We evaluated pneumococcal vaccine effectiveness in this multicenter, matched case-control study conducted in hospitals and clinics. Cases included patients (aged ≥ 65 years) newly diagnosed with CAP between October 2016 and September 2019. A maximum of five non-pneumonia control patients matched for sex, school grade, date of outpatient visit, and medical institution were selected for each case. Conditional logistic regression models were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of pneumococcal vaccines for the occurrence of all-cause CAP and pneumococcal CAP.
The analysis included 740 individuals (142 patients and 598 controls). The median age of participants was 75 years (men: 54%). The adjusted OR for pneumococcal vaccination against all-cause CAP was 1.31 (95% CI: 0.84-2.06), while that for PPSV23 vaccination in the previous 5 years was 1.33 (95% CI: 0.85-2.09). The adjusted OR for PPSV23 vaccination in the previous 5 years against pneumococcal CAP was 0.93 (95% CI: 0.35-2.50).
This study was unable to demonstrate the effectiveness of PPSV23 against all-cause and pneumococcal pneumonia after the introduction of childhood PCV13 in Japan. Nonetheless, additional studies are needed to validate these results.
我们在这个多中心评估了肺炎球菌疫苗的有效性,在医院和诊所进行的匹配病例对照研究。病例包括2016年10月至2019年9月期间新诊断为CAP的患者(年龄≥65岁)。最多五名性别匹配的非肺炎对照患者,学校年级,门诊就诊日期,并为每个病例选择医疗机构。使用条件逻辑回归模型计算肺炎球菌疫苗发生全因CAP和肺炎球菌CAP的比值比(ORs)和95%置信区间(CIs)。
分析包括740名个体(142名患者和598名对照)。参与者的平均年龄为75岁(男性:54%)。肺炎球菌疫苗针对全因CAP的校正OR为1.31(95%CI:0.84-2.06),而前5年PPSV23疫苗接种为1.33(95%CI:0.85-2.09)。前5年PPSV23疫苗接种对肺炎球菌CAP的校正OR为0.93(95%CI:0.35-2.50)。
这项研究无法证明PPSV23在日本引入儿童PCV13后对全因肺炎和肺炎球菌肺炎的有效性。尽管如此,需要更多的研究来验证这些结果.