Burden of illness associated with pneumococcal infections in Japan - a targeted literature review

Figures & data

Table 1. Timings of approved and publicly funded main vaccines.

Status	PCV7	PCV10	PCV13	PPV23†
Approved (Children)	October 2009 (≤9 years old)	March 2015	June 2013	October 2006 (≥2 years old)
Approved (Adults)	NA	NA	June 2014 (≥65 years old only), May 2020 (All ages with high-risk conditions)	October 2006
Publicly funded (Children)	April 2013	NA	November 2013	NA
Publicly funded (Adults)	NA	NA	NA	October 2014
Source	Pharmaceutical and Food Safety Bureau, MHLW [61], Pharmaceutical Safety Committee of the Pharmaceutical Affairs and Food Sanitation Council, MHLW [62]	Pharmaceutical and Food Safety Bureau, MHLW [63]	PMDA [64]	PMDA [65]

MHLW: Ministry of Health, Labour and Welfare; NA: Not applicable; PMDA: Pharmaceuticals and Medical Devices Agency

†PNEUMOVAX® NP.

Table 2. Summary of studies for the epidemiology review.

	All	Nationwide or multi-prefecture			N ≥ 400*			IPDs	All other PDs
		All	General population	Specific population	All	General population	Specific population
Incidence
Children	[8,20–22,24,30,31,39,70–80]	[8,20–22,31,70]	[8,20–22,31]	[70]				[8,20–22,30,31,39,70–76,78–80]	[24,77]
Children and adolescents	[20,39,79]	[20]	[20]	NI				[20,39,79]
Adults	[6,20,81]	[6,20],	[6,20]	NI				[20]	[6,81]
Adults and the elderly	[81]	NI	NI	NI				NI	[81]
The elderly	[6,8,20,81,82]	[6,8,20]	[6,8,20]	NI				[8,20,82]	[6,81]
All ages	[8,20,83]	[8,20,83]	[8,20,83]	NI				[8,20]	[83]
Prevalence
Children	[23,24,33,75,76,84–86]	[33,86]	NI	[33,86]	[23,24,33,84]	NI	[23,24,33,84]	[75,76,86]	[23,24,33,84–86]
Children and adolescents	[25,39,45,70,76,87–92]	[70,92]	NI	[70,92]	[25,39,45,70,88,90–92]	NI	[25,39,45,70,88,90–92]	[70,76,87]	[25,39,45,88–92]
Adults	[6,81,84,93]	[6]	NI	[6]	[84]	NI	[84]	NI	[6,81,84,93]
Adults and the elderly	[6,81,94–102]	[6,95]	NI	[6,95]	[6,94,95,98,102]	NI	[6,94,95,98,102]	NI	[6,81,94–102]
The elderly	[6,26,81,84,93,103,104]	[6,103]	NI	[6,103]	[26,84,103,104]	NI	[26,84,103,104]	[26]	[6,81,84,93,103,104]
All ages	[84,105]	NI	NI	NI	[84]	NI	[84]	NI	[84,105]
Serotype distribution†
Children	[21,22,24,27–38,71,74,106–108]	[21,22,27,29,31–33,36,37,107,108]	NA	NA	[22,27,36,108]	NA	NA	[21,22,27–31,34–36,71,74,108]	[24,32,33,36–38,106,107]
Children and adolescents	[25,27–29,32,34,36,37,39–50,70,72,76,89–91,106,108–116]	[27,29,32,36,37,41,42,44,46,50,70,108,112,115]	NA	NA	[27,36,41,44,47,48,108,111,112,114]	NA	NA	[25,27–29,34,36,39,40,43,44,50,70,72,76,108–110,112,113]	[32,36,37,41,42,45–49,89–91,106,109–112,114–116]
Adults	[34,38,46,55,115,117]	[46,55,115,117]	NA	NA	NI	NA	NA	[34,117]	[34,38,46,55,115]
Adults and the elderly	[44,50,51,82,110,111,114,118–123]	[44,50,51,119,120,122,123]	NA	NA	[44,51,111,114,119,120,122,123]	NA	NA	[44,50,51,82,110,118,121,123]	[110,111,114,119,120,122]
The elderly	[34,35,38,46,52,55,103,115,117,124]	[46,55,103,115,117]	NA	NA	[103]	NA	NA	[34,35,117]	[38,46,52,55,103,115,124]
All ages	[34,35,38,110,111,114,125–127]	[125–127]	NA	NA	[35,38,111,114,126]	NA	NA	[34,35,110,125,126]	[38,110,111,114,126,127]
Treatment adherence/compliance	NI	NI	NI	NI	NI	NI	NI	NI	NI

