Log in with your email address username.

×

Attention doctorportal newsletter subscribers,

After December 2018, we will be moving elements from the doctorportal newsletter to MJA InSight newsletter and rebranding it to Insight+. If you’d like to continue to receive a newsletter covering the latest on research and perspectives in the medical industry, please subscribe to the Insight+ newsletter here.

As of January 2019, we will no longer be sending out the doctorportal email newsletter. The final issue of this newsletter will be distributed on 13 December 2018. Articles from this issue will be available to view online until 31 December 2018.

Impact of pneumococcal polysaccharide vaccine in people aged 65 years or older

- Featured Image

In reply: We agree with Collignon that pneumococcal conjugate vaccines (PCVs) are superior to polysaccharide pneumococcal vaccines (PPVs), and that the herd immunity impact of the PCV on older people is impressive. However, we do not agree that our study shows that the PPV is ineffective in older people, or that its use has resulted in an increase in disease.

The increases in disease due to serotypes not contained in the 7-valent PCV in the ≥ 65-year age group suggest an underlying increase in adults, probably because of serotype replacement driven by the PCV. The fact that these increases were greater in 50–64-year-olds, in whom PPV use was negligible, suggests an attenuating effect from the PPV. The estimate of effectiveness of the PPV in our study was 61%.

Decisions on the PPV’s continued use in older people will depend on several factors. These include disease rates in older adults due to serotypes covered by the PPV but not the 13-valent PCV, and any likely additional impact of PCV use in adults over and above the herd immunity impacts from PCV use in children.

email