[Is polysaccharide pneumococcal vaccine effective in adults?].

Pneumococcal (PC) infections are common and dangerous. Polysaccharide PC vaccine is recommended in some countries for use in adults who have an increased risk of PC infection. Randomised studies of the clinical effect of polysaccharide PC vaccine in healthy adults reported a protective effect, which, in general, was not reproduced in subsequent studies of risk groups. Case-control studies showed a protective effect, but were potentially biased. Two meta-analyses found that the vaccine had an effect on the incidence of PC bacteraemia and pneumonia in healthy adults, but had no effect in risk groups; one meta-analysis found no evidence of less effect in risk groups. There is insufficient evidence to support mass vaccination of risk groups, including elderly people, with polysaccharide PC vaccine.