Protective effects of the 23-valent pneumococcal polysaccharide vaccine in the elderly population: the EVAN-65 study.
Identifieur interne : 000596 ( Main/Exploration ); précédent : 000595; suivant : 000597Protective effects of the 23-valent pneumococcal polysaccharide vaccine in the elderly population: the EVAN-65 study.
Auteurs : Angel Vila-C Rcoles [Espagne] ; Olga Ochoa-Gondar ; Imma Hospital ; Xabier Ansa ; Angels Vilanova ; Teresa Rodríguez ; Carl LlorSource :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [ 1537-6591 ] ; 2006.
Descripteurs français
- KwdFr :
- Espagne (épidémiologie), Femelle (MeSH), Humains (MeSH), Mâle (MeSH), Pneumonie à pneumocoques (mortalité), Pneumonie à pneumocoques (prévention et contrôle), Pneumonie à pneumocoques (épidémiologie), Résultat thérapeutique (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Vaccins antipneumococciques (administration et posologie), Études de cohortes (MeSH), Études prospectives (MeSH).
- MESH :
- administration et posologie : Vaccins antipneumococciques.
- mortalité : Pneumonie à pneumocoques.
- prévention et contrôle : Pneumonie à pneumocoques.
- épidémiologie : Espagne, Pneumonie à pneumocoques.
- Femelle, Humains, Mâle, Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Études de cohortes, Études prospectives.
- Wicri :
- geographic : Espagne.
English descriptors
- KwdEn :
- Aged (MeSH), Aged, 80 and over (MeSH), Cohort Studies (MeSH), Female (MeSH), Humans (MeSH), Male (MeSH), Pneumococcal Vaccines (administration & dosage), Pneumonia, Pneumococcal (epidemiology), Pneumonia, Pneumococcal (mortality), Pneumonia, Pneumococcal (prevention & control), Prospective Studies (MeSH), Spain (epidemiology), Treatment Outcome (MeSH).
- MESH :
- chemical , administration & dosage : Pneumococcal Vaccines.
- geographic , epidemiology : Spain.
- epidemiology : Pneumonia, Pneumococcal.
- mortality : Pneumonia, Pneumococcal.
- prevention & control : Pneumonia, Pneumococcal.
- Aged, Aged, 80 and over, Cohort Studies, Female, Humans, Male, Prospective Studies, Treatment Outcome.
Abstract
BACKGROUND
The 23-valent polysaccharide pneumococcal vaccine (PPV) is currently recommended for elderly persons and persons who are at high risk of infection. However, the effectiveness of the 23-valent PPV remains controversial. We assessed the effectiveness of this vaccine in older adults.
METHODS
A prospective cohort study was conducted from January 2002 through April 2005; it included all community-dwelling individuals aged >or=65 years who were assigned to 1 of 8 primary health care centers in Tarragona, Spain (11,241 subjects). The primary outcomes were invasive pneumococcal disease, pneumococcal pneumonia, overall pneumonia rate, and death due to pneumonia. All cases were validated by a check of the clinical records. The association between pneumococcal vaccination and the risk of each outcome was evaluated by means of multivariate Cox proportional hazard models, adjusted for age, sex, comorbidity, immunocompetence, and influenza vaccine status.
RESULTS
Pneumococcal vaccination was associated with significant reductions in the risk of hospitalization for pneumonia (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.59-0.92) and in the overall pneumonia rate (HR, 0.79; 95% CI, 0.64-0.98). The incidence of invasive pneumococcal disease was low (64 cases per 100,000 person-years), and a considerable protective effect against invasive pneumococcal disease did not attain statistical significance (HR, 0.60; 95% CI, 0.22-1.65). However, the vaccine showed a significant effectiveness of 45% to prevent pneumococcal pneumonia (HR, 0.55; 95% CI, 0.34-0.88). Finally, vaccination was associated with a significant 59% reduction in the risk of death due to pneumonia among vaccinated subjects (HR, 0.41; 95% CI, 0.23-0.72).
CONCLUSIONS
These results indicate that the 23-valent PPV effectively prevented pneumococcal pneumonia (with or without bacteremia) and decreased the rates of overall pneumonia and of mortality due to pneumonia in older adults, providing new arguments for systematic vaccination in the elderly population.
