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Abstract：
Pneumococcal disease constitutes a major global health problem. Adults aged over 50 years and younger adults with specific chronic health conditions are at risk for invasive pneumococcal disease, associated with substantial morbidity and mortality. In Europe, two vaccine types are used in adults for pneumococcal immunization: pneumococcal polysaccharide vaccine (PPV23) and pneumococcal conjugate vaccine (PCV13). To provide an overview and to compare the national guidelines for pneumococcal immunization for adults in Europe. In November 2016, national guidelines on pneumococcal vaccination for adults of 31 European countries were obtained by Google search, the website of European Centre for Disease Prevention and Control, and contacting public health officials. In our analysis, we distinguished between age-based and risk-based guidelines. In October 2017, we used the same method to retrieve guideline updates. We observed great variability regarding age, risk groups, vaccine type, and use of boosters. In age-based guidelines, vaccination is mostly recommended in adults aged over 65 years using PPV23. Boosters are generally not recommended. An upper age limit for vaccination is reported in three countries. In the immunocompromised population, vaccination with both vaccines and administration of a booster is mostly recommended. In the population with chronic health conditions, there is more heterogeneity according vaccine type, sequence, and administration of boosters. Asplenia is the only comorbidity for which all countries recommend vaccination. The great variability in European pneumococcal vaccination guidelines warrants European unification of the guidelines for better control of pneumococcal disease.
摘要：
肺炎球菌疾病构成了主要的全球健康问题。50岁以上的成年人和患有特定慢性健康状况的年轻人有患侵袭性肺炎球菌疾病的风险。与大量发病率和死亡率相关。在欧洲,两种疫苗类型用于成人肺炎球菌免疫:肺炎球菌多糖疫苗(PPV23)和肺炎球菌结合疫苗(PCV13).概述并比较欧洲成人肺炎球菌免疫的国家指南。2016年11月，谷歌搜索获得了31个欧洲国家成年人肺炎球菌疫苗接种的国家指南，欧洲疾病预防和控制中心的网站，并联系公共卫生官员。在我们的分析中,我们区分了基于年龄和基于风险的指南.2017年10月，我们使用相同的方法来检索指南更新。我们观察到年龄的差异很大，风险群体，疫苗类型,和使用助推器。在基于年龄的指南中，使用PPV23的65岁以上的成年人大多推荐接种疫苗。一般不推荐使用助推器。三个国家报告了疫苗接种的年龄上限。在免疫功能低下的人群中，主要推荐使用两种疫苗接种和加强剂。在患有慢性健康状况的人群中，根据疫苗类型有更多的异质性，序列,和助推器的管理。无脾是所有国家推荐接种疫苗的唯一合并症。欧洲肺炎球菌疫苗接种指南的巨大差异保证了欧洲统一指南以更好地控制肺炎球菌疾病。
