Burden of pneumococcal disease in adults aged 65 years and older: an Australian perspective

Earle, Kylie; Williams, Scott

doi:10.1186/s41479-016-0008-8

Cited by 26 publications

(24 citation statements)

References 24 publications

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“…Our study contributes to a small but increasing number of publications which investigated the effect of pediatric pneumococcal vaccination programs on the incidence of pneumonia in non-vaccinated age groups over time. We noted an increased incidence from the pre-vaccine era to the PCV7 era and to the PCV13 era; increases were most apparent in the age groups 50–64 years and those ≥65 years, This is in line with data from Australia, where no effect on hospitalizations for all-cause pneumonia were detected up to 9 years after introduction of PCV7 into the pediatric vaccination program (14, 15) or the Netherlands up to 3 years after pediatric PCV10 introduction (16). In contrast, Finish (17), Brazilian (18), and some US data indicated a decline in all-cause pneumonia hospitalizations and pneumococcal hospitalizations in at least some non-vaccinated adult age groups (7, 19–21), but usually not in all adult age groups whereas others did not note any declines (22, 23) as recently summarized by Wiese et al (24).…”

Section: Discussionsupporting

confidence: 88%

Influence of Older Age and Other Risk Factors on Pneumonia Hospitalization in Switzerland in the Pneumococcal Vaccine Era

et al. 2019

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Background: Pneumococcal pneumonia is a disease of the extremes of age. However, as other traditional risk factors for pneumococcal pneumonia also increase with older age, it is unclear if older age itself should be an indication for pneumococcal vaccination. Therefore, we assessed the effect of age on risk for hospitalization for pneumonia and for pneumococcal pneumonia.Methods: Using a national hospitalization dataset, all patients ≥16 years hospitalized in a Swiss hospital with a diagnosis of pneumonia or pneumococcal pneumonia between 2002 and 2015 were included. Multivariable logistic regression analysis was used to test the association between age (≥50 or ≥65 years) and hospitalization for pneumonia or pneumococcal pneumonia after adjusting for pneumococcal vaccine indications. Similar analyses were performed for effect of age on length of stay (LOS) and mortality.Results: Among a total of 17,619,016 hospitalizations a diagnosis of pneumonia was present in 421,760 (2.4%) and a diagnosis of pneumococcal pneumonia in 21,610 (0.12%). Age ≥50 years (OR: 3.52 and 2.12, respectively; p for both <0.001) and age ≥65 years (OR: 2.98 and 1.80, respectively; p for both <0.001) as well as most Swiss pneumococcal vaccine indications were independent predictors of hospitalization with a pneumonia and pneumococcal pneumonia diagnosis, respectively. Older age with both age cut-offs were associated with increased LOS (≥50 years: aRR: 1.19 and 1.24, respectively; age ≥65 years: aRR: 1.60 and 1.20, respectively; p < 0.001 for all) and mortality (≥50 years: aOR: 4.73 and 2.84, respectively; age ≥65 years: aOR: 2.38 and 2.69, respectively, p < 0.001 for all) in patients with a pneumonia and pneumococcal pneumonia diagnosis, respectively. The effects of pneumococcal vaccine indications decreased with older age. The incidences of hospitalizations with a pneumonia diagnosis and a pneumococcal pneumonia diagnosis increased significantly from the pre-vaccine era to the PCV7 era and the PCV13 era (p for trend for both analyses <0.001).Conclusion: This study confirms the Swiss indications for pneumococcal vaccination as independent risk factors for pneumonia hospitalizations. Older age itself should be considered as an additional vaccine indication. Pneumonia and pneumococcal pneumonia in adults have increased despite pneumococcal vaccination in children.

