BANGOR, ME — As part of the continual evolution of pneumococcal vaccination recommendations, guidelines recently have been updated to urge more use of pneumococcal conjugate vaccines in older adults.
Yet, according to a study led by the Eastern Maine Medical Center in Bangor, ME, and including participation from the White River Junction, VT, VAMC, the comparative clinical benefits of protein conjugate vaccine (PCV 13), pneumococcal polysaccharide vaccine (PPSV 23) and dual vaccination remain unclear.
To help remedy that, the study team conducted a retrospective cohort study between 2014 and 2016 using VHA data on 1.3 million veterans. Primary outcomes were considered to be pneumococcal pneumonia and pneumococcal meningitis. Secondary outcomes were “other” pneumonia and “other” meningitis, with “other” referring to episodes of pneumonia and meningitis without an identified etiological agent.
Results, published in the journal Vaccine, found that PCV 13 was associated with decreased risk of pneumococcal pneumonia (Adjusted HR 0.69; 95 % CI 0.51 to 0.93) and “other” pneumonia (Adjusted HR 0.74; 95 % CI 0.64 to 0.86) when compared to PPSV 23.
On the other hand, No significant difference was found between PCV 13 and PPSV 23 in terms of pneumococcal meningitis (Adjusted HR 3.98; 95 % CI 0.74 to 21.32; P = 0.12) and “other” meningitis (Adjusted HR 0.81; 95 % CI 0.33 to 2.03; P = 0.66).
The researchers pointed out that dual vaccination also was associated with a decrease in the rate of pneumococcal pneumonia (Adjusted HR 0.88; 95 % CI 0.77 to 0.99; P = 0.03) and “other” pneumonia (Adjusted HR 0.90; 95 % CI 0.85 to 0.95; P < 0.01) in comparison to PPSV 23.
“PCV 13 was associated with a 31% decrease in the rate of pneumococcal pneumonia in comparison to PPSV 23 in older adult veterans,” the authors concluded. “Our results demonstrating clinical benefit with PCV 13 vaccination are in alignment with the latest pneumococcal vaccination guidelines that recommend routine vaccination with pneumococcal conjugate vaccines in all older adults.”
- Narsingam S, Munson J, Drescher F. Comparative effectiveness of individual pneumococcal vaccines with dual pneumococcal vaccination in older United States Veterans. Vaccine. 2022 Aug 19;40(35):5223-5228. doi: 10.1016/j.vaccine.2022.07.035. Epub 2022 Aug 1. PMID: 35927134.
