Pneumococcal Vaccine In Patients Research Articles

Pneumococcal Vaccination Rates and Associated Meningitis Events in Patients With Acute Cerebrospinal Fluid Leak.

To characterize the institutional utilization of pneumococcal vaccination during an index hospital admission for acute cerebrospinal fluid (CSF) leakage and associated infectious and clinical outcomes. This retrospective cohort study included patients hospitalized and treated for an acute CSF leak from January 2017 to June 2022. The primary outcome evaluated the incidence of pneumococcal vaccination during the index admission in patients without prior vaccination. Secondary outcomes evaluated the incidence of meningitis, time from CSF leak identification to meningitis, and mortality within 1 year of the index admission. A total of 94 patients were included. Nineteen (20.2%) patients received pneumococcal vaccination prior to admission. Of the 75 patients without prior vaccination, 4 (5.3%) patients received vaccination during the admission. Meningitis occurred in 5/94 (5.3%) patients and occurred 4-24 days from CSF leak identification. Mortality was observed in 9/94 (9.6%) patients. None of the meningitis cases were attributed to culture-positive findings of pneumococcal disease. The results of this study demonstrate an overall low institutional utilization of pneumococcal vaccination in patients with an acute CSF leak. Infectious and clinical outcomes reflected comparable to previous reported literature. Further evaluation into the risk-benefit relationship of vaccination omission is warranted in this patient population.

Assessment Of Knowledge And Practices Of Influenza And Pneumococcal Vaccination Among Type 1 And Type 2 Diabetes Patients In Bewal International Hospital

Patients with diabetes have high risk of developing pneumococcal and influenza infections and are advised to take immunization for prevention against the disease. Objective: To determine the level of awareness and immunization behaviors for influenza and pneumonia among patients with type 1 and type 2 diabetes received treatment at Bewal International Hospital, Gujar Khan. Methods: This cross-sectional study was performed at the diabetic clinic of Bewal International Hospital, Gujar Khan, from June 2023 to August 2023. A total of 200 patients with diabetes were included in the study. Socio-demographic details were noted on a pre-structured questionnaire. Questions about knowledge and practices of vaccination particularly influenza and pneumococcal were asked and responses were noted. Results: The mean age of the patients was 47.0 ± 1.18 years. 193 (96.5%) had poor knowledge regarding influenza and pneumococcal infections and their vaccines. An alarming 99% of the people did not have any clue about any vaccination against pneumococcal and influenza infection in patients with diabetes. Similarly, only 1.0% of patients had good practices regarding these vaccinations. Conclusions: The knowledge and practice of influenza and pneumococcal vaccination in patients with diabetes is drastically low in the study population. The health care providers should educate the patients and the government should take concrete steps towards education and improvement of the socioeconomic condition of people along with cost-effectiveness and availability of vaccines for every individual

Protective Effects from Prior Pneumococcal Vaccination in Patients with Chronic Airway Diseases during Hospitalization for Influenza-A Territory-Wide Study.

Influenza is an important respiratory viral pathogen in adults, with secondary bacterial pneumonia being a common complication. While pneumococcal vaccines can prevent pneumococcal pneumonia and invasive pneumococcal disease, whether they can also prevent the severe in-hospital outcomes among patients hospitalized for influenza has not been examined. A territory-wide retrospective study was conducted in Hong Kong, which included all adult patients having chronic airway diseases (asthma, bronchiectasis, and chronic obstructive pulmonary disease) hospitalized for influenza and who had received seasonal influenza vaccine. The occurrence of secondary bacterial pneumonia, mortality, and other severe in-hospital outcomes were compared among subjects with or without pneumococcal vaccination. There was a total of 3066 eligible patients who were hospitalized for influenza in public hospitals in Hong Kong from 1 January 2016 to 30 June 2023. Completed pneumococcal vaccination with PSV23/PCV13 conferred protection against secondary bacterial pneumonia, all-cause mortality, and respiratory cause of mortality with adjusted odds ratios of 0.74 (95% CI = 0.57-0.95, p = 0.019), 0.12 (95% CI = 0.03-0.53, p = 0.005), and 0.04 (95% CI = 0.00-0.527, p = 0.0038), respectively.

