Prevention of community-acquired pneumonia among a cohort of hospitalized elderly: Benefit due to influenza and pneumococcal vaccination not demonstrated

Abstract Benefits from influenza and 23-valent pneumococcal polysaccharide (23vPPV) vaccines against invasive pneumococcal disease and laboratory confirmed influenza have been well documented. However, their effectiveness against pneumonia remains controversial for community-based elderly ≥65 years....

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Bibliographic Details
Published in:Vaccine 2007-06, Vol.25 (23), p.4631-4640
Main Authors: Skull, Susan A, Andrews, Ross M, Byrnes, Graham B, Kelly, Heath A, Nolan, Terence M, Brown, Graham V, Campbell, Donald A
Format: Article
Language:English
Subjects:
Aged
Allergy and Immunology
Applied microbiology
Bacteriology
Biological and medical sciences
Cohort Studies
Community-Acquired Infections - prevention & control
Female
Fundamental and applied biological sciences. Psychology
Hospitalization
Humans
Immunization
Influenza
Influenza vaccines
Influenza Vaccines - immunology
Male
Microbiology
Miscellaneous
Multivariate analysis
Pneumococcal vaccines
Pneumococcal Vaccines - immunology
Pneumonia
Pneumonia - prevention & control
Streptococcus pneumoniae
Studies
Vaccination
Vaccines
Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects)
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Summary:Abstract Benefits from influenza and 23-valent pneumococcal polysaccharide (23vPPV) vaccines against invasive pneumococcal disease and laboratory confirmed influenza have been well documented. However, their effectiveness against pneumonia remains controversial for community-based elderly ≥65 years. Using a case–cohort design we examined incremental VE of 23vPPV over and above influenza vaccine against hospitalization with community-acquired pneumonia (HCAP) in two large Australian hospitals. 1952 cases (ICD-10-AM codes for pneumonia: J10–J18) and 2927 randomly selected cohort subjects were studied. Vaccination status was confirmed by providers. Benefit against HCAP was not demonstrated in multivariate analysis for influenza vaccine compared with neither vaccine (RR 1.02, 95%CI 0.84–1.20) or for both vaccines compared with influenza vaccine (RR 0.98, 95%CI 0.81–1.18). The current program of funding these vaccines for the elderly is not having a discernable impact on HCAP in this setting.
ISSN:0264-410X
1873-2518
DOI:10.1016/j.vaccine.2007.03.015