Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study

Jong Hun Kim; Byung Chul Chun; Joon Young Song; Hyo Youl Kim; In Gyu Bae; Dong Min Kim; Young Hwa Choi; Yoon Hee Jun; Won Suk Choi; Seong Hee Kang; Hyun Hee Kwon; Hye Won Jeong; Sae Yoon Kee; Jian Hur; Jin Won Chung; Young Kyung Yoon; Jang Wook Sohn; Kyung Sook Yang; Min Ja Kim

doi:10.1016/j.vaccine.2019.04.017

Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study

Jong Hun Kim, Byung Chul Chun, Joon Young Song, Hyo Youl Kim, In Gyu Bae, Dong Min Kim, Young Hwa Choi, Yoon Hee Jun, Won Suk Choi, Seong Hee Kang, Hyun Hee Kwon, Hye Won Jeong, Sae Yoon Kee, Jian Hur, Jin Won Chung, Young Kyung Yoon, Jang Wook Sohn, Kyung Sook Yang, Min Ja Kim

Department of Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

28 Citations (Scopus)

Abstract

Background: While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population. Methods: For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100. Results: We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3. Conclusions: This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.

Original language	English
Pages (from-to)	2797-2804
Number of pages	8
Journal	Vaccine
Volume	37
Issue number	21
DOIs	https://doi.org/10.1016/j.vaccine.2019.04.017
Publication status	Published - 2019 May 9

Keywords

23-valent pneumococcal vaccine
Case-control study
Effectiveness
Pneumococcal infections
Streptococcus pneumoniae

ASJC Scopus subject areas

Molecular Medicine
Immunology and Microbiology(all)
veterinary(all)
Public Health, Environmental and Occupational Health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.vaccine.2019.04.017

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Kim, J. H., Chun, B. C., Song, J. Y., Kim, H. Y., Bae, I. G., Kim, D. M., Choi, Y. H., Jun, Y. H., Choi, W. S., Kang, S. H., Kwon, H. H., Jeong, H. W., Kee, S. Y., Hur, J., Chung, J. W., Yoon, Y. K., Sohn, J. W., Yang, K. S., & Kim, M. J. (2019). Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study. Vaccine, 37(21), 2797-2804. https://doi.org/10.1016/j.vaccine.2019.04.017

Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study. / Kim, Jong Hun; Chun, Byung Chul; Song, Joon Young et al.
In: Vaccine, Vol. 37, No. 21, 09.05.2019, p. 2797-2804.

Research output: Contribution to journal › Article › peer-review

Kim, JH, Chun, BC, Song, JY, Kim, HY, Bae, IG, Kim, DM, Choi, YH, Jun, YH, Choi, WS, Kang, SH, Kwon, HH, Jeong, HW, Kee, SY, Hur, J, Chung, JW, Yoon, YK, Sohn, JW, Yang, KS & Kim, MJ 2019, 'Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study', Vaccine, vol. 37, no. 21, pp. 2797-2804. https://doi.org/10.1016/j.vaccine.2019.04.017

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title = "Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study",

abstract = "Background: While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population. Methods: For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100. Results: We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3. Conclusions: This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.",

keywords = "23-valent pneumococcal vaccine, Case-control study, Effectiveness, Pneumococcal infections, Streptococcus pneumoniae",

author = "Kim, {Jong Hun} and Chun, {Byung Chul} and Song, {Joon Young} and Kim, {Hyo Youl} and Bae, {In Gyu} and Kim, {Dong Min} and Choi, {Young Hwa} and Jun, {Yoon Hee} and Choi, {Won Suk} and Kang, {Seong Hee} and Kwon, {Hyun Hee} and Jeong, {Hye Won} and Kee, {Sae Yoon} and Jian Hur and Chung, {Jin Won} and Yoon, {Young Kyung} and Sohn, {Jang Wook} and Yang, {Kyung Sook} and Kim, {Min Ja}",

note = "Funding Information: This research was supported by funding (No. 2015-E32008-00 ) from the Korea Centers for Disease Control and Prevention . Funding Information: The authors thank professor Moon Nahm at the World Health Organization pneumococcal serology reference laboratory at the University of Alabama at Birmingham for providing reagents and invaluable supports for serotyping of pneumococcal isolates. JHK, BCC, and MJK were involved in the conception and the design of the study project. All authors contributed to the acquisition and interpretation of data for the work. JHK, BCC, and MJK were involved in the analyses of the study data. JHK drafted the manuscript. MJK revised the manuscript. All authors declare no competing interests. This research was supported by funding (No. 2015-E32008-00) from the Korea Centers for Disease Control and Prevention. This study was approved by the institutional review board at the Korea University Anam Hospital (IRB Number 2016AN0249). Publisher Copyright: {\textcopyright} 2019 Elsevier Ltd",

year = "2019",

month = may,

day = "9",

doi = "10.1016/j.vaccine.2019.04.017",

language = "English",

volume = "37",

pages = "2797--2804",

journal = "Vaccine",

issn = "0264-410X",

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number = "21",

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TY - JOUR

T1 - Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine

T2 - A case-control study

AU - Kim, Jong Hun

AU - Chun, Byung Chul

AU - Song, Joon Young

AU - Kim, Hyo Youl

AU - Bae, In Gyu

AU - Kim, Dong Min

AU - Choi, Young Hwa

AU - Jun, Yoon Hee

AU - Choi, Won Suk

AU - Kang, Seong Hee

AU - Kwon, Hyun Hee

AU - Jeong, Hye Won

AU - Kee, Sae Yoon

AU - Hur, Jian

AU - Chung, Jin Won

AU - Yoon, Young Kyung

AU - Sohn, Jang Wook

AU - Yang, Kyung Sook

AU - Kim, Min Ja

N1 - Funding Information: This research was supported by funding (No. 2015-E32008-00 ) from the Korea Centers for Disease Control and Prevention . Funding Information: The authors thank professor Moon Nahm at the World Health Organization pneumococcal serology reference laboratory at the University of Alabama at Birmingham for providing reagents and invaluable supports for serotyping of pneumococcal isolates. JHK, BCC, and MJK were involved in the conception and the design of the study project. All authors contributed to the acquisition and interpretation of data for the work. JHK, BCC, and MJK were involved in the analyses of the study data. JHK drafted the manuscript. MJK revised the manuscript. All authors declare no competing interests. This research was supported by funding (No. 2015-E32008-00) from the Korea Centers for Disease Control and Prevention. This study was approved by the institutional review board at the Korea University Anam Hospital (IRB Number 2016AN0249). Publisher Copyright: © 2019 Elsevier Ltd

PY - 2019/5/9

Y1 - 2019/5/9

N2 - Background: While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population. Methods: For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100. Results: We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3. Conclusions: This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.

AB - Background: While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population. Methods: For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100. Results: We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3. Conclusions: This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.

KW - 23-valent pneumococcal vaccine

KW - Case-control study

KW - Effectiveness

KW - Pneumococcal infections

KW - Streptococcus pneumoniae

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Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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