Infectious Diseases and Tropical Medicine Department, Cayenne General Hospital, Cayenne, French Guiana.
Hum Vaccin Immunother. 2013 Jan;9(1):128-35. doi: 10.4161/hv.22550.
Elderly people are at increased risk of influenza and pneumococcal diseases. Influenza increases clinical pneumococcal disease incidence. Pneumococcal vaccination could therefore be a supplement to influenza vaccination. This study evaluated all-cause mortality and antibiotic consumption according to elderly people's influenza and pneumococcal vaccination status. Its goal was to demonstrate that vaccination with both Influenza and pneumococcal vaccines decrease all-cause mortality and antibiotic consumption. From 2004-10-01 to 2004-12-31 (3 mo), elderly people (≥ 65 y) who lived in the Gard department (South of France) were offered both vaccinations. Among the 68,897 subjects followed-up one year after this vaccination campaign, 21,303 (30.9%) were vaccinated with both vaccines, 18,651 (27.1%) with influenza vaccine alone, 3,769 (5.5%) with pneumococcal vaccine alone; 25,174 (36.5%) subjects were unvaccinated. Mortality rate (per 1,000 inhabitants-year) adjusted on gender, age and prior underlying chronic disease was 17.9 (95% CI: 16.3-19.6), 20.8 (19.0-22.8), 22.5 (19.0-26.6) and 24.7 (22.7-26.8), respectively. It was 42.1 (38.8-45.8) in elderly people with underlying chronic disease who received both vaccines vs. 58.1 (53.7-62.9) in unvaccinated elderly people. The decrease in mortality rate was 27.0% (20.0-34.0) in subjects who received both vaccines and 16.0% (6.0-24.0) in those who received influenza vaccine. No significant reduction in mortality rate was seen with the pneumococcal vaccine alone. Influenza and/or pneumococcal vaccinations did not decrease antibiotic consumption that drastically increases during the winter period. An additive effect was observed in the prevention of all-cause mortality with influenza and pneumococcal vaccines given together in elderly people, including in those with underlying chronic disease.
老年人患流感和肺炎球菌病的风险增加。流感会增加临床肺炎球菌病的发病率。因此，肺炎球菌疫苗接种可以作为流感疫苗接种的补充。本研究评估了根据老年人流感和肺炎球菌疫苗接种状况的全因死亡率和抗生素使用情况。其目的是证明接种流感和肺炎球菌疫苗可降低全因死亡率和抗生素使用量。在 2004 年 10 月 1 日至 2004 年 12 月 31 日（3 个月）期间，居住在法国南部加尔省的老年人（≥65 岁）接种了这两种疫苗。在接种疫苗后一年随访的 68897 名受试者中，21303 名（30.9%）接种了两种疫苗，18651 名（27.1%）仅接种了流感疫苗，3769 名（5.5%）仅接种了肺炎球菌疫苗；25174 名（36.5%）受试者未接种疫苗。经性别、年龄和既往基础慢性病调整后的死亡率（每 1000 名居民-年）分别为 17.9（95%CI：16.3-19.6）、20.8（19.0-22.8）、22.5（19.0-26.6）和 24.7（22.7-26.8）。在患有基础慢性病的老年人中，同时接种两种疫苗的死亡率为 42.1（38.8-45.8），而未接种疫苗的老年人为 58.1（53.7-62.9）。同时接种两种疫苗的死亡率降低了 27.0%（20.0-34.0），而仅接种流感疫苗的死亡率降低了 16.0%（6.0-24.0）。单独使用肺炎球菌疫苗不能显著降低死亡率。流感和/或肺炎球菌疫苗接种并不能显著降低冬季期间急剧增加的抗生素使用量。在患有基础慢性病的老年人中，流感和肺炎球菌疫苗联合接种可显著降低全因死亡率，具有附加效应。
