title: Streptococcus pneumoniae vaccination in older adults.
abstract: BACKGROUND
  Streptococcus pneumoniae infections are a major cause of morbidity and mortality in older adults. Vaccination in older adults is intended to prevent S pneumoniae infections, yet little information is available regarding its efficacy in this patient population.
  
  
  OBJECTIVE
  The aim of this article was to review the current literature to determine the efficacy and tolerability of S pneumoniae vaccination in older adults.
  
  
  METHODS
  PubMed (1950-present) and EMBASE (1974-present) were searched using the search terms Streptococcus pneumoniae immunization, pneumococcus immunization, pneumococcus vaccine, and aged. Additional articles were identified from the reference lists of included studies. Studies were included if they reported information in older (55-<65 years) and elderly (≥65 years) adults and were related to at least 1 of the following topics: epidemiology of S pneumoniae, estimates of vaccine coverage, recommendations for vaccination, tolerability, and efficacy and/or effectiveness of vaccination against S pneumoniae.
  
  
  RESULTS
  Six randomized controlled trials and 18 observational studies that evaluated the efficacy of pneumococcal vaccination in older and elderly adults were reviewed. Findings from evaluations of efficacy, as measured by clinical outcomes and immunogenicity, in older adults have been conflicting, with some subsets of prospective, well-controlled studies finding little benefit, whereas findings from several retrospective studies have suggested significant benefit. This discord may have been a result of the limited power of the prospective subanalyses to detect significant differences.
  
  
  CONCLUSIONS
  In light of the potential clinical benefit and few reports of serious adverse events, vaccination in older adults is likely warranted. Prospective, well-controlled studies are needed to better quantitatively evaluate the benefit of pneumococcal vaccine in older adults.
authors: Department of Pharmacy, University of Rochester Medical Center, New York, USA.
authors: Elizabeth
authors: E
authors: Rightmier
authors: Vanessa
authors: V
authors: Stevens
authors: Jack
authors: J
authors: Brown
mesh_terms: D000367:Age Factors; D000368:Aged; D006801:Humans; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000009:adverse effects / Q000627:therapeutic use*; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control*; D014611:Vaccination / Q000009:adverse effects / Q000379:methods*
chemical_list: D022242:Pneumococcal Vaccines