Serra-Prat Mateu, Bolíbar Ignasi, Palomera Elisabet, Lavado Àngel, Almirall Jordi
Research Unit, Consorci Sanitari del Maresme, 08304 Mataró, Spain.
Networked Biomedical Research Centre for Liver and Digestive Diseases (CIBEREHD), 28029 Madrid, Spain.
Vaccines (Basel). 2024 Sep 6;12(9):1023. doi: 10.3390/vaccines12091023.
The aim was to assess the effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) in preventing CAP in adults.
This was a population-based cohort study, followed up over 5 years (2015-2019), that included 47,768 persons aged ≥18 years assigned to three primary care centres. Data were retrospectively obtained from electronic medical records and databases. The vaccination effect was adjusted for potential confounders. Analyses were performed for the entire study population and for the ≥65 age subgroup.
The annual incidence of CAP (per 10 adult inhabitants) was 3.29 overall, and 8.08 and 2.93 for vaccinated and non-vaccinated persons, respectively. The non-adjusted effect of PPV23 on CAP was evidenced by HR = 2.80 (95% CI: 2.32-3.37), and after adjusting for possible confounders, PPV23 showed no significant independent effect on CAP in the overall population (HR = 1.14; = 0.277) or in persons aged ≥65 years (HR = 1.30; = 0.051). No protective effect was observed in persons vaccinated <2 years previously (HR = 1.17; = 0.514).
PPV23 showed no effect in preventing CAP in adults aged ≥18 years or in the subgroup aged ≥65 years, even if vaccinated <2 years previously.
评估23价肺炎球菌多糖疫苗（PPV23）在预防成人社区获得性肺炎（CAP）方面的有效性。
这是一项基于人群的队列研究，随访时间超过5年（2015 - 2019年），纳入了分配至三个初级保健中心的47768名年龄≥18岁的人员。数据通过回顾性方式从电子病历和数据库中获取。对潜在混杂因素进行了疫苗接种效果调整。对整个研究人群以及年龄≥65岁的亚组进行了分析。
CAP的年发病率（每10名成年居民）总体为3.29，接种疫苗者和未接种疫苗者分别为8.08和2.93。PPV23对CAP的未调整效应通过HR = 2.80（95%CI：2.32 - 3.37）得以证明，在对可能的混杂因素进行调整后，PPV23在总体人群（HR = 1.14；P = 0.277）或年龄≥65岁的人群中（HR = 1.30；P = 0.051）对CAP均未显示出显著的独立效应。在接种疫苗时间<2年的人群中未观察到保护作用（HR = 1.17；P = 0.514）。
PPV23在预防≥18岁成人或≥65岁亚组的CAP方面没有效果，即使在接种疫苗时间<2年的情况下也是如此。
