Fletcher Mark A, Vojicic Jelena, Daigle Derek, Taysi Bulent, Haridy Hammam, Abalos Maria Gabriela, Del Carmen Morales Graciela
Pfizer Vaccines and Antivirals, Medical and Scientific Affairs, Emerging Markets Region, France.
Pfizer Vaccines and Antivirals, Medical and Scientific Affairs, Canada.
Vaccine. 2024 Dec 2;42(26):126390. doi: 10.1016/j.vaccine.2024.126390. Epub 2024 Sep 29.
Adults who are elderly or who have underlying health conditions are at particular risk of Streptococcus pneumoniae infections, and pneumococcal vaccines are available. Nonetheless, only national recommendations from countries of North America and Europe have been previously reviewed in the literature.
Consequently, we aimed to collate national guidelines for adult pneumococcal immunization across the 161 countries within the World Health Organization (WHO) regions-the Americas (except Canada and the United States of America), Africa, Eastern Mediterranean, South East Asia, and Western Pacific-from country-level official websites and documents, from the WHO portal, and from direct contact with public health officials, pertinent governmental sources, or local vaccination experts.
For 40.4 % (65/161) of these countries, adult pneumococcal vaccination information was available. Among these 65 with available information, 63.1 % (41/65) include adult pneumococcal vaccination in the national vaccination schedule: 58.5 % (24/41) recommend vaccination both for older adults and for risk groups, while 9.8 % (4/41) recommend it only for older adults, and 31.7 % (13/41) only for risk groups. Of note, among the 13 national risk based-only recommendations, 30.8 % (4/13) are age-dependent and strictly reserved for older adults. The regions where age-based adult pneumococcal vaccination recommendations seem to predominate are South East Asia, Western Pacific, and the Americas. The threshold for age-based pneumococcal vaccination recommendations varies between 50 and 70 years of age. The Americas has the highest proportion of countries with risk-based recommendations. Three-quarters of these countries include PCV and PPV23 in the recommendations, most often given in sequence.
Less than half of countries of the five WHO regions analyzed have accessible information on adult pneumococcal vaccination, and only 25.5 % (41/161) of all countries reviewed recommend adult pneumococcal immunization within the national vaccination schedule. Policymakers should consider extending pneumococcal vaccination guidelines-adapted to national priorities for adult healthcare-as based on local age demographics and risk factor predominance.
老年人或有基础健康状况的成年人感染肺炎链球菌的风险尤其高，且有肺炎球菌疫苗可用。尽管如此，此前文献中仅对北美和欧洲国家的相关建议进行过综述。
因此，我们旨在从国家官方网站和文件、世界卫生组织（WHO）门户网站以及通过直接联系公共卫生官员、相关政府部门或当地疫苗接种专家，整理出世界卫生组织（WHO）各区域（美洲（不包括加拿大和美利坚合众国）、非洲、东地中海、东南亚和西太平洋）161个国家的成人肺炎球菌免疫国家指南。
在这些国家中，40.4%（65/161）有成人肺炎球菌疫苗接种信息。在这65个有可用信息的国家中，63.1%（41/65）将成人肺炎球菌疫苗接种纳入国家疫苗接种计划：58.5%（24/41）建议老年人和高危人群都接种疫苗，9.8%（4/41）仅建议老年人接种，31.7%（13/41）仅建议高危人群接种。值得注意的是，在仅基于风险的13项国家建议中，30.8%（4/13）与年龄相关且严格限于老年人。基于年龄的成人肺炎球菌疫苗接种建议似乎占主导的区域是东南亚、西太平洋和美洲。基于年龄的肺炎球菌疫苗接种建议的年龄阈值在50至70岁之间。美洲有基于风险的建议的国家比例最高。这些国家中有四分之三在建议中纳入了13价肺炎球菌结合疫苗（PCV）和23价肺炎球菌多糖疫苗（PPV23），大多数情况下是按顺序接种。
在分析的世界卫生组织五个区域的国家中，不到一半的国家有关于成人肺炎球菌疫苗接种的可获取信息，在所有审查的国家中，只有25.5%（41/161）在国家疫苗接种计划中建议进行成人肺炎球菌免疫。政策制定者应考虑根据当地年龄人口统计学和主要风险因素，扩展适合成人医疗保健国家优先事项的肺炎球菌疫苗接种指南。
