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. 2025 Dec;21(1):2515760.
doi: 10.1080/21645515.2025.2515760. Epub 2025 Jul 9.

Clinical burden of pneumococcal disease among adults in France: A retrospective cohort study

M Doyinsola Bailey  1 , Gaëlle Farge  2 , Salini Mohanty  1 , Manon Breau-Brunel  2 , Gem Roy  3 , Gérard de Pouvourville  4 , Benoit de Wazieres  5 , Cécile Janssen  6 , Solenne Tauty  7 , Françoise Bugnard  7 , Mélanie Goguillot  7 , Stève Bénard  7 , Kelly D Johnson  1
Affiliations

Clinical burden of pneumococcal disease among adults in France: A retrospective cohort study

M Doyinsola Bailey et al. Hum Vaccin Immunother. 2025 Dec.

Abstract

Pneumococcal disease (PD) is associated with high morbidity and mortality, specifically among individuals ≥65 years of age and those with underlying medical conditions (UMCs). This retrospective cohort study estimated the clinical burden of PD in adults ≥18 years of age with or without UMCs in France. Data were obtained from the French National Health Data System for four yearly cohorts (1 January 2015-31 December 2018). Characteristics of patients with UMCs, with or without PD (UMC population), and the incidence rate and lethality rate of PD leading to hospitalization (in-patient PD population), stratified by age and risk status, were described. In the UMC population (n = 7,947,622; mean age: 65 years), the incidence rate of in-patient PD episodes was 121.98 per 100,000 person-years and was highest among individuals ≥65 years of age (138.52) and in those considered medium-risk (102.45) or high-risk (165.77). In the in-patient PD population (n = 41,885), 59.6% were ≥65 years of age; 1-year all-cause mortality following the initial in-patient PD episode was 26.5%. Individuals ≥65 years of age (regardless of risk status) had a higher risk of PD leading to hospitalization than individuals 18-64 years of age. This study shows a high burden of PD in France due to in-patient PD among adults with UMCs, particularly in those ≥65 years of age, despite their eligibility for pneumococcal vaccination. This highlights the need for higher vaccination coverage, supported by the recent extension of vaccination to all people ≥65 years of age, regardless of their health risk status.

Keywords: Invasive pneumococcal disease; clinical burden; fatality; incidence; mortality; non-bacteremic pneumococcal pneumonia; older adults; pneumococcal conjugate vaccine.

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Conflict of interest statement

M.D., S.M., G.R., and K.D.J. are employees of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, who may own stock and/or stock options in Merck & Co., Inc., Rahway, NJ, USA. G.F. and M.B.-B are employees of MSD, France, who may own stock and/or stock options in Merck & Co., Inc., Rahway, NJ, USA. G.de.P. and B.de.W. have received honoraria for participation in the Scientific Committee of this study. C.J. reports fees for board membership from AstraZeneca, Pfizer, and MSD. S.T., F.B., and M.G. are employees of stève consultants, a Cytel company, which has a research consultancy contract with Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. S.B. is Executive Manager of stève consultants, a Cytel company, which has a research consultancy contract with Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA.

Figures

Figure 1.
Figure 1.
Population identification of (a) the UMC population and (b) the in-patient PD population.
Figure 2.
Figure 2.
Distribution of risk groups stratified by age category in the overall population.
Figure 3.
Figure 3.
(a) All-cause and (b) pneumococcal disease-related mortality within a year of first episode among the in-patient pneumococcal disease population.
See this image and copyright information in PMC

References

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