Influenza and pneumococcal vaccination in patients with COPD from 3 French cohorts: Insufficient coverage and associated factors

BackgroundLow vaccination rates against influenza and Streptococcus (S.) pneumoniae infections in COPD could impair outcomes. Understanding underlying factors could help improving implementation. ObjectivesTo describe vaccination rates at inclusion in COPD cohorts and analyze associated factors. MethodsBetween 2012 and 2018, 5927 patients with sufficient data available were recruited in 3 French COPD cohorts (2566 in COLIBRI-COPD, 2653 in PALOMB and 708 in Initiatives BPCO). Data at inclusion were pooled to describe vaccination rates and analyze associated factors. ResultsMean age was 66 years, 34 % were women, 35 % were current smokers, mean FEV1 was 58 % predicted, 22 % reported ≥2 exacerbations in the year prior to inclusion, mMRC dyspnea grade was ≥2 in 59 %, 52 % had cardiovascular comorbidities and 9 % a history of asthma. Vaccinations rates in the year prior to study entry were 34.4 % for influenza + S. pneumoniae, 17.5 % for influenza alone and 8.9 % for S. pneumoniae alone. In multivariate analyses, influenza vaccination rate was greater in older age, smoking status, low FEV1, exacerbation history, mMRC dyspnea>2, asthma history, hypertension, diabetes mellitus, and the year of inclusion. SP vaccination was associated with type of practice of the respiratory physician, age, smoking status, FEV1, exacerbation history, dyspnea grade, asthma history and the year of inclusion. ConclusionRates of vaccination against influenza and S. pneumoniae infection at inclusion in COPD cohorts remain insufficient and vaccination appears restricted to patients with specific features especially regarding severity and comorbidities, which is not consistent with current recommendations.

Determinants of uptake of influenza, zoster and pneumococcal vaccines in patients with cardiovascular diseases

BackgroundGlobally, cardiovascular disease (CVD) is the leading cause of death and illness. Vaccine-preventable infections may increase acute coronary vascular disease events and the risk of complications. Low vaccine coverage has been reported among adults at high risk of complications from vaccine-preventable infections. There is a gap in research evidence around determinants of uptake of vaccines among adults with CVD. This study examined the uptake of influenza, pneumococcal and zoster vaccines and the determinants of uptake of the vaccines among cardiac patients. MethodA prospective cross-sectional study was carried out among hospitalised cardiac patients through an interviewer-administered questionnaire. Descriptive statistics were used to investigate self-reported uptake of influenza, pneumococcal and zoster vaccines. Univariate and multivariate analyses of participants' social demographic and clinical characteristics were conducted to identify factors for receiving influenza vaccine. ResultsLow vaccination rates among 104 participants were found for influenza (45.2%), pneumococcal (13.5%) and zoster (5.8%) vaccines. The most common reason for not receiving influenza vaccine was concern about side effects. Lack of awareness about the pneumococcal and zoster vaccines was the main reason for the poor uptake of these vaccines. Australia–born participants were more likely to receive influenza vaccine than overseas-born participants. Working-age participants and, interestingly, people living with a current smoker were less likely to receive influenza vaccine. ConclusionInfluenza, pneumococcal and zoster vaccine uptake among cardiac patients was low. Encouraging physician recommendations for vaccination for cardiac patients under 65 years of age and addressing vaccination challenges among people from culturally and linguistically diverse backgrounds and pharmacy, workplace, and hospital vaccination may help increase vaccination uptake among cardiac patients.

