A post hoc assessment of duration of protection in CAPiTA (Community Acquired Pneumonia immunization Trial in Adults)

Patterson, Scott D.; Webber, Chris; Patton, Michael A.; Drews, Wayne; Huijts, Susanne M.; Bolkenbaas, Marieke; Gruber, William C.; Scott, Daniel A.; Bonten, Marc J. M.

doi:10.1016/j.trivac.2016.04.004

Cited by 57 publications

(35 citation statements)

References 18 publications

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“…This could suggest that the population in CAPITA actually was less healthy than previously reported. Patterson et al studied the VE of time since vaccination, and did not find any evidence of waning over the study period of four years [15].…”

Section: Evidence Base For Pcv13mentioning

confidence: 90%

“…Nine studies reported on PCV13 VE [11][12][13][14][15][16][17][18][19] (Table 1). Five of these were post-hoc analyses based on CAPITA data [11][12][13][14][15]. Besides the post-hoc studies, we identified two cohort studies, one from Spain [16] and one from Germany [17], and two studies using test-negative design (TND), one from the US [18] and one from Italy [19].…”

Section: Conjugate Vaccinementioning

confidence: 99%

“…Four of the five post hoc studies using CAPITA data provided VE estimates for PCV13 stratified by comorbidities [11][12][13] and exploratory outcomes [14]. The last post hoc study analyzed the VE of time since vaccination and did not find evidence of waning over the study period [15]. The remaining studies reported VE on the following outcomes: all-cause pneumonia [16,17], pneumococcal pneumonia [16], pneumococcal-CAP [19] and VT-CAP [18,19] (Table 1).…”

Section: Conjugate Vaccinementioning

confidence: 99%

See 2 more Smart Citations

A Systematic Review of Studies Published between 2016 and 2019 on the Effectiveness and Efficacy of Pneumococcal Vaccination on Pneumonia and Invasive Pneumococcal Disease in an Elderly Population

et al. 2020

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Adult vaccination is high on the agenda in many countries. Two different vaccines are available for the prevention of pneumococcal disease in adults: a 23-valent polysaccharide vaccine (PPV23), and a 13-valent conjugated vaccine (PCV13). The objective of this review is to update the evidence base for vaccine efficacy and effectiveness of PPV23 and PCV13 against invasive pneumococcal disease and pneumonia among an unselected elderly population. We systematically searched for clinical trials and observational studies published between January 1 2016 and April 17 2019 in Pubmed, Embase, Cinahl, Web of Science, Epistemonikos and Cochrane databases. Risk of bias was assessed using Cochrane Risk of Bias tool for and the Newcastle–Ottawa Scale. Results were stratified by vaccine type and outcome. We identified nine studies on PCV13 and six on PPV23. No new randomized clinical trials were identified. Due to different outcomes, it was not possible to do a meta-analysis. New high-quality observational studies indicate protective vaccine effectiveness for both vaccines against vaccine type pneumonia. Our estimates for the protective vaccine efficacy and effectiveness (VE) of PPV23 on pneumonia and pneumococcal pneumonia overlap with results from previously published reviews. Some of the results indicate that the effectiveness of the PPV23 is best in younger age groups, and that it decreases over time.

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Section: Evidence Base For Pcv13mentioning

confidence: 90%

Section: Conjugate Vaccinementioning

confidence: 99%

Section: Conjugate Vaccinementioning

confidence: 99%

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A Systematic Review of Studies Published between 2016 and 2019 on the Effectiveness and Efficacy of Pneumococcal Vaccination on Pneumonia and Invasive Pneumococcal Disease in an Elderly Population

et al. 2020

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“…Vaccine effectiveness was assumed to be stable for the initial 5 years of the modeling horizon (no waning), based on stable vaccine effectiveness during the follow-up period (mean 3.97 years) observed in a post hoc analysis of CAPiTA [76]. As with other studies, another limitation is the fact that no empirical evidence is available after this time period.…”

Section: Sensitivity Analysismentioning

confidence: 99%

The cost-effectiveness of using pneumococcal conjugate vaccine (PCV13) versus pneumococcal polysaccharide vaccine (PPSV23), in South African adults

