ABSTRACT

Introduction: Routine pneumococcal vaccination for adults aged ≥60 or ≥65 years and those with underlying at-risk and high-risk conditions is recommended in many countries. However, studies estimating the effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPSV23) have revealed mixed results, partly due to variability in study design and endpoints used to assess outcomes.Areas covered: The authors conducted a literature review of independently randomized trials and real-world studies published from 2010 to 2020 that assessed the effectiveness and efficacy of PPSV23 against vaccine-type or any-serotype invasive and noninvasive pneumococcal disease in adults aged ≥60 years. The authors also evaluated differences in study design that may contribute to the heterogeneity of available evidence.Expert opinion: Policy decisions regarding the inclusion of vaccines into national immunization plans should consider study quality and limitations. This review shows that PPSV23 is effective against vaccine-type invasive pneumococcal disease and vaccine-type pneumococcal pneumonia and can lower the burden of vaccine-type pneumococcal pneumonia. PPSV23-conferred protection may be lower in adults aged ≥75 years, those with certain underlying conditions, and individuals who were vaccinated >5 years before disease onset. This is an important finding that supports the benefit of PPSV23 vaccination for older adults.

摘要

简介：许多国家建议对≥60 岁或≥65 岁的成年人以及有潜在高危和高危状况的成年人进行常规肺炎球菌疫苗接种。然而，估计 23 价肺炎球菌多糖疫苗 (PPSV23) 有效性的研究揭示了不同的结果，部分原因是研究设计和用于评估结果的终点存在差异。涵盖的领域：作者对 2010 年至 2020 年发表的独立随机试验和真实世界研究进行了文献综述，这些试验评估了 PPSV23 在 60 岁以上成人中对疫苗型或任何血清型侵袭性和非侵袭性肺炎球菌疾病的有效性和疗效。作者还评估了可能导致现有证据异质性的研究设计差异。专家意见：关于将疫苗纳入国家免疫计划的政策决定应考虑研究质量和局限性。本综述表明，PPSV23对疫苗型侵袭性肺炎球菌病和疫苗型肺炎球菌肺炎有效，可降低疫苗型肺炎球菌肺炎的负担。PPSV23 对 75 岁以上的成年人、有某些潜在疾病的人以及在疾病发作前 5 年以上接种疫苗的人的保护作用可能较低。这是一个重要的发现，支持 PPSV23 疫苗接种对老年人的益处。