Heo Jung Yeon, Seo Yu Bin, Choi Won Suk, Kim Eun Jin, Jeong Hye Won, Lee Jacob, Yoon Jin Gu, Noh Ji Yun, Cheong Hee Jin, Kim Woo Joo, Song Joon Young
Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea.
Division of Infectious Disease, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
J Infect Dis. 2022 Mar 2;225(5):836-845. doi: 10.1093/infdis/jiab474.
Despite use of the 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23) over the last decade, the disease burden of pneumococcal pneumonia is still high. We evaluated the field effectiveness of PCV13, PPSV23, and sequential vaccination against pneumococcal pneumonia in older adults.
This prospective multicenter study was conducted in adults aged ≥65 years hospitalized with community-acquired pneumonia (CAP) between September 2015 and August 2017. The case-control test-negative design was used to estimate vaccine effectiveness (VE) against pneumococcal CAP.
Of 1525 cases with CAP hospitalization, 167 (11.0%) were identified as pneumococcal CAP. In the elderly aged ≥65 years, the adjusted VE of pneumococcal vaccines against pneumococcal CAP was statistically insignificant: 40.0% (95% confidence interval [CI], -10.8% to 67.5%) for PCV13 and 11.0% (95% CI, -26.4% to 37.3%) for PPSV23. However, in the younger subgroup (aged 65-74 years), sequential PCV13/PPSV23 vaccination showed the highest adjusted VE of 80.3% (95% CI, 15.9%-95.4%), followed by single-dose PCV13 (adjusted VE, 66.4% [95% CI, .8%-88.6%]) and PPSV23 (adjusted VE, 18.5% [95% CI, -38.6% to 52.0%]).
Sequential PCV13/PPSV23 vaccination is most effective for preventing pneumococcal CAP among the elderly aged 65-74 years.
尽管在过去十年中使用了13价肺炎球菌结合疫苗（PCV13）和23价肺炎球菌多糖疫苗（PPSV23），但肺炎球菌肺炎的疾病负担仍然很高。我们评估了PCV13、PPSV23以及序贯接种在预防老年人肺炎球菌肺炎方面的实际效果。
这项前瞻性多中心研究于2015年9月至2017年8月期间，在年龄≥65岁因社区获得性肺炎（CAP）住院的成年人中进行。采用病例对照检测阴性设计来评估针对肺炎球菌性CAP的疫苗效力（VE）。
在1525例因CAP住院的病例中，167例（11.0%）被确诊为肺炎球菌性CAP。在年龄≥65岁的老年人中，肺炎球菌疫苗针对肺炎球菌性CAP的校正VE在统计学上无显著意义：PCV13为40.0%（95%置信区间[CI]，-10.8%至67.5%），PPSV23为11.0%（95%CI，-26.4%至37.3%）。然而，在较年轻的亚组（65-74岁）中，PCV13/PPSV23序贯接种显示出最高的校正VE，为80.3%（95%CI，15.9%-95.4%），其次是单剂量PCV13（校正VE，66.4%[95%CI，0.8%-88.6%]）和PPSV23（校正VE，18.5%[95%CI，-38.6%至52.0%]）。
PCV13/PPSV23序贯接种在预防65-74岁老年人的肺炎球菌性CAP方面最为有效。
