Tags

Type your tag names separated by a space and hit enter

Protective effects of the 23-valent pneumococcal polysaccharide vaccine in the elderly population: the EVAN-65 study.
Clin Infect Dis. 2006 Oct 01; 43(7):860-8.CI

Abstract

BACKGROUND

The 23-valent polysaccharide pneumococcal vaccine (PPV) is currently recommended for elderly persons and persons who are at high risk of infection. However, the effectiveness of the 23-valent PPV remains controversial. We assessed the effectiveness of this vaccine in older adults.

METHODS

A prospective cohort study was conducted from January 2002 through April 2005; it included all community-dwelling individuals aged >or=65 years who were assigned to 1 of 8 primary health care centers in Tarragona, Spain (11,241 subjects). The primary outcomes were invasive pneumococcal disease, pneumococcal pneumonia, overall pneumonia rate, and death due to pneumonia. All cases were validated by a check of the clinical records. The association between pneumococcal vaccination and the risk of each outcome was evaluated by means of multivariate Cox proportional hazard models, adjusted for age, sex, comorbidity, immunocompetence, and influenza vaccine status.

RESULTS

Pneumococcal vaccination was associated with significant reductions in the risk of hospitalization for pneumonia (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.59-0.92) and in the overall pneumonia rate (HR, 0.79; 95% CI, 0.64-0.98). The incidence of invasive pneumococcal disease was low (64 cases per 100,000 person-years), and a considerable protective effect against invasive pneumococcal disease did not attain statistical significance (HR, 0.60; 95% CI, 0.22-1.65). However, the vaccine showed a significant effectiveness of 45% to prevent pneumococcal pneumonia (HR, 0.55; 95% CI, 0.34-0.88). Finally, vaccination was associated with a significant 59% reduction in the risk of death due to pneumonia among vaccinated subjects (HR, 0.41; 95% CI, 0.23-0.72).

CONCLUSIONS

These results indicate that the 23-valent PPV effectively prevented pneumococcal pneumonia (with or without bacteremia) and decreased the rates of overall pneumonia and of mortality due to pneumonia in older adults, providing new arguments for systematic vaccination in the elderly population.

Authors+Show Affiliations

Primary Care Service of Tarragona-Valls, Catalonian Health Institute, Tarragona, 43001, Spain. avila.tarte.ics@gencat.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16941367

Citation

Vila-Córcoles, Angel, et al. "Protective Effects of the 23-valent Pneumococcal Polysaccharide Vaccine in the Elderly Population: the EVAN-65 Study." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 43, no. 7, 2006, pp. 860-8.
Vila-Córcoles A, Ochoa-Gondar O, Hospital I, et al. Protective effects of the 23-valent pneumococcal polysaccharide vaccine in the elderly population: the EVAN-65 study. Clin Infect Dis. 2006;43(7):860-8.
Vila-Córcoles, A., Ochoa-Gondar, O., Hospital, I., Ansa, X., Vilanova, A., Rodríguez, T., & Llor, C. (2006). Protective effects of the 23-valent pneumococcal polysaccharide vaccine in the elderly population: the EVAN-65 study. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 43(7), 860-8.
Vila-Córcoles A, et al. Protective Effects of the 23-valent Pneumococcal Polysaccharide Vaccine in the Elderly Population: the EVAN-65 Study. Clin Infect Dis. 2006 Oct 1;43(7):860-8. PubMed PMID: 16941367.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Protective effects of the 23-valent pneumococcal polysaccharide vaccine in the elderly population: the EVAN-65 study. AU - Vila-Córcoles,Angel, AU - Ochoa-Gondar,Olga, AU - Hospital,Imma, AU - Ansa,Xabier, AU - Vilanova,Angels, AU - Rodríguez,Teresa, AU - Llor,Carl, AU - ,, Y1 - 2006/08/21/ PY - 2006/04/19/received PY - 2006/06/01/accepted PY - 2006/8/31/pubmed PY - 2006/9/16/medline PY - 2006/8/31/entrez SP - 860 EP - 8 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 43 IS - 7 N2 - BACKGROUND: The 23-valent polysaccharide pneumococcal vaccine (PPV) is currently recommended for elderly persons and persons who are at high risk of infection. However, the effectiveness of the 23-valent PPV remains controversial. We assessed the effectiveness of this vaccine in older adults. METHODS: A prospective cohort study was conducted from January 2002 through April 2005; it included all community-dwelling individuals aged >or=65 years who were assigned to 1 of 8 primary health care centers in Tarragona, Spain (11,241 subjects). The primary outcomes were invasive pneumococcal disease, pneumococcal pneumonia, overall pneumonia rate, and death due to pneumonia. All cases were validated by a check of the clinical records. The association between pneumococcal vaccination and the risk of each outcome was evaluated by means of multivariate Cox proportional hazard models, adjusted for age, sex, comorbidity, immunocompetence, and influenza vaccine status. RESULTS: Pneumococcal vaccination was associated with significant reductions in the risk of hospitalization for pneumonia (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.59-0.92) and in the overall pneumonia rate (HR, 0.79; 95% CI, 0.64-0.98). The incidence of invasive pneumococcal disease was low (64 cases per 100,000 person-years), and a considerable protective effect against invasive pneumococcal disease did not attain statistical significance (HR, 0.60; 95% CI, 0.22-1.65). However, the vaccine showed a significant effectiveness of 45% to prevent pneumococcal pneumonia (HR, 0.55; 95% CI, 0.34-0.88). Finally, vaccination was associated with a significant 59% reduction in the risk of death due to pneumonia among vaccinated subjects (HR, 0.41; 95% CI, 0.23-0.72). CONCLUSIONS: These results indicate that the 23-valent PPV effectively prevented pneumococcal pneumonia (with or without bacteremia) and decreased the rates of overall pneumonia and of mortality due to pneumonia in older adults, providing new arguments for systematic vaccination in the elderly population. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/16941367/Protective_effects_of_the_23_valent_pneumococcal_polysaccharide_vaccine_in_the_elderly_population:_the_EVAN_65_study_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/507340 DB - PRIME DP - Unbound Medicine ER -