Narii Nobuhiro, Kitamura Tetsuhisa, Komukai Sho, Zha Ling, Komatsu Masayo, Murata Fumiko, Maeda Megumi, Kiyohara Kosuke, Sobue Tomotaka, Fukuda Haruhisa
Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan.
Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan.
Vaccine. 2023 Mar 24;41(13):2307-2313. doi: 10.1016/j.vaccine.2023.02.077. Epub 2023 Mar 2.
The protective effect of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) against cardiovascular disease has been investigated in the United States and Europe; however, its effect has not been fully established. This study aimed to investigate the protective effect of PPSV23 on cardiovascular events in adults aged ≥ 65 years. This population-based nested case-control study was conducted using the claims data and vaccine records between April 2015 and March 2020 from the Vaccine Effectiveness, Networking, and Universal Safety (VENUS) Study. PPSV23 vaccination was identified using vaccination records in each municipality. The primary outcome was acute myocardial infarction (AMI) or stroke. The adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for PPSV23 vaccination were calculated using conditional logistic regression. Among 383,781 individuals aged ≥ 65 years, 5,356 and 25,730 individuals with AMI or stroke were matched with 26,753 and 128,397 event-free controls, respectively. Individuals who were PPSV23 vaccinated, compared with the unvaccinated individuals, had significantly lower odds of AMI or stroke events (aOR, 0.70 [95% CI, 0.62-0.80] and aOR, 0.81 [95% CI, 0.77-0.86], respectively). More recent PPSV23 vaccination was associated with lower odds ratios (AMI, aOR 0.55 [95% CI, 0.42-0.72] for 1-180 days and aOR 1.11 [95% CI, 0.84-1.47] for 720 days or longer; stroke, aOR 0.83 [95% CI, 0.74-0.93] for 1-180 days and aOR 0.90 [95% CI, 0.78-1.03] for 720 days or longer). Among Japanese older adults, individuals who were PPSV23 vaccinated, compared with unvaccinated individuals, had significantly lower odds of AMI or stroke events.
23价肺炎球菌多糖疫苗（PPSV23）对心血管疾病的保护作用已在美国和欧洲进行了研究；然而，其效果尚未完全明确。本研究旨在调查PPSV23对65岁及以上成年人心血管事件的保护作用。这项基于人群的巢式病例对照研究使用了2015年4月至2020年3月期间来自疫苗有效性、网络和通用安全性（VENUS）研究的理赔数据和疫苗接种记录。通过各市的疫苗接种记录确定PPSV23疫苗接种情况。主要结局为急性心肌梗死（AMI）或中风。使用条件逻辑回归计算PPSV23疫苗接种的调整优势比（aOR）及其95%置信区间（CI）。在383,781名65岁及以上的个体中，5356名发生AMI或中风的个体与26,753名无事件对照个体匹配，25,730名发生AMI或中风的个体与128,397名无事件对照个体匹配。与未接种疫苗的个体相比，接种PPSV23疫苗的个体发生AMI或中风事件的几率显著更低（aOR分别为0.70 [95%CI，0.62 - 0.80]和aOR为0.81 [95%CI，0.77 - 0.86]）。更近一次接种PPSV23疫苗与更低的优势比相关（AMI，接种后1 - 180天aOR为0.55 [95%CI，0.42 - 0.72]，接种后720天或更长时间aOR为1.11 [95%CI，0.84 - 1.47]；中风，接种后1 - 180天aOR为0.83 [95%CI，0.74 - 0.93]，接种后720天或更长时间aOR为0.90 [95%CI，0.78 - 1.03]）。在日本老年人中，与未接种疫苗的个体相比，接种PPSV23疫苗的个体发生AMI或中风事件的几率显著更低。
