Does the pneumococcal vaccine benefit nursing home residents?

January 01, 0001

Does the pneumococcal vaccine benefit nursing home residents?

The pneumococcal vaccine is recommended especially in elderly populations, but just how beneficial is it? These Japanese and US researchers sought to determine the efficacy of a 23-valent pneumococcal polysaccharide vaccine in nursing home residents in Japan, a population at high risk of pneumococcal pneumonia. They performed a prospective, randomized, placebo controlled double blind study enlisting 1006 nursing home residents. The residents were randomized to either 23-valent pneumococcal polysaccharide vaccine (n=502) or placebo (n=504). The primary end points were pneumonia and pneumococcal pneumonia. Secondary end points were deaths from pneumococcal pneumonia, all cause pneumonia, and any other causes.

The researchers report: "Pneumonia occurred in 63 (12.5%) participants in the vaccine group and 104 (20.6%) in the placebo group. Pneumococcal pneumonia was diagnosed in 14 (2.8%) participants in the vaccine group and 37 (7.3%) in the placebo group. All cause pneumonia and pneumococcal pneumonia were significantly more frequent in the placebo group than in the vaccine group: incidence per 1000 person years 55 v 91 and 12 v 32, respectively. Death from pneumococcal pneumonia was significantly higher in the placebo group than in the vaccine group (35.1% (13/37) v 0% (0/14). The death rate from all cause pneumonia (vaccine group 20.6% (reduced 13/63) v placebo group 25.0% (26/104)) and from other causes (vaccine group 17.7% (89/502) v placebo group (80/504) 15.9%) did not differ between the two study groups."

The authors concluded: "The 23-valent pneumococcal polysaccharide vaccine prevented pneumococcal pneumonia and mortality from pneumococcal pneumonia in nursing home residents."

This trial found the 23-valent pneumococcal polysaccharide vaccine was protective for pneumococcal pneumonia, pneumonia in general, and deaths from pneumococcal pneumonia, but did not show an overall drop in pneumonia mortality.

For the full abstract, click here.

BMJ 340:c1004, 8 March 2010 © 2010 Maruyama et al.
Efficacy of 23-valent pneumococcal vaccine in preventing pneumonia and improving survival in nursing home residents: double blind, randomised and placebo controlled trial. Takaya Maruyama, Osamu Taguchi, Michael S Niederman, et al.. Correspondence to E C Gabazza: [email protected]

Category: B. Blood/Immune Mechanisms, R. Respiratory. Keywords: pneumococcal vaccine, pneumonia, pneumococcal pneumonia, elderly, nursing home residents, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 6 April 2010 2010

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