What about pneumococcal (pneumonia) vaccine?

From the Guidelines

Pneumococcal vaccine is highly recommended for preventing pneumococcal disease, including invasive pneumococcal disease (IPD), pneumonia, and acute otitis media (AOM) among infants, children, and adults, especially those with certain underlying medical conditions or decreased immunologic function 1.

Key Points

• The 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23) are the recommended vaccines for preventing pneumococcal disease 1.
• PCV13 has been shown to be 97.4% efficacious against IPD caused by vaccine serotypes among fully vaccinated infants, and 80% efficacious against vaccine-type IPD among healthy children aged <2 years 1.
• PCV7 has been shown to be 57% efficacious in preventing culture-confirmed, vaccine serotype AOM episodes, and 34% efficacious in reducing the overall net reduction in AOM caused by any pneumococcal serotype 1.
• The vaccine is cost-effective and potentially cost-saving among persons aged ≥65 years for prevention of bacteremia 1.
• Immunocompromised patients may not respond as well to the vaccine, but the potential benefits and safety of the vaccine justify its use 1.

Recommendations

• All children aged <2 years should receive PCV13 as part of their routine vaccination schedule 1.
• Adults aged ≥65 years and those with certain underlying medical conditions or decreased immunologic function should receive PPSV23 and/or PCV13 as recommended by the Advisory Committee on Immunization Practices (ACIP) 1.

From the Research

Pneumococcal Vaccine Effectiveness

• The effectiveness of pneumococcal vaccination in preventing pneumococcal pneumonia and invasive pneumococcal disease has been demonstrated in several studies 2, 3, 4.
• A study published in 1999 found that pneumococcal polysaccharide vaccine is efficacious in preventing pneumococcal bacteraemia and pneumococcal pneumonia in young adults, but the effectiveness in older adults is less clear 2.
• Another study published in 2007 found that the 23-valent polysaccharide pneumococcal vaccine (PPV) offers approximately 60% protection against invasive disease in the general elderly population, but provides incomplete protection, especially in those with underlying high-risk conditions 3.
• A prospective, test-negative study published in 2022 found that sequential PCV13/PPSV23 vaccination is most effective for preventing pneumococcal CAP among the elderly aged 65-74 years, with an adjusted vaccine effectiveness of 80.3% 5.

Pneumococcal Vaccine Types

• There are several types of pneumococcal vaccines, including polysaccharide vaccines, protein-polysaccharide conjugate vaccines, and protein-based vaccines 3, 6.
• The 23-valent polysaccharide pneumococcal vaccine (PPV) is currently recommended for high-risk patients and the general elderly population, but has limited serotype coverage and provides incomplete protection 3.
• Pneumococcal conjugate vaccines (PCVs), such as PCV7, PCV10, and PCV13, have been developed to overcome the limitations of polysaccharide vaccines, but are serotype-specific and pose the challenge of new serotypes replacing vaccine types 6.
• Research is ongoing to develop serotype-independent vaccines, which could provide a foundation of life-long protection against pneumococcal infection 2, 6.

Vaccination Strategies

• Vaccination strategies, such as sequential PCV13/PPSV23 vaccination, have been shown to be effective in preventing pneumococcal CAP among the elderly aged 65-74 years 5.
• The use of pneumococcal conjugate vaccines in infants has been observed to have a considerable indirect protective effect in parents and grandparents, highlighting the importance of herd immunity 3.
• The increase of pneumococcal vaccination coverage in elderly patients should be strongly considered, taking into account the preventive effect of PPV23 on invasive pneumococcal disease and the threat of a pandemic flu 4.