title: Effectiveness of a publicly funded pneumococcal vaccination program against invasive pneumococcal disease among the elderly in Victoria, Australia.
abstract: Within Australia, Victoria is the only jurisdiction where the 23-valent polysaccharide pneumococcal vaccine (23vPPV) has been publicly funded for the elderly (aged > or = 65 years). We compared age-specific rates of invasive pneumococcal disease (IPD) for periods before and after implementation of the program, and data from a comparable Australian population that does not have a funded program. Vaccine effectiveness (VE) was estimated using the screening and indirect cohort methods. Compared to the pre-program period, there was a 36% reduction in the reported rates of IPD among persons aged > or = 65 years. Adjusted for under-reporting in the referent rate, the decrease was equivalent to an annual reduction of 112 cases and an estimated 14 deaths among persons > or = 65 years. VE was 71% (95% CI 54-82) using the screening method and 79% (95% CI -14 to 96) by the indirect cohort method. Both point estimates were consistent with the VE expected among persons aged > or = 65 years, although the small number of isolates meant the indirect cohort method was inconclusive at the lower 95% confidence limit. Consideration should be given to publicly funding pneumococcal vaccine for this age group in other settings.
authors.affiliation: National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. ross.andrews@mcri.edu.au
authors.forename: Ross M
authors.initials: RM
authors.lastname: Andrews
authors.forename: Megan L
authors.initials: ML
authors.lastname: Counahan
authors.forename: Geoff G
authors.initials: GG
authors.lastname: Hogg
authors.forename: Peter B
authors.initials: PB
authors.lastname: McIntyre
mesh_terms: D000368:Aged; D001315:Australia / Q000453:epidemiology; D006801:Humans; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D011159:Population Surveillance; D011634:Public Health; D014611:Vaccination / Q000592:standards
chemical_list: C414006:23-valent pneumococcal capsular polysaccharide vaccine; D022242:Pneumococcal Vaccines