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<p>The 13-valent pneumococcal conjugate vaccine (PCV13) has been recommended for more than a decade for older adults and individuals with chronic medical or immunocompromising conditions. However, real-world evidence on its vaccine effectiveness (VE) in this population especially Low- or Middle-Income Country (LMIC) is limited. This study aimed to evaluate the VE of PCV13 against pneumococcal lower respiratory tract infection (LRTI) among older and high-risk adults.</p><p>The study was a case–control design using data from a tertiary, university-affiliated hospital between Jan 2014 and Dec 2024. Adults aged ≥ 60&#xa0;years with medically attended LRTI were included. Cases were defined as culture-confirmed pneumococcal LRTI. Controls were patients with LRTI in whom <i>Streptococcus pneumoniae</i> was not isolated, identified via ICD-10 codes. VE was estimated using logistic regression, comparing odds of PCV13 vaccination between cases and controls. Among 825 patients with LRTI, 39 (4.7%) had received PCV13 and 786 (95.3%) were unvaccinated. The crude VE of PCV13 against pneumococcal LRTI was 71.9% (95% CI: 27.3–89.1), and the adjusted VE was 73.3% (95% CI: 9.0–92.1). The requirement for mechanical ventilation at admission decreased among PCV13-vaccinated patients compared with unvaccinated patients with pneumococcal LRTI. VE appeared comparable among individuals aged ≥ 75&#xa0;years compared to those &lt; 75&#xa0;years. In a sensitivity analysis restricted to controls with non-pneumococcal bacterial LRTI, the crude VE increased to 76.1% (95% CI: 34.3–91.3).</p><p>PCV13 demonstrated real-world effectiveness in preventing medically attended pneumococcal LRTI among older adults. The public health benefit of PCV13 in older adults in LMICs was clearly demonstrated.</p>

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Effectiveness of the 13-valent pneumococcal conjugate vaccine against medically attended pneumococcal lower respiratory tract infection among older adults: a case–control study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月20日

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  • Thundon Ngamprasertchai,
  • Phatharajit Phatharodom,
  • Kaewta Intalapaporn,
  • Kamolawat Sutthipool,
  • Piriyaporn Chongtrakool,
  • Thitiya Yungyuen,
  • Viravarn Luvira,
  • Winai Ratanasuwan,
  • Pinyo Rattanaumpawan,
  • Saranath Lawpoolsri,
  • Punnee Pitisuttithum

摘要

The 13-valent pneumococcal conjugate vaccine (PCV13) has been recommended for more than a decade for older adults and individuals with chronic medical or immunocompromising conditions. However, real-world evidence on its vaccine effectiveness (VE) in this population especially Low- or Middle-Income Country (LMIC) is limited. This study aimed to evaluate the VE of PCV13 against pneumococcal lower respiratory tract infection (LRTI) among older and high-risk adults.

The study was a case–control design using data from a tertiary, university-affiliated hospital between Jan 2014 and Dec 2024. Adults aged ≥ 60 years with medically attended LRTI were included. Cases were defined as culture-confirmed pneumococcal LRTI. Controls were patients with LRTI in whom Streptococcus pneumoniae was not isolated, identified via ICD-10 codes. VE was estimated using logistic regression, comparing odds of PCV13 vaccination between cases and controls. Among 825 patients with LRTI, 39 (4.7%) had received PCV13 and 786 (95.3%) were unvaccinated. The crude VE of PCV13 against pneumococcal LRTI was 71.9% (95% CI: 27.3–89.1), and the adjusted VE was 73.3% (95% CI: 9.0–92.1). The requirement for mechanical ventilation at admission decreased among PCV13-vaccinated patients compared with unvaccinated patients with pneumococcal LRTI. VE appeared comparable among individuals aged ≥ 75 years compared to those < 75 years. In a sensitivity analysis restricted to controls with non-pneumococcal bacterial LRTI, the crude VE increased to 76.1% (95% CI: 34.3–91.3).

PCV13 demonstrated real-world effectiveness in preventing medically attended pneumococcal LRTI among older adults. The public health benefit of PCV13 in older adults in LMICs was clearly demonstrated.