Systematic literature review of the disease burden and vaccination of pneumococcal disease among adults in select Asia-Pacific areas

ABSTRACT

Introduction

Pneumococcal diseases are common and cause significant morbidity and mortality, with higher rates especially in developing areas including many in the Asia-Pacific (AP) region. However, current strategies to prevent pneumococcal disease in adults are quite complicated and not well implemented among many AP areas, and vaccination coverage rates among adults are generally low or perceived as low in the region. Thus, this literature review’s purpose was to summarize the disease burden and vaccination against pneumococcal diseases among adults in select AP areas (Australia, Hong Kong, India, Indonesia, South Korea, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand, and Vietnam).

Areas Covered

This systematic review included published articles from January 2010 to August 2020 using MEDLINE/Embase. Grey literature websites were searched for national immunization programs and medical society vaccination recommendations from areas of interest. A total of 69 publications were identified.

Expert Opinion

In the AP region, pneumococcal disease burden and serotype prevalence are variable among adult populations, particularly among older adults. Data was provided primarily from countries with established national immunization programs (NIPs). Further research on the disease burden and emphasis on the benefits of vaccination in AP areas lacking pneumococcal vaccination programs is warranted.

KEYWORDS:

• Pneumococcal
• vaccine
• Asia Pacific
• disease burden
• cost

Funding

The study was supported by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.

Article highlights

• The incidence of invasive pneumococcal disease (IPD) varied across AP areas and age groups, with higher incidence and disease burden among older populations (age ≥ 50 years of age). These trends were also consistent among studies reporting incidence of pneumococcal pneumonia

• Incidence data was lacking in approximately 50% of select AP areas

• Among studies reporting specific serotype prevalence in AP adults, ST3 was among the most prevalent serotypes, with high prevalence primarily in areas with pediatric pneumococcal conjugate vaccine (PCV) NIPs

• Additionally, larger gaps between PCV13 and pneumococcal polysaccharide vaccine 23 (PPSV23) serotypes and diverse non-vaccine serotypes seem to occur among areas with pediatric PCV NIPs (e.g. the Philippines, Singapore, and South Korea)

• Evidence on the humanistic burden of pneumococcal disease among adult AP population is also lacking

• Among the 12 AP areas included in this review, approximately 58% of countries have made pneumococcal vaccines available through their NIPs, with full government funding available for the elderly (mainly age ≥ 65 years) or adults with high-risk medical conditions in 50% of countries

• Continuous monitoring of serotype prevalence can provide important information for pneumococcal vaccine recommendations and policy decisions to ensure protection and vaccination from pneumococcal disease

• Vaccination policies are variable across the AP region. Increased awareness of the public health and economic benefits of pneumococcal vaccination in the AP region are therefore warranted

Acknowledgments

This work has been presented as two abstracts at APCCMI Singapore 2021.

Author contributions

All authors have substantially contributed to the conception and design of the review article and interpreting the relevant literature and been involved in writing the review article or revised it for intellectual content.

Supplementary material

Supplemental data for this article can be accessed here.