Immunogenicity and Safety of 13-valent Conjugated Pneumococcal Vaccine in Patients with Rheumatoid Arthritis

Immunogenicity and Safety of 13-valent Conjugated Pneumococcal Vaccine in Patients with Rheumatoid Arthritis

Experience with 23-valent pneumococcal polysaccharide vaccine in patients with ankylosing spondylitis and psoriatic arthritis

Pneumococcus plays a primary role as a causative agent of pneumonia both in the general population and in patients with immuno-inflammatory rheumatic diseases (IVRS), including spondylarthritis (SpA). However, data on the immunogenicity, efficacy and safety of pneumococcal vaccines in patients with SpA are limited.The aim of the study. To study the immunogenicity, efficacy and safety of the 23-valent pneumococcal polysaccharide vaccine (PPV-23) in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA), observed at the V.A. Nasonova Research Institute (Moscow, Russia).Materials and methods. 145 people were included in the study: 51 patients with AS, 25 with PsA, 69 in control group (СG) without IVR. The majority of patients (65.8%) received immunosuppressive therapy. PPV-23 was administered in an amount of one dose (0.5 ml) subcutaneously against the background of antirheumatic therapy, regardless of the activity of the main IVR. The level of antibodies (AT) to pneumococcal capsular polysaccharide was determined using the EIA PCP IgG kit (TestLine Clinical Diagnostics, Czech Republic) before vaccination and 1, 3 and 12 months after it. The clinical efficacy and safety of PPV-23 were also evaluated, including the effect on the activity of AS and PsA according to the dynamics of BASDAI and DAPSA indices.Results. After 1, 3 and 12 months after vaccination, the concentration of pneumococcal AT was significantly higher compared to baseline values, which indicates sufficient immunogenicity of PPV-23. The clinical efficacy of PPV-23 in patients with AS and PsA was 98.7%. In general, there was no negative effect of vaccination on the activity of the underlying disease. The frequency of postvaccinal reactions in patients and in СG was comparable.Conclusions. The obtained results of the study indicate sufficient immunogenicity, clinical efficacy and safety of PPV-23 in patients with AS and Ps A.

Influenza and pneumococcal vaccination coverage and associated factors in patients hospitalized with acute exacerbations of COPD in China: Findings from the real-world data.

Influenza and pneumococcal vaccination are a priority in patients with chronic obstructive pulmonary disease (COPD). However, limited information is available on vaccination coverage among patients with acute exacerbations of COPD (AECOPD) in China. This study aimed to determine the rates and associated factors of influenza and pneumococcal vaccination in patients hospitalized with AECOPD. Baseline data from a national, multicenter, hospital-based study that included adult inpatients with AECOPD between 2017 and 2021 were analyzed. The outcomes of interest were the influenza vaccination in the past year and the pneumococcal vaccination in the past 5 years. To ensure national representativeness, rates were weighted according to the distribution of hospital levels and types enrolled in this study. Multivariable Poisson regression based on mixed-effects models were used to determine the associated factors. The independent variables included the region and hospital features where the participants were located, sociodemographic characteristics (age, sex, rural/urban residence, education, etc.), and clinical indicators (COPD disease history, lung function parameters, comorbidities, etc.). The treatment profiles of the vaccinated and unvaccinated participants were compared. Of 6949 eligible participants, the weighted rates of influenza/pneumococcal, influenza, and pneumococcal vaccination were 2.72% (95% confidence interval [CI]: 2.34-3.10%), 2.09% (95% CI: 1.76-2.43%), and 1.25% (95% CI: 0.99-1.51%), respectively. In multivariable models, age ≥60 years (60-69 years, odds ratio [OR]: 1.90, 95% CI: 1.11-3.25; ≥80 years, OR: 2.00, 95% CI: 1.06-3.78), geographical regions (Northern China relative to Eastern China, OR: 5.09, 95% CI: 1.96-13.21), urban residence (OR: 1.69, 95% CI: 1.07-2.66), a higher education level (junior high school, OR: 1.77, 95% CI: 1.21-2.58; senior high school or above, OR: 2.61, 95% CI: 1.69-4.03), former smoking (OR: 1.79, 95% CI: 1.15-2.79), and regular inhaled medication treatment (OR: 3.28, 95% CI: 2.29-4.70) were positively associated with vaccination. Patients who had experienced severe exacerbations in the past year were less likely to be vaccinated (OR: 0.65, 95% CI: 0.45-0.96). Compared with unvaccinated participants, vaccinated participants adhered better to pharmacological and non-pharmacological treatment. Influenza and pneumococcal vaccination coverage are extremely low. Urgent measures are necessary to increase vaccination coverage among inpatients with AECOPD in China.

