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Pneumococcal vaccine in adults

Angel Vila-Córcoles, Olga Ochoa-Gondar
There are currently two anti-pneumococcal vaccines available for use in adults: the classical 23-valent polysaccharide pneumococcal vaccine (PPV23) and the new 13-valent pneumococcal conjugate vaccine (PCV13). The main advantage of the PCV13 is the potentially better immunogenicity, with its major disadvantages being the higher cost and the lower serotype-coverage than the PPV23. The currently available scientific evidence supports the following basic recommendations: (i)among adults with greatest risk (basically asplenia and immunocompromised), a dual vaccination (PCV13+PPV23) is recommended; (ii)among adults with increased risk (basically persons >65years-old and patients 15-64years with chronic pulmonary or heart disease, diabetes and/or alcoholism), a single vaccination with PPV23 is recommended (single dose in primo-vaccinated >65years; re-vaccination at 5-10years in those primo-vaccinated <65years-old); and (iii) in the rest of adults (risk normal/low) vaccination is not recommended...
October 17, 2016: Atencion Primaria
Francesco Blasi, Murat Akova, Paolo Bonanni, Nathalie Dartois, Evelyne Sauty, Chris Webber, Antoni Torres
Pneumococcal pneumonia remains a clear unmet medical need for adults worldwide. Despite advances in vaccine technology, vaccination coverage remains low, putting many people at risk of significant morbidity and mortality. The herd effect seen with paediatric vaccination is not enough to protect all older and vulnerable people in the community, and more needs to be done to increase the uptake of pneumococcal vaccination in adults. Several key groups are at increased risk of contracting pneumococcal pneumonia, and eligible patients are being missed in clinical practice...
October 15, 2016: European Journal of Internal Medicine
Brenda Anna Kwambana-Adams, Franklin Asiedu-Bekoe, Badu Sarkodie, Osei Kuffour Afreh, George Khumalo Kuma, Godfred Owusu-Okyere, Ebenezer Foster-Nyarko, Sally-Ann Ohene, Charles Okot, Archibald Kwame Worwui, Catherine Okoi, Madikay Senghore, Jacob Kweku Otu, Chinelo Ebruke, Richard Bannerman, Kwame Amponsa-Achiano, David Opare, Gemma Kay, Timothy Letsa, Owen Kaluwa, Ebenezer Appiah-Denkyira, Victor Bampoe, Syed M A Zaman, Mark J Pallen, Umberto D'Alessandro, Jason M Mwenda, Martin Antonio
BACKGROUND: An outbreak of pneumococcal meningitis among non-infant children and adults occurred in the Brong-Ahafo region of Ghana between December 2015 and April 2016 despite the recent nationwide implementation of a vaccination programme for infants with the 13-valent pneumococcal conjugate vaccine (PCV13). METHODS: Cerebrospinal fluid (CSF) specimens were collected from patients with suspected meningitis in the Brong-Ahafo region. CSF specimens were subjected to Gram staining, culture and rapid antigen testing...
October 18, 2016: BMC Infectious Diseases
Richard K Zimmerman, Anthony E Brown, Valory N Pavlik, Krissy K Moehling, Jonathan M Raviotta, Chyongchiou J Lin, Song Zhang, Mary Hawk, Shakala Kyle, Suchita Patel, Faruque Ahmed, Mary Patricia Nowalk
OBJECTIVES: To test the effectiveness of a step-by step, evidence-based guide, the 4 Pillars Practice Transformation Program, to increase adult pneumococcal vaccination. DESIGN: Randomized controlled cluster trial (RCCT) in Year 1 (June 1, 2013 to May 31, 2014) and pre-post study in Year 2 (June 1, 2014 to January 31, 2015) with data analyzed in 2016. Baseline year was June 1, 2012, to May 31, 2013. Demographic and vaccination data were derived from deidentified electronic medical record extractions...
