Re: ‘Effects of 13-valent pneumococcal conjugate vaccination of adults on lower respiratory tract infections and antibiotic use in primary care’ by van Werkhoven et al

Abstract

Abstract In a secondary analysis from the Community Acquired Pneumonia immunization Trial in Adults (CAPiTA), van Werkhoven and colleagues evaluated vaccine efficacy (VE) of 13-valent pneumococcal conjugate vaccine (PCV13) for community-treated Lower Respiratory Tract Infections (LRTI) and community acquired pneumonia (CAP) outcomes among Dutch adults age ≥ 65 years. However, relative endpoints such as VE are useful for regulatory purposes to assess whether a vaccine works against a target outcome, usually one that is etiologically confirmed, rather than to measure immunization program efficiency. The latter is better quantified by absolute endpoints such as the vaccine preventable disease incidence (VPDI, also called the incidence rate reduction, calculated as the control group minus the intervention group incidences) and numbers needed to vaccinate (NNV). We have calculated both VPDI and NNV for the evaluated primary care outcomes and report impressive results, with PCV-associated VPDIs similar to those reported for pneumonia among children in The Gambia, South Africa, and Finland.