Efficacy and effectiveness of a 23-valent polysaccharide vaccine against invasive and noninvasive pneumococcal disease and related outcomes: a review of available evidence

• Published in: Expert review of vaccines Vol. 20; no. 3; p. 243
• Main Authors: Niederman, Michael S, Folaranmi, Temitope, Buchwald, Ulrike K, Musey, Luwy, Cripps, Allan W, Johnson, Kelly D
• Format: Journal Article
• Language: English
• Published: England 04.03.2021
• Subjects: Humans; Pneumococcal Infections - epidemiology; Pneumococcal Infections - prevention & control; Pneumococcal Vaccines - immunology; Pneumonia, Pneumococcal - epidemiology; Pneumonia, Pneumococcal - prevention & control; Treatment Outcome; Vaccination; pneumococcal pneumonia; review; at-risk; older adults; invasive pneumococcal disease; high-risk; 23-valent pneumococcal polysaccharide vaccine
• ISSN: 1744-8395
• DOI: 10.1080/14760584.2021.1880328

: 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. : 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. : 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.