DOI: 10.1086/507340
PubMed: 16941367
Affiliations:
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sort="Hospital, Imma" uniqKey="Hospital I" first="Imma" last="Hospital">Imma Hospital</name></author><author><name sortKey="Ansa, Xabier" sort="Ansa, Xabier" uniqKey="Ansa X" first="Xabier" last="Ansa">Xabier Ansa</name></author><author><name sortKey="Vilanova, Angels" sort="Vilanova, Angels" uniqKey="Vilanova A" first="Angels" last="Vilanova">Angels Vilanova</name></author><author><name sortKey="Rodriguez, Teresa" sort="Rodriguez, Teresa" uniqKey="Rodriguez T" first="Teresa" last="Rodríguez">Teresa Rodríguez</name></author><author><name sortKey="Llor, Carl" sort="Llor, Carl" uniqKey="Llor C" first="Carl" last="Llor">Carl Llor</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2006">2006</date><idno type="RBID">pubmed:16941367</idno><idno type="pmid">16941367</idno><idno type="doi">10.1086/507340</idno><idno type="wicri:Area/Main/Corpus">00588</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" 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à pneumocoques (prévention et contrôle)</term><term>Pneumonie à pneumocoques (épidémiologie)</term><term>Résultat thérapeutique (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Vaccins antipneumococciques (administration et posologie)</term><term>Études de cohortes (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Pneumococcal Vaccines</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Spain</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Vaccins antipneumococciques</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Pneumonia, Pneumococcal</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Pneumonia, Pneumococcal</term></keywords><keywords scheme="MESH" 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type="geographic" xml:lang="fr"><term>Espagne</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The 23-valent polysaccharide pneumococcal vaccine (PPV) is currently recommended for elderly persons and persons who are at high risk of infection. However, the effectiveness of the 23-valent PPV remains controversial. We assessed the effectiveness of this vaccine in older adults.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A prospective cohort study was conducted from January 2002 through April 2005; it included all community-dwelling individuals aged >or=65 years who were assigned to 1 of 8 primary health care centers in Tarragona, Spain (11,241 subjects). The primary outcomes were invasive pneumococcal disease, pneumococcal pneumonia, overall pneumonia rate, and death due to pneumonia. All cases were validated by a check of the clinical records. The association between pneumococcal vaccination and the risk of each outcome was evaluated by means of multivariate Cox proportional hazard models, adjusted for age, sex, comorbidity, immunocompetence, and influenza vaccine status.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Pneumococcal vaccination was associated with significant reductions in the risk of hospitalization for pneumonia (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.59-0.92) and in the overall pneumonia rate (HR, 0.79; 95% CI, 0.64-0.98). The incidence of invasive pneumococcal disease was low (64 cases per 100,000 person-years), and a considerable protective effect against invasive pneumococcal disease did not attain statistical significance (HR, 0.60; 95% CI, 0.22-1.65). However, the vaccine showed a significant effectiveness of 45% to prevent pneumococcal pneumonia (HR, 0.55; 95% CI, 0.34-0.88). Finally, vaccination was associated with a significant 59% reduction in the risk of death due to pneumonia among vaccinated subjects (HR, 0.41; 95% CI, 0.23-0.72).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>These results indicate that the 23-valent PPV effectively prevented pneumococcal pneumonia (with or without bacteremia) and decreased the rates of overall pneumonia and of mortality due to pneumonia in older adults, providing new arguments for systematic vaccination in the elderly population.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">16941367</PMID><DateCompleted><Year>2006</Year><Month>09</Month><Day>15</Day></DateCompleted><DateRevised><Year>2007</Year><Month>02</Month><Day>28</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1537-6591</ISSN><JournalIssue CitedMedium="Internet"><Volume>43</Volume><Issue>7</Issue><PubDate><Year>2006</Year><Month>Oct</Month><Day>01</Day></PubDate></JournalIssue><Title>Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</Title><ISOAbbreviation>Clin. Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>Protective effects of the 23-valent pneumococcal polysaccharide vaccine in the elderly population: the EVAN-65 study.</ArticleTitle><Pagination><MedlinePgn>860-8</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The 23-valent polysaccharide pneumococcal vaccine (PPV) is currently recommended for elderly persons and persons who are at high risk of infection. However, the effectiveness of the 23-valent PPV remains controversial. We assessed the effectiveness of this vaccine in older adults.