Preventing non bacteremic pneumococcal pneumonia in older adults

Figures & data

Table 1. Annual incidence of hospitalized community-acquired pneumonia (CAP) among older adults in Nottingham¹

Age group (y)	Annual incidence of CAP/100 000
	All cases	All pneumococcal^2	PCV7-serotype^3	Non-PCV7 serotype^4
65–74	288	71	17	28
75–84	439	135	26	57
³85	986	274	71	102
³65	424	234	53	94

¹Adapted from Tables 2 and 3 in reference 39. All rates have rounded to the nearest whole number. ²The rates shown in the column do not reflect the total number of cases of all pneumococcal CAP because not all cases could be detected by the BinaxNOW urinary antigen test. ³Cases of PCV7-serotype CAP were diagnosed by the Bio-Plex urinary antigen test. ⁴The rates shown in the column do not reflect the total numbers of cases of non-PCV7-serotype CAP. These numbers include Bio-Plex-positive cases with serotypes unique to PCV13 and cases with a positive BinaxNOW test but a negative Bio-Plex urinary antigen test. Other cases of non-PCV7-serotype CAP may have escaped detection because of the low sensitivity of BinaxNOW test.

Table 2. Annual incidence of IPD/100 000 (all serotypes) in young children and older adults in the US following the introduction of childhood PCV7 and PCV13 vaccination¹

Year	Vaccine	<5 y	≥65 y
1998–1999	no PCV	97.6	59.6
2009	10 y after PCV7	21.8	38.5
2020	10 y after PCV13	9.3	25.0

¹Adapted from reference 51, Tables 2 and 3. PCV7 was introduced in childhood vaccination in 2000 and replaced by PCV13 in 2010.

Table 3. Comparative effectiveness of PPV23 (CAPAMIS)¹ and efficacy of PCV13 (CAPiTA)² vaccination of older adults

	CAPAMIS				CAPiTA
Method	Retrospective cohort				Randomized controlled trial
Duration of follow up	3 y				2.5 y
Serotypes	All serotypes				PCV13 serotypes only
Study population vaccinated / non vaccinated	8981/12 044				42 240/42 256
Outcome	Cases Vac/ nonVac	Adj. HR^3	95% CI^4	VE^5 (%)	Cases Vac/ non-Vac	VE (%)	95% CI
All pneumococcal CAP	45/39	0.49	0.29 - 0.84	51	49/90	46	21.8 -62.5
Non-bacteremic pneumococcal CAP (NPP)	41/31	0.52	0.29 - 0.92	48	33/60	45	14.2 -65.3
All-cause CAP	206/169	0.75	0.58 - 0.98	25	nd^6	nd	nd
Bacteremic pneumococcal CAP/IPD	4/8	0.38	0.09 -1.68	62	7/28	75	41.4 -90.8

¹Adapted from reference 55. ²Adapted from reference 56; per protocol analysis. ³Adj. HR indicates adjusted hazard ratio. ⁴CI indicates confidence interval. ⁵VE indicates vaccination effectiveness and vaccine efficacy.6 indicates no data

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