Evaluating clinical effectiveness of 13-valent pneumococcal conjugate vaccination against pneumonia among middle-aged and older adults in Catalonia : results from the EPIVAC cohort study
Vila-Corcoles, Angel (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Ochoa-Gondar, Olga (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
De Diego-Cabanes, Cinta (Tarragona, Spain)
Satue, Eva (Tarragona, Spain)
Aragón, María (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Vila-Rovira, Angel (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Gómez-Bertomeu, Frederic (Tarragona, Spain)
Magarolas, Ramon (Tarragona, Spain)
Figuerola-Massana, Enric (Tarragona, Spain)
Raga, Xavier (Hospital Sant Pau i Santa Tecla (Tarragona))
Pérez Moreno, Mar Olga (Hospital de Tortosa Verge de la Cinta)
Ballester, Frederic (Hospital Universitari Sant Joan de Reus (Tarragona))
Universitat Autònoma de Barcelona

Data:	2018
Resum:	Benefits using the 13-valent pneumococcal conjugate vaccine (PCV13) in adults are controversial. This study investigated clinical effectiveness of PCV13 vaccination in preventing hospitalisation from pneumonia among middle-aged and older adults. Population-based cohort study involving 2,025,730 individuals ≥50 years in Catalonia, Spain, who were prospectively followed from 01/01/2015 to 31/12/2015. Primary outcomes were hospitalisation for pneumococcal or all-cause pneumonia and death from any cause. Cox regression models were used to evaluate the association between PCV13 vaccination and the risk of each outcome, adjusting for age, sex and major comorbidities/underlying risk conditions. Cohort members were observed for a total of 1,990,701 person-years, of which 6912 person-years were PCV13 vaccinated. Overall, crude incidence rates (per 100,000 person-years) were 82. 8 (95% confidence interval [CI]: 77. 7-88. 1) for pneumococcal pneumonia, 637. 9 (95% CI: 599. 0-678. 7) for all-cause pneumonia and 2367. 2 (95% CI: 2222. 8-2518. 7) for all-cause death. After multivariable adjustments we found that the PCV13 vaccination did not alter significantly the risk of pneumococcal pneumonia (multivariable-adjusted hazard ratio [mHR]: 1. 17; 95% CI: 0. 75-1. 83; p = 0. 493) and all-cause death (mHR: 1. 07; 95% CI: 0. 97-1. 18; p = 0. 190), although it remained significantly associated with an increased risk of all-cause pneumonia (mHR: 1. 69; 95% CI: 1. 48-1. 94; p < 0. 001). In stratified analyses focused on middle-aged or elderly persons and immunocompromised or immunocompetent subjects, PCV13 vaccination did not appear effective either. Our data does not support clinical benefits of PCV13 vaccination against pneumonia among adults in Catalonia. It must be closely monitored in future studies involving more vaccinated person-time at-observation.
Ajuts:	Instituto de Salud Carlos III PI15-01230
Nota:	Altres ajuts: This work is cofinanced by the European Union through the "Fondo Europeo de Desarrollo Regional" (FEDER).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Adults ; Effectiveness ; Pneumococcal conjugate vaccine ; Pneumonia ; Streptococcus pneumoniae
Publicat a:	BMC Infectious diseases, Vol. 18 (april 2018) , ISSN 1471-2334

DOI: 10.1186/s12879-018-3096-7
PMID: 29699550

10 p, 702.4 KB

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