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A prospective cohort study was conducted from January 2002 through April 2005; it included all community-dwelling individuals aged >or=65 years who were assigned to 1 of 8 primary health care centers in Tarragona, Spain (11,241 subjects). The primary outcomes were invasive pneumococcal disease, pneumococcal pneumonia, overall pneumonia rate, and death due to pneumonia. All cases were validated by a check of the clinical records. The association between pneumococcal vaccination and the risk of each outcome was evaluated by means of multivariate Cox proportional hazard models, adjusted for age, sex, comorbidity, immunocompetence, and influenza vaccine status.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Pneumococcal vaccination was associated with significant reductions in the risk of hospitalization for pneumonia (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.59-0.92) and in the overall pneumonia rate (HR, 0.79; 95% CI, 0.64-0.98). The incidence of invasive pneumococcal disease was low (64 cases per 100,000 person-years), and a considerable protective effect against invasive pneumococcal disease did not attain statistical significance (HR, 0.60; 95% CI, 0.22-1.65). However, the vaccine showed a significant effectiveness of 45% to prevent pneumococcal pneumonia (HR, 0.55; 95% CI, 0.34-0.88). Finally, vaccination was associated with a significant 59% reduction in the risk of death due to pneumonia among vaccinated subjects (HR, 0.41; 95% CI, 0.23-0.72).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">These results indicate that the 23-valent PPV effectively prevented pneumococcal pneumonia (with or without bacteremia) and decreased the rates of overall pneumonia and of mortality due to pneumonia in older adults, providing new arguments for systematic vaccination in the elderly population.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Vila-Córcoles</LastName><ForeName>Angel</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Primary Care Service of Tarragona-Valls, Catalonian Health Institute, Tarragona, 43001, Spain. avila.tarte.ics@gencat.net</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ochoa-Gondar</LastName><ForeName>Olga</ForeName><Initials>O</Initials></Author><Author ValidYN="Y"><LastName>Hospital</LastName><ForeName>Imma</ForeName><Initials>I</Initials></Author><Author ValidYN="Y"><LastName>Ansa</LastName><ForeName>Xabier</ForeName><Initials>X</Initials></Author><Author ValidYN="Y"><LastName>Vilanova</LastName><ForeName>Angels</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Rodríguez</LastName><ForeName>Teresa</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Llor</LastName><ForeName>Carl</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><CollectiveName>EVAN Study Group</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D018848">Controlled Clinical Trial</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2006</Year><Month>08</Month><Day>21</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Clin Infect Dis</MedlineTA><NlmUniqueID>9203213</NlmUniqueID><ISSNLinking>1058-4838</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C414006">23-valent pneumococcal capsular polysaccharide vaccine</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D022242">Pneumococcal Vaccines</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Clin Infect Dis. 2007 Feb 15;44(4):617; author reply 617-8</RefSource><PMID Version="1">17260423</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D022242" MajorTopicYN="N">Pneumococcal Vaccines</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011018" MajorTopicYN="N">Pneumonia, Pneumococcal</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N" Type="Geographic">Spain</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2006</Year><Month>04</Month><Day>19</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2006</Year><Month>06</Month><Day>01</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2006</Year><Month>8</Month><Day>31</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2006</Year><Month>9</Month><Day>16</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2006</Year><Month>8</Month><Day>31</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">16941367</ArticleId><ArticleId IdType="pii">CID39878</ArticleId><ArticleId IdType="doi">10.1086/507340</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Espagne</li></country><region><li>Catalogne</li></region></list><tree><noCountry><name sortKey="Ansa, Xabier" sort="Ansa, Xabier" uniqKey="Ansa X" first="Xabier" last="Ansa">Xabier Ansa</name><name sortKey="Hospital, Imma" sort="Hospital, Imma" uniqKey="Hospital I" first="Imma" last="Hospital">Imma Hospital</name><name sortKey="Llor, Carl" sort="Llor, Carl" uniqKey="Llor C" first="Carl" last="Llor">Carl Llor</name><name sortKey="Ochoa Gondar, Olga" sort="Ochoa Gondar, Olga" uniqKey="Ochoa Gondar O" first="Olga" last="Ochoa-Gondar">Olga Ochoa-Gondar</name><name sortKey="Rodriguez, Teresa" sort="Rodriguez, Teresa" uniqKey="Rodriguez T" first="Teresa" last="Rodríguez">Teresa Rodríguez</name><name sortKey="Vilanova, Angels" sort="Vilanova, Angels" uniqKey="Vilanova A" first="Angels" last="Vilanova">Angels Vilanova</name></noCountry><country name="Espagne"><region name="Catalogne"><name sortKey="Vila C Rcoles, Angel" sort="Vila C Rcoles, Angel" uniqKey="Vila C Rcoles A" first="Angel" last="Vila-C Rcoles">Angel Vila-C Rcoles</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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