October 18, 2016: Journal of the American Geriatrics Society
Julia L Marcus, Roger Baxter, Wendy A Leyden, Dharushana Muthulingam, Arnold Yee, Michael A Horberg, Daniel B Klein, William J Towner, Chun R Chao, Charles P Quesenberry, Michael J Silverberg
It is unclear whether HIV-infected individuals remain at higher risk of invasive pneumococcal disease (IPD) compared with HIV-uninfected individuals. We conducted a cohort study of HIV-infected and demographically matched HIV-uninfected adults within Kaiser Permanente Northern California during the period 1996-2011. We used Poisson models to obtain rate ratios (RRs) for incident IPD associated with HIV infection and other risk factors. Among 13,079 HIV-infected and 137,643 HIV-uninfected adults, the IPD rate per 100,000 person-years was 160 (n = 109 events) for HIV-infected and 8 (n = 75 events) for HIV-uninfected subjects, with an adjusted RR of 13...
October 2016: AIDS Patient Care and STDs
Shalini Desai, Michelle E Policarpio, Kenney Wong, Jonathan Gubbay, Jill Fediurek, Shelley Deeks
BACKGROUND: In Ontario, pneumococcal conjugate vaccines (PCVs) have been sequentially introduced into the publicly funded childhood vaccination program since 2005. A 23-valent polysaccharide pneumococcal vaccine (PPV23) has been routinely recommended for adults aged 65 years and older since 1996. To determine the effect of herd immunity, we examined the epidemiology of invasive pneumococcal disease in adults aged 65 years and older. METHODS: Invasive pneumococcal disease is a provincially reportable disease...
July 2016: CMAJ Open
Anne L Wyllie, Lidewij W Rümke, Kayleigh Arp, Astrid A T M Bosch, Jacob P Bruin, Nynke Y Rots, Alienke J Wijmenga-Monsuur, Elisabeth A M Sanders, Krzysztof Trzciński
Carriage of Streptococcus pneumoniae in adults is rarely detected by the gold standard culture method. With molecular tests of high sensitivity now available, we analysed upper respiratory tract samples collected during autumn/winter 2012/2013 from parents of PCV7-vaccinated infants and from childless adults, directly comparing culture and qPCR-based S. pneumoniae detection. As compared to the gold standard of testing nasopharyngeal swabs, qPCR-based analysis of oral samples significantly improved detection of pneumococcal carriage (5% versus 20%, p < 0...
October 7, 2016: Scientific Reports
Young-Eun Kim, Ye-Rin Lee, So-Youn Park, Kyung Suk Lee, In-Hwan Oh
Background. Otitis media (OM) is a common communicable disease that is associated with a substantial economic burden. However, no Korean studies have evaluated OM-related trends after the introduction of the pneumococcal conjugate vaccines. Purpose. This study aimed to estimate the prevalence and economic burden of OM in Korea using nationally representative data. Methods. The burden of OM was estimated nationally representative data such as national health insurance claims data from 2012, based on the prevalence approach and the societal perspective...
2016: BioMed Research International
Charles Feldman, Ronald Anderson
Pneumococcal infections continue to cause significant morbidity and mortality in patients throughout the world. This microorganism remains the most common bacterial cause of community-acquired pneumonia and is associated with a considerable burden of disease and health-care costs in both developed and developing countries. Emerging antibiotic resistance has been a concern because of its potential negative impact on the outcome of patients who receive standard antibiotic therapy. However, there have been substantial changes in the epidemiology of this pathogen in recent years, not least of which has been due to the use of pneumococcal conjugate vaccines in children, with subsequent herd protection in unvaccinated adults and children...
2016: F1000Research
Barbara Rita Porchia, Paolo Bonanni, Angela Bechini, Gugliemo Bonaccorsi, Sara Boccalini
Pneumococcal infection is a public health concern that disproportionately affects the young, the elderly, and the immunocompromised. There is an open debate on the implementation of polysaccharide and/or conjugate vaccines for pneumococcal diseases in adults and the elderly in many countries. The aim of this paper is to systematically review the economic profile of pneumococcal vaccines in adults in terms of costs and benefits. Areas covered: The search for economic studies on pneumococcal vaccination was carried out in Pubmed, Embase, Scopus, and the HTA and NHS EED databases and through a manual search in journals dealing with economic evaluations...