Healthcare Providers' Adherence to Recommended Pneumococcal and Influenza Vaccination in Patients Discharged with Respiratory Diseases from General Medical Wards.

The periodic assessment of adherence to vaccination recommendations is an essential component of any vaccination process. This study aimed to investigate the adherence of healthcare providers to the international recommendations on influenza and pneumococcal vaccine in patients discharged from the internal medicine department with respiratory diseases. All medical records of adult patients who are 18 years of age and older with respiratory illnesses and who were discharged in January-February, May-June, and October-November of 2018 were retrospectively analyzed. A total of 264 discharge summaries from 190 patients were included in this analysis. The mean age was 55.5 years, with 54.7% of them being males. Pneumonia was the leading cause of hospitalization (63.7%), followed by asthma or chronic obstructive pulmonary disease (COPD) exacerbation (27.4%). None of the discharged patients had immunization recommendations at discharge or a documented immunization request within 6 months of discharge from the hospital. The findings of this study demonstrated that healthcare providers need to pay more attention to adhering to the global recommendations on influenza and pneumococcal vaccine among patient who were recently discharged with respiratory disease. Additional measures are needed to improve adherence to routinely recommended vaccines among adults with respiratory diseases.

P601 Pneumococcal vaccination in patients with immunomediated inflammatory diseases (IMIDs) using a real-world multidisciplinary project

Abstract Background Vaccination is a crucial element in managing patients with IMIDs, however rates of vaccination remains suboptimal. This study assessed the adherence to pneumococcal vaccination. Methods A prospective cohort study was conducted between January 2020 and December 2021. Vaccine prescription and adherence were assessed during an Infectious Diseases (ID) consultation. Were considered pneumococcal conjugate (PCV13) and polysaccharide (PPS23) vaccines. Results There were 262 patients included (215 with inflammatory bowel disease and 47 with rheumatological diseases), 136 (52%) were male, median age was 41±15 years and 167 (64%) were on immunossuppresive therapy. At baseline, 26 (10%) patients were fully vaccinated against pneumococcal disease and for 236 (90%) vaccination was prescribed as such: PCV13 followed by PPSV23 in 86 (36%) patients, PCV13 in 126 (54%) and PPSV23 in 24 (10%). Adherence to PCV13 occurred in 185 (87%) patients and to PPSV23 in 76 (69%). In patients with both vaccines prescribed (n=86), 57 (66%) had complete adherence and the remaining had at least one of them. In this group (n=86), patients with complete adherence were older than the remaining (45±17 vs. 38±12 years, p=0.03) but no difference was found concerning the baseline disease. After the ID consultation, 175 patients from 236 (74%) became fully vaccinated against pneumococcal disease. Conclusion A multidisciplinary approach and adequate local interventions shall be considered to improve vaccine adherence. ID physicians can play a role in the process of increasing vaccine prescription and adherence.

Determination of Vaccination Rates for Influenza and Pneumococcal Vaccines in Patients with Chronic Obstructive Pulmonary Disease and Factors Affecting Vaccination

Determination of Vaccination Rates for Influenza and Pneumococcal Vaccines in Patients with Chronic Obstructive Pulmonary Disease and Factors Affecting Vaccination

110. Improving Pneumococcal Vaccination in Patients Treated with Tumor Necrosis Factor-alpha Inhibitors: A Multidisciplinary Education-Based Quality Improvement Project

