Effectiveness of pneumococcal vaccination in older adults with chronic respiratory diseases: results of the EVAN-65 study

Vaccine. 2008 Apr 7;26(16):1955-62. doi: 10.1016/j.vaccine.2008.02.021. Epub 2008 Feb 27.

Abstract

A prospective cohort study evaluating the clinical effectiveness of the 23-valent pneumococcal polysaccharide vaccine was conducted among 1298 Spanish older adults with chronic respiratory diseases (bronchitis, emphysema or asthma) who were followed between 2002 and 2005. Main outcomes were all-cause community-acquired pneumonia (CAP) and 30 days mortality from CAP. The association between vaccination and the risk of each outcome was evaluated by multivariable Cox proportional-hazard models adjusted for age and comorbidity pneumococcal vaccination did not alter significantly the risk of overall CAP (hazard ratio [HR]: 0.77; 95% confidence interval [CI]: 0.56-1.07) and 30 days mortality from CAP (HR: 0.87; 95% CI: 0.33-2.28). However, a borderline significant reduction of 30% in the risk of all-cause hospitalisation for CAP was observed among vaccinated subjects (HR: 0.70; 95% CI: 0.48-1.00; p=0.052). The effectiveness of the vaccine on the combined endpoint of pneumococcal and unknown organism infections reached 34% (HR: 0.66; 95% CI: 0.43-1.01; p=0.059). Although our findings suggest moderate benefits from the vaccination, the evidence of clinical effectiveness appears limited.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Cohort Studies
  • Community-Acquired Infections / mortality
  • Community-Acquired Infections / prevention & control*
  • Endpoint Determination
  • Female
  • Humans
  • Male
  • Pneumococcal Vaccines / administration & dosage*
  • Proportional Hazards Models
  • Respiratory Tract Diseases
  • Risk Factors
  • Spain
  • Streptococcus pneumoniae / isolation & purification
  • Treatment Outcome
  • Vaccination

Substances

  • Pneumococcal Vaccines