October 12, 2016: Expert Review of Vaccines
Amalie Dyda, Surendra Karki, Andrew Hayen, C Raina MacIntyre, Robert Menzies, Emily Banks, John M Kaldor, Bette Liu
BACKGROUND: In the absence of an adult vaccination register, coverage estimates for influenza and pneumococcal vaccination come from surveys and other data sources. METHODS: Systematic review and meta-analysis of studies examining vaccination coverage in Australian adults from 1990 to 2015, focusing on groups funded under the National Immunisation Program, and intervals prior to and following the introduction of universal funding. RESULTS: Twenty-two studies met the inclusion criteria; 18 used self-report to determine vaccination status...
September 26, 2016: BMC Infectious Diseases
Erika Britz, Olga Perovic, Claire von Mollendorf, Anne von Gottberg, Samantha Iyaloo, Vanessa Quan, Verushka Chetty, Charlotte Sriruttan, Nazir A Ismail, Ananta Nanoo, Alfred Musekiwa, Carl Reddy, Karien Viljoen, Cheryl Cohen, Nelesh P Govender
INTRODUCTION: Meningitis is a major cause of mortality in southern Africa. We aimed to describe the aetiologies and frequencies of laboratory-confirmed fungal and bacterial meningitis among adults in a South African province with an 11% HIV prevalence, over 4 years. METHODS: We conducted a retrospective, observational study of secondary laboratory data, extracted on all cerebrospinal fluid (CSF) specimens submitted to public-sector laboratories in Gauteng province from 2009 through 2012...
2016: PloS One
Devrim Emel Alici, Abdullah Sayiner, Serhat Unal
Immunization is an important component of preventive healthcare services aiming to prevent and eventually eradicate infectious diseases by immunizing people before they become infected. Although immunization is an integral part of children's healthcare, this fact is underrated, even ignored in adults. In Turkey, adult immunization is available only for certain high risk groups such as health care professionals and populations aged >65 years and under certain conditions including pregnancy, military service, travel-pilgrimage, and employment procedures...
September 26, 2016: Human Vaccines & Immunotherapeutics
Momanna B Ahmed, Kanan Patel, Gregg C Fonarow, Charity J Morgan, Javed Butler, Vera Bittner, Andrzej Kulczycki, Raya E Kheirbek, Wilbert S Aronow, Ross D Fletcher, Cynthia J Brown, Ali Ahmed
AIMS: Octogenarians have the highest incidence of heart failure (HF) that is not fully explained by traditional risk factors. We explored whether lack of pneumococcal vaccination is associated with higher risk of incident HF among octogenarians. METHODS AND RESULTS: In the Cardiovascular Health Study (CHS), 5290 community-dwelling adults, ≥65 years of age, were free of baseline HF and had data on pneumococcal vaccination. Of these, 851 were octogenarians, of whom, 593 did not receive pneumococcal vaccination...
March 2016: ESC Heart Failure
Michal Chowers, Gili Regev-Yochay, Orna Mor, Ronit Cohen-Poradosu, Klaris Riesenberg, Oren Zimhony, Daniel Chemtob, Michal Stein, Ron Dagan, Itzchak Levy
STUDY AIM: to assess the incidence, risk factors and outcome of invasive pneumococcal disease (IPD) among the Israeli HIV population. A matched case-control study nested in a nationwide, prospective, population-based, cohort of adult IPD was performed. In addition, the HIV-IPD patients were compared to the general adult HIV population in Israel. STUDY PERIOD: from the introduction of PCV into the national immunization program (NIP) in July 2009 to June 2014. Each HIV patient within the IPD cohort was matched to four non-HIV controls...