et al. 2020

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Streptococcus pneumoniae (pneumococcus) remains an important cause of morbidity and mortality. Pneumococcal vaccination is part of the South African pediatric public immunization program but the potential cost-effectiveness of such an intervention for adults is unknown. This study aimed to compare the cost-effectiveness of two widely used pneumococcal vaccines: pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23) in South African adults, 18 years and older. Four analyses were carried out in a) both the private and public health care sectors; and b) for the HIV-infected population alone and for the total mixed population (all HIV-infected and-uninfected people). A previously published global pharmacoeconomic model was adapted and populated to represent the South African adult population. The model utilized a Markov-type process to depict the lifetime clinical and economic outcomes of patients who acquire pneumococcal disease in 2015, from a societal perspective. Costs were sourced in South African rand and converted to US dollar (USD). The incremental cost divided by the incremental effectiveness (expressed as quality-adjusted life years gained) represented the incremental cost-effectiveness ratio for PCV13 compared to PPSV23. Results indicated that the use of PCV13 compared to PPSV23 is highly cost-effective in the public sector cohorts with incremental cost-effectiveness ratios of $771 (R11,106)/quality-adjusted life year and $956 (R13,773)/ quality-adjusted life year for the HIV-infected and mixed populations, respectively. The private sector cohort showed similar highly cost-effective results for the mixed population (incremental cost-effectiveness ratio $626 (R9,013)/quality-adjusted life year) and the HIVinfected cohort (dominant). In sensitivity analysis, the model was sensitive to vaccine price

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“…51 Specifically, the authors applied their observed vaccine-effectiveness estimates 51 to the CAP burden seen in the Louisville Pneumonia Study 27 using a simple mathematical model that assumed: i) approximately 49 million adults aged ≥ 65 years in the United States (based on US Census data), ii) the incidence rate of all-cause hospitalized CAP is roughly 2300 per 100,000 per year (based on the Louisville Pneumonia Study), 27 iii) median hospital length of stay for CAP is 6 days, 51 iv) mortality for patients hospitalized for CAP occurs in 6.5% to 12.7% of cases, 51 v) at least 4% of all CAP still caused by PCV13 serotypes in unvaccinated older adults, 51 vi) 73% (95% CI: 13% to 92%) effectiveness of PCV13 against vaccine-type CAP, 51 and vii) five years is the minimum duration of protection for PCV13. 59,60 Based on these assumptions, it was projected that as many as 137,000 (24,000 to 173,000) cumulative cases of hospitalized CAP, 824,000 (145,000 to 1,035,000) hospital days, and 17,440 (1570 to 21,920) deaths could potentially be averted over five years with adult PCV13 use in the United States (assuming 100% uptake; Figure 2). 51 The study underscored that this potential impact of PCV13 use in adults aged ≥ 65 years is comparable to the number of hospitalizations potentially averted with the US seasonal influenza vaccination program in the same age group.…”

Section: Introductionmentioning

confidence: 99%

Decision-making for PCV in adults

Swerdlow

Istúriz

Jódar

2018

Human Vaccines & Immunotherapeutics

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Thirteen-valent pneumococcal conjugate vaccine (PCV13) was licensed in adults to address the unmet medical need of vaccine-type community acquired pneumonia (CAP) and the limitations of previous plain-polysaccharide vaccines. Since then, some have questioned the utility of adult PCV13 use, arguing that: i) high PCV13 uptake in young children would provide indirect effects that, by themselves, would sufficiently protect unvaccinated adults and ii) no data describing the real-world effectiveness of PCV13 use in adults, especially with immunocompromising conditions, exist. Even in countries like the United States where PCV13 has been routinely recommended for all adults aged ≥ 65 years, the recommendation is contingent on a re-evaluation to determine if continued use is needed in the context of a mature PCV13 pediatric immunization program. Emerging evidence, however, suggests that i) a meaningful burden of PCV13-type pneumococcal pneumonia still persists in adults at increased risk for pneumococcal disease, despite indirect effects from long-standing pediatric PCV13 use, ii) adult PCV13 use is effective and has reduced pneumococcal CAP, even in the elderly and those with chronic medical or immunocompromising conditionsand disease could come back if PCV13 were removed, and iii) ethical and pragmatic vaccine policy considerations support continued adult PCV13 use in countries that have already introduced the vaccine (eg, disparities in adult PCV13 uptake, confusion stemming from removing a previously-recommended vaccine for a non-safety-related concern, and the reality that next-generation PCVs are only a few years away). Together, these findings suggest that continued PCV13 vaccination in adults is needed to control vaccine-type CAP.

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A post hoc assessment of duration of protection in CAPiTA (Community Acquired Pneumonia immunization Trial in Adults)

Cited by 57 publications

References 18 publications

A Systematic Review of Studies Published between 2016 and 2019 on the Effectiveness and Efficacy of Pneumococcal Vaccination on Pneumonia and Invasive Pneumococcal Disease in an Elderly Population

A Systematic Review of Studies Published between 2016 and 2019 on the Effectiveness and Efficacy of Pneumococcal Vaccination on Pneumonia and Invasive Pneumococcal Disease in an Elderly Population

The cost-effectiveness of using pneumococcal conjugate vaccine (PCV13) versus pneumococcal polysaccharide vaccine (PPSV23), in South African adults

Decision-making for PCV in adults

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