Abstract Background In 2012, pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23) were recommended for immunocompromised adults ≥19 years, but pneumococcal vaccination (PV) in these patients (pts) remains suboptimal. With a new PV (PCV20) allowing for simplified PV, we study rates of PV in pts on infliximab (INX) 1 year post-initiation of a pt and provider education-based quality improvement project aiming to increase PV in pts on Tumor Necrosis Factor-alpha inhibitors (TNF-αI). Methods Starting in 11/2020, pamphlets detailing PV indications were distributed to the Walter Reed National Military Medical Center infusion center and pharmacies to be given to pts prescribed/administered TNF-αI. Provider educational materials and pt pamphlets were given to services prescribing TNF-αI. Provider education was also offered to these services. Up to date (UTD) on PV was defined as receipt of PCV13 and PPSV23 (including additional PPSV23 dose ≥5 years post-initial PPSV23 if applicable). Ongoing INX (o-INX) was defined as INX initiation before 10/1/2020. Newly initiated INX (new-INX) was 10/1/2020-10/1/2021. One-year post implementation, we reviewed the PCV13 and PPSV23 immunization records of pts ≥19 years of age on INX from 1/1/21-12/31/21. This project was approved by the IRB under a non-research determination. Results 111 pts prescribed INX between 1/1/21-12/31/21 met inclusion criteria (87 o-INX and 24 new-INX). Prior to the intervention, of 87 o-INX pts, 45 (52%), 45 (52%), and 18 (21%) pts had received PCV13, ≥1 PPSV23 dose, and were UTD on PV respectfully. Between 1/1/21-12/31/21, 14 o-INX pts had PV (1 PCV13 and PPSV23, 7 PCV13, and 6 PPSV23), with 7 newly UTD (10% of the 69 previously not UTD), totaling 25 (29%) o-INX pts UTD on PV (figure 1). Of 24 new-INX pts, only 12 (48%), 9 (36%), and 6 (24%) had had PCV13, PPSV23, and were UTD on PV as of 12/31/21. No services prescribing TNF-αI requested the offered PV educational talks. Conclusion Despite frequent healthcare in a system where vaccination has no out of pocket expense, guideline-concordant PV was low in this cohort. With new, simplified PV, next steps include updated pt and targeted provider education. However, with prior small gains using multidisciplinary education, additional efforts to remove PV barriers may be needed. Disclosures Benjamin L. Custer, MD, Beam Therapeutics: Stocks/Bonds|CRISPR Therapeutics: Stocks/Bonds|glaxo-smith-kline: Stocks/Bonds|Hologic: Stocks/Bonds|Moderna: Stocks/Bonds|Pfizer: Stocks/Bonds|Regeneron: Stocks/Bonds|sanofi: Stocks/Bonds|Vertex Pharmaceuticals: Stocks/Bonds.

S779 Efficacy of Pneumococcal Vaccine in Patients With Inflammatory Bowel Disease - A Propensity-Matched Analysis

S779 Efficacy of Pneumococcal Vaccine in Patients With Inflammatory Bowel Disease - A Propensity-Matched Analysis

The comparison of exacerbation and pneumonia before and after conjugated pneumococcal vaccination in patients with chronic obstructive pulmonary disease, and the effect of inhaled corticosteroid use on results.

Pneumococcal infections and exacerbations are important causes of mortality and morbidity in chronic obstructive pulmonary disease (COPD). The use of inhaled corticosteroids and pneumococcal vaccination are suggested for the control of the disease progression and exacerbations. The aim of this study is to assess the effect of pneumococcal conjugate vaccine on pneumonia and exacerbation in COPD patients using inhaled corticosteroids (ICSs). The secondary aim is to analyze the effect of ICS use and different ICS types, if administered, on exacerbation and pneumonia incidence in the study population. Medical records of 108 adult patients with COPD who were vaccinated with the pneumococcal conjugate vaccine (PCV13) were retrospectively evaluated. The number of acute exacerbations and pneumonia within one year before and after vaccination were evaluated in all included COPD patients. The comparison analysis was also performed based on the ICS types. There were statistically significant differences between the mean numbers of pneumonia and exacerbations before and after vaccination (p<0.05). There were no significant differences in the mean pneumonia attacks and acute exacerbations between patients using ICS and not using ICS (p> 0.05). This study revealed that PCV13 provides a significant decrease in both exacerbation and pneumonia episodes in COPD patients. On the other hand, the use of ICSs and the types of ICSs were not found to have adverse effects on pneumonia and acute exacerbations in vaccinated COPD patients.