September 20, 2016: Human Vaccines & Immunotherapeutics
Justin R Ortiz, Marc Perut, Laure Dumolard, Pushpa Ranjan Wijesinghe, Pernille Jorgensen, Alba Maria Ropero, M Carolina Danovaro-Holliday, James D Heffelfinger, Carol Tevi-Benissan, Nadia A Teleb, Philipp Lambach, Joachim Hombach
INTRODUCTION: The WHO recommends annual influenza vaccination to prevent influenza illness in high-risk groups. Little is known about national influenza immunization policies globally. MATERIAL AND METHODS: The 2014 WHO/UNICEF Joint Reporting Form (JRF) on Immunization was adapted to capture data on influenza immunization policies. We combined this dataset with additional JRF information on new vaccine introductions and strength of immunization programmes, as well as publicly available data on country economic status...
October 26, 2016: Vaccine
E Redondo, I Rivero, D A Vargas, E Mascarós, J L Díaz-Maroto, M Linares, J Valdepérez, A Gil, J Molina, I Jimeno, D Ocaña, F Martinón-Torres
INTRODUCTION: Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in adults. The annual incidence of CAP in adults in Spain ranges from 3 to 14 cases per 1,000 inhabitants. Current clinical guidelines primarily focus on the therapeutic approach to CAP rather than its prevention. The aim of this study is to develop and propose a practical guide for CAP prevention through vaccination in Spain according to available vaccines and evidence. METHODS: A literature review and expert opinion...
October 2016: Semergen
Jin Han, Shubha Bhat, Michel Gowhari, Victor R Gordeuk, Santosh L Saraf
Ambulatory care clinical pharmacy services have expanded beyond primary care settings, but literature supporting the benefits of clinical pharmacy involvement with patients who have rare diseases such as sickle cell disease (SCD) is lacking. Hydroxyurea is the only agent approved by the U.S. Food and Drug Administration for the treatment of SCD; full benefit in controlling pain episodes and other complications is achieved through monitored escalation to a maximum tolerated dose. The primary objective of this analysis was to evaluate the impact of a newly implemented clinical pharmacy service on the management of patients with SCD...
September 16, 2016: Pharmacotherapy
Han Wool Kim, Soyoung Lee, Kyung-Hyo Kim
Cross-reactivity of pneumococcal capsular polysaccharides is a key element for formulating pneumococcal vaccines and evaluating vaccine efficacy. This study examined whether 23-valent pneumococcal polysaccharide vaccine (PPSV23), which only contains 6B, can elicit cross-functional immune responses against recently discovered serotypes (6C and 6D), as well as against 6A, in 2 adult age groups.Young adults (25-51 years; N = 28) and elderly subjects (over 65 years; N = 60) were immunized with PPSV23. Functional antibody responses were determined in pre- and postimmune sera via multiplexed opsonophagocytic killing assay against serotypes 6A/B/C/D...
September 2016: Medicine (Baltimore)
Yan-Yang Zhang, Xue-Feng Tang, Chang-Hui Du, Bin-Bing Wang, Zhen-Wang Bi, Bi-Rong Dong
The purpose of this study was to perform a meta-analysis comparing the effectiveness of influenza vaccination alone versus influenza plus pneumococcal dual vaccination for the prevention of pneumonia and mortality in adults ≥ 65 years of age. Medline, Cochrane, CENTRAL, EMBASE, and Google Scholar databases were searched. Inclusion criteria were: 1) Randomized controlled trials (RCTs), 2-arm prospective studies, or retrospective cohort studies; 2) Patients were ≥ 65 years of age with or without chronic respiratory disease; 3) Patients received the influenza vaccine alone or dual pneumococcal and influenza vaccination; 4) Results included incidence of recurrent respiratory tract infections, length of hospital stay, and overall mortality rate...
September 14, 2016: Human Vaccines & Immunotherapeutics
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