IPDs: Invasive pneumococcal diseases; NI: Not identified; NA: Not applicable; PDs: Pneumococcal diseases

*Sample size for studies on incidence is not reported due to large variability depending on the study population.

†While Hotomi, Nakajima [128], Yamagishi, Mikamo [129], and Takano, Ozaki [92] met the inclusion criteria and therefore were included in Table 3 and PRISMA, their data were not analyzed in the serotype distribution sections in this manuscript and therefore they were not included in this table as the studies did not report detailed data on vaccine type serotypes.

Table 3. Summary of studies for the humanistic burden review.

	All	Nationwide or multi-prefecture	N ≥ 400
HRQoL
Children	NI	NI	NI
Children and adolescents	NI	NI	NI
Adults	NI	NI	NI
Adults and the elderly	NI	NI	NI
The elderly	NI	NI	NI
All ages	NI	NI	NI
Other PROs
Children	NI	NI	NI
Children and adolescents	NI	NI	NI
Adults	[53]	NI	NI
Adults and the elderly	[52,54,130]	[130]	NI
The elderly	[26,53,55]	[26,55]	[26,55]
All ages	NI	NI	NI
Patients’ satisfaction
Children	NI	NI	NI
Children and adolescents	NI	NI	NI
Adults	NI	NI	NI
Adults and the elderly	NI	NI	NI
The elderly	NI	NI	NI
All ages	NI	NI	NI

HRQoL: Health-related quality-of-life; NI: Not identified; PROs: Patient-reported outcomes.

Figure 1. PRISMA diagram of the search results for the epidemiology (A), humanistic burden (B) and economic burden (C) review.

Table 4. Summary of the studies for the economic burden review.

	All	Nationwide or multi-prefecture	N ≥ 400	IPDs	Other PDs (including unspecified)
Direct costs
Children	[56–58,84,131]	[57,131]	NI	[56,57]	[58,84,131]
Children and adolescents	NI	NI	NI	NI	NI
Adults	[84]	NI	NI	NI	[84]
Adults and the elderly	[59,132]	NI	NI	NI	[59,132]
The elderly	[26,60,84]	[26,60]	[26]	[26]	[60,84]
All ages	[84]	NI	NI	NI	[84]
Indirect costs
Children	[58,131]	[131]	NI	[58]	[131]
Children and adolescents	NI	NI	NI	NI	NI
Adults	NI	NI	NI	NI	NI
Adults and the elderly	NI	NI	NI	NI	NI
The elderly	NI	NI	NI	NI	NI
All ages	NI	NI	NI	NI	NI
Resource use
Children	[23,56,57,84,86,133,134]	[57,86,133]	NI	[56,57,133]	[23,84,86,134]
Children and adolescents	[70]	[70]	NI	[70]	NI
Adults	[53,84]	NI	NI	NI	[53,84]
Adults and the elderly	[54,59,94,130,132]	[130]	NI	[130]	[54,59,94,132]
The elderly	[26,53,60,84]	[26,60]	[26]	[26]	[53,60,84]
All ages	[84]	NI	NI	NI	[84]
Productivity loss
Children	[56,58]	NI	NI	[56,58]	NI
Children and adolescents	NI	NI	NI	NI	NI
Adults	NI	NI	NI	NI	NI
Adults and the elderly	NI	NI	NI	NI	NI
The elderly	NI	NI	NI	NI	NI
All ages	NI	NI	NI	NI	NI

IPDs: Invasive pneumococcal diseases; NI: Not identified; PDs: Pneumococcal diseases

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