Department of Public Health, University of Barcelona, 08036 Barcelona, Spain.
Eur Respir J. 2010 Sep;36(3):608-14. doi: 10.1183/09031936.00171309. Epub 2010 Jan 14.
The objective of our study was to evaluate the effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPV) in preventing hospital admission for community-acquired pneumonia (CAP) in people ≥65 yrs of age. We conducted a matched case-control study in patients with CAP admitted to five Spanish hospitals. Cases were persons aged ≥65 yrs admitted to hospital through the emergency department, who presented a clinical and radiological pattern compatible with pneumonia, assessed using established criteria. We matched each case with three control subjects by sex, age (±5 yrs), date of hospitalisation (±30 days) and underlying disease. The study period was May 1, 2005 to January 31, 2007. The PPV immunisation status of cases and controls was investigated. Adjusted ORs for vaccination were calculated using logistic regression analysis. A total of 489 cases and 1,467 controls were included in the final analysis. The overall adjusted vaccination effectiveness for all patients was 23.6% (95% CI 0.9-41.0). The adjusted vaccination effectiveness for immunosuppressed patients was 21.0% (95% CI -18.7-47.5). Our results suggest that the PPV may potentially reduce hospitalisations for pneumonia in the elderly and supports vaccination programmes in this age group.
我们的研究目的是评估 23 价肺炎球菌多糖疫苗（PPV）对预防≥65 岁老年人社区获得性肺炎（CAP）住院的有效性。我们在西班牙的五家医院进行了一项匹配病例对照研究，纳入了因 CAP 而住院的患者。病例为≥65 岁的患者，通过急诊科住院，根据既定标准，他们表现出符合肺炎的临床和影像学模式。我们通过性别、年龄（±5 岁）、住院日期（±30 天）和基础疾病，将每个病例与 3 名对照进行匹配。研究期间为 2005 年 5 月 1 日至 2007 年 1 月 31 日。我们调查了病例和对照者的 PPV 免疫状况。使用逻辑回归分析计算接种疫苗的调整比值比（OR）。共有 489 例病例和 1467 例对照纳入最终分析。所有患者的总体调整接种有效性为 23.6%（95%CI：0.9-41.0）。免疫抑制患者的调整接种有效性为 21.0%（95%CI：-18.7-47.5）。我们的结果表明，PPV 可能潜在地减少老年人因肺炎住院的情况，支持在该年龄组开展疫苗接种计划。
