The latest U.S. pneumococcal vaccine guidelines recommend routine vaccination with pneumococcal conjugate vaccines in all older adults.
With pneumococcal vaccination recommendations constantly evolving and clinical benefits of the vaccines not always clear, researchers from the Eastern Maine Medical Center in Bangor and colleagues sought to determine the effectiveness of the PCV-13, PPSV-23, and dual vaccination.
The investigative team conducted a retrospective cohort study between 2014 and 2016, using data from 1.3 million Veterans Health administration patients. The results were published in the journal Vaccine.
The primary outcomes were defined as pneumococcal pneumonia and pneumococcal meningitis, while secondary outcomes were "other" pneumonia and "other" meningitis, with "other" referring to episodes of pneumonia and meningitis without an identified etiological agent.
The study determined that PCV-13 was associated with decreased risk of pneumococcal pneumonia (adjusted hazard ratio [HR], 0.69; 95% CI 0.51-0.93) and "other" pneumonia (adjusted HR, 0.74; 95% CI 0.64-0.86) compared with PPSV-23.
The researchers found no significant difference between PCV-13 and PPSV-23 in terms of pneumococcal meningitis (adjusted HR, 3.98; 95 % CI 0.74-21.32; P = .12) and "other" meningitis (adjusted HR 0.81; 95% CI 0.33-2.03; P = .66), however.
The researchers reported that dual vaccination was also associated with a decrease in the rate of pneumococcal pneumonia (adjusted HR, 0.88; 95 % CI 0.77 to 0.99; P = .03) and "other" pneumonia (adjusted HR, 0.90; 95% CI 0.85-0.95; P <.01) compared with 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 wrote. "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."
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