The Community-Acquired Pneumonia immunization Trial in Adults (CAPiTA): what is the future of pneumococcal conjugate vaccination in elderly?
Pneumococcal community-acquired pneumonia (PCAP) and invasive pneumococcal disease (IPD) are important causes of morbidity and mortality in elderly. In the Community-Acquired Pneumonia immunization Trial in Adults (CAPiTA), a randomized double-blind placebo-controlled trial of 84,496 community-dwelling immunocompetent adults over 65 years of age, the 13-valent pneumococcal conjugate vaccine (PCV13) reduced the incidence of first episode of vaccine-type (VT) PCAP with 38 and of VT-IPD with 76% in the modified intention-to-treat population. In The Netherlands, where PCV7 immunization of newborns was introduced in 2007 and replaced by PCV10 in 2011, introduction of PCV13 immunization of elderly--based on 2012 data--would be highly cost effective. However, this is probably different in countries where the VT disease burden has declined more, for instance due to herd effects following child immunization with PCV13. Apart from cost-effectiveness analyses, ethical aspects of PCAP prevention should be taken into account in policy making for pneumococcal vaccination in elderly.
Julius Center for Health Sciences & Primary Care, University Medical Center Utrecht, The Netherlands.
Cornelis H
CH
van Werkhoven
Julius Center for Health Sciences & Primary Care, University Medical Center Utrecht, The Netherlands.|Department of Medical Microbiology, University Medical Center Utrecht, The Netherlands.
Marc J M
MJ
Bonten
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000382:microbiology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D000069443:Heptavalent Pneumococcal Conjugate Vaccine / Q000008:administration & dosage; D006801:Humans; D007121:Immunocompetence; D015994:Incidence; D009426:Netherlands; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000191:economics; D011018:Pneumonia, Pneumococcal / Q000382:microbiology / Q000517:prevention & control*; D013296:Streptococcus pneumoniae / Q000276:immunology; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000191:economics
C538862:13-valent pneumococcal vaccine; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
community-acquired pneumonia; elderly; invasive pneumococcal disease; pneumococcal conjugate vaccine; prevention