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Abstract
Pneumococcal vaccination is an effective intervention to prevent pneumococcal infections. Earlier randomized clinical trials and most case-control studies have shown a significant protection against invasive pneumococcal diseases and pneumococcal pneumonia in the elderly and chronic patients with a higher risk of pneumococcal infections. However, more recent randomized clinical trials have only detected a significant protection in immunocompetent individuals. A review of the studies assessing the cost–effectiveness of the 23-valent polysaccharide vaccine has shown that pneumococcal vaccination should be recommended in all individuals aged over 64 years, and in chronic patients with a higher risk of pneumocccal infections. In these population groups, vaccination costs are lower than healthcare costs reduced with the intervention. In individuals aged over 64 years, cost savings could be obtained when the vaccine effectiveness is higher than 30%. Recent cost–effectiveness studies have shown that pneumococcal vaccination could also be recommended in individuals aged between 45 and 64 years without risk factors, since the cost–effectiveness ratio is lower than €30,000 per life-year gained. In individuals aged between 45 and 64 years, cost savings could be obtained when the vaccine effectiveness is higher than 90%, and when the percentage of pneumonias caused by Streptococcus pneumoniae are 40%.