Effectiveness of influenza and pneumococcal vaccines on chronic obstructive pulmonary disease exacerbations.

Single-study evidence of separate and combined effectiveness of influenza and pneumococcal vaccination in patients with chronic obstructive pulmonary disease (COPD) is limited. To fill this gap, we studied the effectiveness of trivalent seasonal influenza vaccine (TIV) and 23-valent pneumococcal polysaccharide vaccine (PPSV23), separately and together, at preventing adverse COPD outcomes. Our study used a self-controlled, before-and-after cohort design to assess the effectiveness of TIV and PPSV23 in COPD patients. Patients were recruited from hospitals in Tangshan City, Hebei Province, China. Subjects self-selected into one of the three vaccination schedules: TIV group, PPSV23 group and TIV&PPSV23 group. We used a physician-completed, medical record-verified questionnaire to obtain data on acute exacerbations of COPD (AECOPD), pneumonia and related hospitalization. Vaccine effectiveness was determined by comparing COPD outcomes before and after vaccination, controlling for potential confounding using Cox regression. We recruited 474 COPD patients, of whom 109 received TIV, 69 received PPSV23 and 296 received TIV and PPSV23. Overall effectiveness for preventing AECOPD, pneumonia and related hospitalization were respectively 70%, 59% and 58% in the TIV group; 54%, 53% and 46% in the PPSV23 group; and 72%, 73% and 69% in the TIV&PPSV23 group. The vaccine effectiveness without COVID-19 non-pharmaceutical intervention period were 84%, 77% and 88% in the TIV group; 63%, 74% and 66% in the PPSV23 group; and 82%, 83% and 91% in the TIV&PPSV23 group. Influenza vaccination and PPSV23 vaccination, separately and together, can effectively reduce the risk of AECOPD, pneumonia and related hospitalization. Effectiveness for preventing AECOPD was the greatest.

AB0618 Tolerability and safety of 23-valent polysaccharide pneumococcal vaccine in patients with systemic vasculitis, preliminary results

