Effectiveness of pneumococcal polysaccharide vaccine against pneumonia and cost analysis for the elderly who receive seasonal influenza vaccine in Japan.
To determine the clinical efficacy and cost-saving effect of pneumococcal polysaccharide vaccine (PPV) against community-acquired pneumonia (CAP), an open-label, randomized clinical trial was conducted involving 786 Japanese subjects older than 65 years of age receiving a routine influenza vaccine during the 2-year period. Study subjects were randomly assigned to either a PPV group (n=394) or to a non-PPV group (n=392). The incidence, admission and the medical cost for all-cause pneumonia were compared between these two groups. PPV vaccination significantly reduced the incidence of admission for all-cause pneumonia for subjects older than 75 years of age (41.5%, P=0.039) and for those who had difficulty walking (62.7%, P=0.005), but not for all study subjects older than 65 years of age (P=0.183), for the 2-year period. The Kaplan-Meier survival curves for subjects who had difficulty walking free from all-cause pneumonia demonstrated a significant difference (P=0.0146) between the two groups. PPV vaccination significantly reduced medical costs for all study subjects during the first year period (P=0.027). Our present data demonstrated that PPV was effective for all-cause pneumonia for study subjects older than 75 years of age, although the effect was not significant for all study subjects older than 65 years of age.
Kawakami
Kenji
K
Department of Respiratory Medicine, Nagasaki Kawatana Medical Center, Japan.
Ohkusa
Yasushi
Y
Kuroki
Reiki
R
Tanaka
Takeshi
T
Koyama
Kazuhiko
K
Harada
Yoshitaka
Y
Iwanaga
Kouichi
K
Yamaryo
Takeshi
T
Oishi
Kazunori
K
D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D003365:Costs and Cost Analysis; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D015994:Incidence; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D022242:Pneumococcal Vaccines / Q000191:economics / Q000276:immunology*; D011018:Pneumonia, Pneumococcal / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*
D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines