Potential effect of PCV13 introduction on Emergency Department accesses for lower respiratory tract infections in elderly and at risk adults

Abstract

Liguria, an administrative region in northern Italy characterized by a decade of high PCV coverage in paediatric age group, has issued new PCV13 recommendations for free active immunization in adults with risk factors and subjects aged ≥ 70 years old. Main aims of this study are: (1) a descriptive epidemiology of the clinical burden of lower respiratory tract infections (LRTI) in adults ≥18 years of age; and (2) a crossover evaluation of the effect of introduction of PCV13 vaccination in adults aged ≥70 years old, in terms of ED accesses for LRTI, obtained by a Syndrome Surveillance System (SSS). The ED access, chief complaint based SSS will allow an active surveillance of a population cohort of >430 000 individuals resident in Genoa metropolitan area, aged ≥18 years old, for a period of 60 months. During pre-PCV period, annual cumulative incidence of ED accesses for LRTI was equal to 7/1000 and 2% in ≥65 and ≥85 year adults, respectively. In ≥65 years adults, more than 70% of subjects identified by the SSS has at least one risk condition, with a peak of 87% in ≥85 year cohort. New Ligurian PCV13 recommendations can potentially reach more than 75% of ED accesses for LRTI. Data highlights the heavy impact of LRTI in terms of ED accesses, especially in the elderly and subjects with chronic conditions and the usefulness of SSS tool for monitoring PCV vaccination effect.

Keywords: :

• lower respiratory tract infections
• pneumonia
• hospital access
• syndrome surveillance
• pneumococcal vaccination

Disclosure of Potential Conflicts of Interest

F Ansaldi, P Durando, and G Icardi have previously participated at speaker’s bureaus and advisory board meetings sponsored by GSK, Novartis, Pfizer, and Sanofi Pasteur and has received research funding as investigator or principal investigator from Crucell Berna, GSK, Novartis, Pfizer, and Sanofi Pasteur.

D de Florentiis, Andrea Orsi, C Trucchi, S Schiaffino, Valter Turello, Roberto Rosselli, and R Carloni have no conflict of interest. No other relationships/conditions/circumstances that present a potential conflict of interest exist.

Acknowledgement

This study was supported by a research grant from Pfizer.

The study sponsor was not involved in study design, the collection, analysis, and interpretation of data, the writing of the report or the decision to submit the manuscript for publication.