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Section: Discussionsupporting

confidence: 88%

Influence of Older Age and Other Risk Factors on Pneumonia Hospitalization in Switzerland in the Pneumococcal Vaccine Era

et al. 2019

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“…Other studies and reviews published in the last four years from different parts of the world, including Australia 10,11 and the Asia Pacific region 12 , Canada 13,14 , Latin America [15][16][17] , and the Caribbean 17 , have documented similar findings. Namely, there is an ongoing high rate of pneumococcal pneumonia in all of these regions; in more recent years, this is often the case despite decreased rates associated with herd protection in adults from implementation of childhood PCV immunization as well as a residual burden of vaccine-serotype pneumonia and invasive pneumococcal disease (IPD), as described above.…”

Section: Burden Of Pneumococcal Diseasesupporting

confidence: 56%

Recent advances in the epidemiology and prevention of Streptococcus pneumoniae infections

Feldman

Anderson

2020

F1000Res

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The introduction of pneumococcal conjugate vaccines (PCVs) 7 and 13 into national childhood immunization programs in the US in 2000 and 2010, respectively, proved to be remarkably successful in reducing infant mortality due to invasive pneumococcal disease (IPD), resulting in widespread uptake of these vaccines. Secondary herd protection of non-vaccinated adults against IPD has proven to be an additional public health benefit of childhood immunization with PCVs, particularly in the case of the vulnerable elderly who are at increased risk due to immunosenescence and underlying comorbidity. Despite these advances in pneumococcal immunization, the global burden of pneumococcal disease, albeit of unequal geographic distribution, remains high. Reasons for this include restricted access of children living in many developing countries to PCVs, the emergence of infection due to non-vaccine serotypes of the pneumococcus, and non-encapsulated strains of the pathogen. Emerging concerns affecting the elderly include the realization that herd protection conferred by the current generation of PCVs (PCV7, PCV10, and PCV13) has reached a ceiling in many countries at a time of global population aging, compounded by uncertainty surrounding those immunization strategies that induce optimum immunogenicity and protection against IPD in the elderly. All of the aforementioned issues, together with a consideration of pipeline and pending strategies to improve access to, and serotype coverage of, PCVs, are the focus areas of this review.

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“…Only the U.S. estimated national incidence of influenza, pneumococcal disease, and herpes zoster disease among adults ≥ 50 years [29] . There were significant data gaps in LMICs, with most studies conducted in high-income settings like the U.S. [30] , Canada [31] , Australia [32] , and Japan [33] . This may be more pronounced for some VPDs than others; for example, herpes zoster studies were almost exclusively focused in high-income settings including Poland [34] , the U.S. [35] , [36] , and France [37] , [38] .…”

Section: Resultsmentioning

confidence: 99%

Situational assessment of adult vaccine preventable disease and the potential for immunization advocacy and policy in low- and middle-income countries

Sauer¹,

Vasudevan²,

Meghani³

et al. 2021

Vaccine

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By 2050, the number of adults over 65 years of age will be double the under-5 population, and heavily concentrated in low- and middle-income countries. Population growth and increasing life expectancies call for effective healthy aging strategies inclusive of immunization to reduce the burden of vaccine-preventable diseases, improve quality of life, and mitigate antimicrobial resistance. Based on a review of available literature on the pneumococcal disease, influenza, and herpes zoster epidemiology and economic burden, and the health systems and policy barriers for adult immunization, we identified evidence gaps and considerations for prioritizing adult immunization. The body of evidence for adult immunization and the health and economic burden of adult disease is heavily concentrated in high-income countries. The few countries reporting adult immunization policies generally focus on high-risk groups. Despite robust child immunization programs in most countries, adult immunization programs and policies lag far behind and there is a general lack of appropriate delivery platforms. Global adult disease burden and economic costs are substantial but evidence from low- and middle-income countries is limited. There is a need for a strengthened evidence base and political commitment to drive a comprehensive, global technical consensus on adult immunization.

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Burden of pneumococcal disease in adults aged 65 years and older: an Australian perspective

Cited by 26 publications

References 24 publications

Influence of Older Age and Other Risk Factors on Pneumonia Hospitalization in Switzerland in the Pneumococcal Vaccine Era

Influence of Older Age and Other Risk Factors on Pneumonia Hospitalization in Switzerland in the Pneumococcal Vaccine Era

Recent advances in the epidemiology and prevention of Streptococcus pneumoniae infections

Situational assessment of adult vaccine preventable disease and the potential for immunization advocacy and policy in low- and middle-income countries

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