high already it might have to be increased for vaccinations against pneumocoocal infections.
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Affiliation(s)
- Carolina J Klett-Tammen
- Department of Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124, Braunschweig, Germany.
- Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124, Braunschweig, Germany.
- Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Linda Seefeld
- Unit of Basic medical issues; preventive and medical activities in health education, Federal Centre for Health Education (BZgA), Maarweg 149-161, 50825, Köln, Germany.
| | - Jördis J Ott
- Department of Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstrasse 7, 38124, Braunschweig, Germany.
- Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Gubbins PO, Li C. The Influence of Influenza and Pneumococcal Vaccines on Community-Acquired Pneumonia (CAP) Outcomes Among Elderly Patients. Curr Infect Dis Rep 2015; 17:49. [PMID: 26446610 DOI: 10.1007/s11908-015-0505-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
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.
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Affiliation(s)
- Paul O Gubbins
- Division of Pharmacy Practice and Administration, University of Missour Kansas City, UMKC School of Pharmacy at MSU, Bldg 1 Brick City, 327 West Mill Street #425, Springfield, MO, 65806, USA.
| | - Chenghui Li
- Division of Pharmaceutical Evaluation and Policy, Department of Pharmacy Practice, University of Arkansas for Medical Sciences College of Pharmacy, 4301 West Markham 522, Little Rock, AR, 72205, USA.
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