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Multicenter Study
. 2013 Apr;9(4):865-73.
doi: 10.4161/hv.23090. Epub 2013 Apr 1.

Effectiveness of vaccination with 23-valent pneumococcal polysaccharide vaccine in preventing hospitalization with laboratory confirmed influenza during the 2009-2010 and 2010-2011 seasons

Angela Domínguez  1 , Jesús Castilla, Pere Godoy, Miguel Delgado-Rodríguez, Marc Saez, Núria Soldevila, Jenaro Astray, José María Mayoral, Vicente Martín, José María Quintana, Fernando González-Candelas, Juan Carlos Galán, Sonia Tamames, Ady Castro, Maretva Baricot, Olatz Garín, Tomas Pumarola; CIBERESP Cases and Controls in Pandemic Influenza Working Group (Spain)
Collaborators, Affiliations
Multicenter Study

Effectiveness of vaccination with 23-valent pneumococcal polysaccharide vaccine in preventing hospitalization with laboratory confirmed influenza during the 2009-2010 and 2010-2011 seasons

Angela Domínguez et al. Hum Vaccin Immunother. 2013 Apr.

Abstract

Background: Since influenza predisposes to bacterial pneumonia caused by Streptococcus pneumoniae, studies have suggested that pneumococcal vaccination might reduce its occurrence during pandemics. We assessed the effectiveness of pneumococcal polysaccharide vaccination alone and in combination with influenza vaccination in preventing influenza hospitalization during the 2009-2010 pandemic wave and 2010-2011 influenza epidemic.

Results: 1187 cases and 2328 controls were included. The adjusted estimate of effectiveness of pneumococcal vaccination in preventing influenza hospitalization was 41% (95% CI 8-62) in all patients and 43% (95% CI 2-78) in patients aged ≥ 65 y. The adjusted effectiveness of dual PPV23 and influenza vaccination was 81% (95% CI 65-90) in all patients and 76% (95% CI 46-90) in patients aged ≥ 65 y. The adjusted effectiveness of influenza vaccination alone was 58% (95% CI 38-72).

Methods: We conducted a multicenter case-control study in 36 Spanish hospitals. We selected patients aged ≥ 18 y hospitalized with confirmed influenza and two hospitalized controls per case, matched according to age, date of hospitalization and province of residence. Multivariate analysis was performed using conditional logistic regression. Subjects were considered vaccinated if they had received the pneumococcal or seasonal influenza vaccine>14 d (or>7 d for pandemic influenza vaccine) before the onset of symptoms (cases) or the onset of symptoms in matched cases (controls).

Conclusions: In elderly people and adults with chronic illness, pneumococcal vaccination may reduce hospitalizations during the influenza season. In people vaccinated with both the influenza and pneumococcal vaccines, the benefit in hospitalizations avoided was greater than in those vaccinated only against influenza.

Keywords: effectiveness; hospitalization; influenza vaccine; laboratory-confirmed influenza; pneumococcal polysaccharide vaccine.

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Figure 1. Flowchart of patients included in the study.
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