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. 2019 Nov;51(9):571-578.
doi: 10.1016/j.aprim.2018.07.009. Epub 2018 Nov 1.

[Risk of pneumococcal disease in elderly patients with and without previous vaccination]

[Article in Spanish]
María Flores-Copete  1 , Ricardo Reolid-Martínez  1 , Mónica López-García  2 , Pilar Alcantud-Lozano  3 , Esther Mudarra-Tercero  3 , Milagros Azorín-Ras  3 , María Del Campo-Giménez  3 , M Candelaria Ayuso-Raya  1 , Francisco Escobar-Rabadán  4
Affiliations

[Risk of pneumococcal disease in elderly patients with and without previous vaccination]

[Article in Spanish]
María Flores-Copete et al. Aten Primaria. 2019 Nov.

Abstract
in English, Spanish

Objectives: To know the pneumococcal vaccination coverage in patients≥65 years old, as well as the risk of pneumococcal disease according to whether or not they received such vaccination.

Design: Cross-sectional study, followed by historical cohort.

Location: Urban area.

Participants: By systematic sampling, 2,805 people≥65 years from the city of Albacete were selected.

Main measurements: Dependent variable: diagnosis of pneumococcal disease and date.

Independent variables: age, sex, chronic pathologies, medication, pneumococcal vaccination and date. The computerized medical records were reviewed, from 1-1-2009 to October-December 2015. A descriptive analysis was carried out, the relative risk of the onset of pneumococcal disease according to vaccination has been calculated, and survival analysis has been carried out, with the statistical program SPSS 17.0.

Results: Median age 71 years; 57.2% were women; 46% received polysaccharide vaccine (95% CI 44.1-47.8). Only 10 people received conjugated vaccine. Twenty-two people were diagnosed with invasive pneumococcal disease and 153 non-invasive. The relative risk of pneumococcal disease in vaccinated versus unvaccinated, respectively for invasive and non-invasive, was 1.59 (95% CI 0.69-3.68) and 1.84 (95% CI 1.33-2.54). Cox regression showed a higher risk of non-invasive disease for COPD (1.95; 95% CI 1.32-2.89), smoking (1.87; 95% CI 1.28-2.73), corticoid-therapy (1.73; 95% CI 1.08-2.79), polysaccharide vaccination (141.41; 95% CI 5.92-3,378.49) and age (1.11; 95% CI 1.08-1.14), with interaction between these 2 (0.94, 95% CI 0.91-0.98).

Conclusions: There is an increased risk of pneumococcal disease in patients≥65 years vaccinated with polysaccharide, although with a protective effect in vaccinated older.

Objetivos: Conocer la cobertura vacunal antineumocócica en pacientes ≥ 65 años, así como el riesgo de enfermedad neumocócica según hayan o no recibido dicha vacunación.

Diseño: Estudio transversal, seguido de cohorte histórica.

Emplazamiento: Ámbito urbano.

Participantes: Se seleccionaron por muestreo sistemático 2.805 personas ≥ 65 años de la ciudad de Albacete.

Mediciones principales: Variable dependiente: diagnóstico de enfermedad neumocócica y fecha. Variables independientes: edad, sexo, enfermedades crónicas, medicación, vacunación antineumocócica y fecha. Se revisaron las historias clínicas informatizadas, de 1-1-2009 a octubre-diciembre de 2015. Se ha realizado un análisis descriptivo, se ha calculado el riesgo relativo de aparición de enfermedad neumocócica según la vacunación y se ha realizado un análisis de supervivencia con el programa estadístico SPSS 17.0.

Resultados: La mediana de edad era de 71 años; el 57,2% eran mujeres. Recibieron vacuna polisacárida el 46,0% (IC 95% 44,1-47,8). Solo 10 recibieron la conjugada. Fueron diagnosticadas de enfermedad neumocócica invasiva 22 personas, y de no invasiva, 153. El riesgo relativo de enfermedad neumocócica en vacunados frente a no vacunados, respectivamente para invasiva y no invasiva, era 1,59 (IC 95% 0,69-3,68) y 1,84 (IC 95% 1,33-2,54). Por regresión de Cox se demostró un mayor riesgo de enfermedad no invasiva para EPOC (1,95; IC 95% 1,32-2,89), tabaquismo (1,87; IC 95% 1,28-2,73), corticoterapia (1,73; IC 95% 1,08-2,79), vacunación polisacárida (141,41; IC 95% 5,92-3.378,49) y edad (1,11; IC 95% 1,08-1,14), con interacción entre estas 2 (0,94; IC 95% 0,91-0,98).

Conclusiones: Existe un mayor riesgo de presentar enfermedad neumocócica en pacientes ≥ 65 años vacunados con la polisacárida, si bien habría que considerar un efecto protector en los vacunados de mayor edad.

Keywords: Aged; Anciano; Infecciones neumocócicas; Neumonía neumocócica; Pneumococcal infections; Pneumococcal pneumonia; Streptococcus pneumoniae; Vaccination; Vacunación.

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Figures

None
Esquema general del estudio. Estudio transversal sobre el riesgo de enfermedad neumocócica en pacientes de edad igual o superior a 65 años, en función de si habían recibido o no vacunación previa.
Figura 1
Figura 1
Tiempo de seguimiento hasta la aparición de enfermedad neumocócica no invasiva en vacunados y no vacunados.
See this image and copyright information in PMC

Comment in

  • [Pneumococcal vaccine for adults over 65].
    López Gobernado M, Pérez-Rubio A, Eiros Bouza JM. López Gobernado M, et al. Aten Primaria. 2020 Dec;52(10):802-803. doi: 10.1016/j.aprim.2019.12.007. Epub 2020 Mar 5. Aten Primaria. 2020. PMID: 32147234 Free PMC article. Spanish. No abstract available.

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References

    1. Falcó V., Burgos J. Neumonía neumocócica: cambios epidemiológicos, diagnósticos y terapéuticos. Enferm Infecc Microbiol Clin. 2011;29:247–249. - PubMed
    1. Guevara M., Barricarte A., Pérez B., Arriazu M., García Cenoz M., Castilla J. La vacuna neumocócica conjugada heptavalente (Prevenar™). Diferencias en su efectividad en distintas poblaciones. An Sist Sanit Navar. 2008;31:171–192. - PubMed
    1. Durando P., Faust S.N., Fletcher M., Krizova P., Torres A., Welte T. Experience with pneumococcal polysaccharide conjugate vaccine (conjugated to CRM197 carrier protein) in children and adults. Clin Microbiol Infect. 2013;19(Suppl 1):1–9. - PubMed
    1. Blasi F., Mantero M., Santus P.A., Tarsia P. Understanding the burden of pneumococcal disease in adults. Clin Microbiol Infect. 2012;18(Suppl 5):7–14. - PubMed
    1. Jackson L.A., Gurtman A., Rice K., Pauksens K., Greenberg R.N., Jones T.R. Immunogenicity and safety of a 13-valent pneumococcal conjugate vaccine in adults 70 years of age and older previously vaccinated with 23-valent pneumococcal polysaccharide vaccine. Vaccine. 2013;31:3585–3593. - PubMed

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