BackgroundSystemic vasculitis (VS) is a severe autoimmune disease requiring active immunosuppressive therapy. The probability of infectious complications in these patients is very high. Immunization with the 23-valent polysaccharide pneumococcal vaccine (PPV-23) is required to reduce the risk of severe respiratory infections in this group of patients.ObjectivesThe aim of the study was to study the tolerability and safety of PPV-23 in patients with SV.MethodsAt this stage, the study included 13 patients with WS: 10 with vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA) (AAV), (5 with granulomatosis with polyangitis (GPA), 4 with eosinophilic granulomatosis with polyangiitis (EGPA), 2 - with microscopic polyangiitis (MPA)), 1 - with polyarteritis nodosa, 1 - with Takayasu’s arteritis (AT); of which 10 women, 3 men, aged 22 to 76 years. 9 (69%) patients were older than 50 years. Remission of the disease was observed in 1 patient (EGPA), in 3 - low disease activity, in 9 - active vasculitis (all 9 with AAV, BVAS from 4 to 13). All patients received glucocorticoids (GC): 2 - 55-60 mg/day, 9 - 10-20 mg/day, 2-2.5-5 mg/day; 5 -bDMARD: 4 - rituximab (RTM), 1 - TNF inhibitors; 11 - cytostatics (CS): 4 - mycophenolate mofetil (MM), 3 - azathioprine (AZ), 2 - cyclophosphamide (CPh), 2 - methotrexate (MTX). Two patients were on induction therapy (GC 55-60 mg + CPh) with a plan to switch to RTM. Only 1 patient with EGPA received HA as monotherapy. The 23-valent polysaccharide pneumococcal vaccine was administered subcutaneously in 0.5 ml (1 dose). The follow-up period was 1-6 months. During the visits, standard clinical and laboratory tests and the determination of antibodies to S.pneumoniae were carried out.ResultsVaccination tolerance was good in all patients. One (7,7%) patient with EGPA (in remission) had a mild local reaction (pain at the injection site) within 1 day. Another 1 (7,7%) patient with severe concomitant pathology (EGPA + multiple sclerosis) had a general reaction in the form of a transient increase in weakness in the lower extremities for up to 5 days (this symptom was a manifestation of polyneuropathy, persisted earlier, and to a greater extent was associated with multiple sclerosis than with EGPA). Vaccinal reactions were completely reversible and did not require additional prescriptions. During the follow-up period, no deterioration in the course of SV was recorded in any case, and no new autoimmune phenomena, both laboratory and clinical, were noted in any of them. 7 (53,8%) patients (all 5 with GPA, 2 with EGPA) had ENT lesions (destructive rhinosinusitis (5), sinusitis (2)) with frequent exacerbations. 1 patient with GPA reported a significant improvement in the condition of the ENT organs (no exacerbations of rhinosinusitis, disappearance of nasal discharge for 5 months). In the remaining 6 patients, the condition also remained stable, no progression of sinusitis was noted during the observation period (1-4 months). No infections of the lower respiratory tract were registered during the observation period.Conclusion1. All patients had a high risk of infectious complications: combined immunosuppressive therapy (92% of patients), age over 50 years (69% of patients), severe lesion of ENT organs (53,8% of patients). 2. The tolerance of PPV-23 vaccination was good. 3. There was no deterioration in the course of SV.Disclosure of InterestsNone declared

Progress on the effectiveness of the pneumococcal vaccination in patients with chronic obstructive pulmonary disease

Streptococcus pneumonia is an important pathogen leading to the acute exacerbation of chronic obstructive pulmonary disease (COPD) or COPD with pneumonia. Pneumococcal vaccination can reduce the incidence of community-acquired pneumonia, reduce the number of acute exacerbations, and have a significant protective effect on patients with COPD. However, there are still controversies about the timing of vaccination, revaccination, and the selection of vaccine types. This review mainly summarized the related researches and recommendations of pneumococcal vaccination in patients with COPD.

Health-care utilization for sinusitis after pneumococcal vaccination in patients with low antibody titers.

Pneumococcal antibody deficiency has been the subject of limited study in chronic rhinosinusitis (CRS) and has not been studied in recurrent acute rhinosinusitis (RARS). The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is considered for patients with nonprotective Streptococcus pneumoniae titers. We hypothesized that both RARS and CRS patients with deficient S pneumoniae titers and subsequent PPSV23 vaccination would have reduced health-care encounters for sinusitis and fewer prescriptions for antibiotics or steroids. A retrospective cohort study was performed of patient encounters between January 2011 and December 2019. All patients included were ≥18 and ≤65 years old with a diagnosis of CRS or RARS and pneumococcal titer data. Patients with immunodeficiency and comorbid conditions requiring PPSV23 vaccination before 65 years of age were excluded. A total of 938 patients were included in the study. Nonprotective antibody titers were present in 75.8% of CRS and 74.8% of RARS patients. A total of 306 patients with deficient antibody titers received the PPSV23 vaccine. Eighty-nine percent of CRS and 90.1% of RARS patients had protective responses. Among the 217 patients with continuous data from 2 years before through 2 years after PPSV23 vaccination, a decrease in the number of encounter diagnoses of CRS (p<0.0001) and RARS (p=0.0006) was observed. Decreases in the frequency of antibiotic (p=0.002) and corticosteroid (p=0.04) prescriptions were also appreciated. Most patients with CRS and RARS have nonprotective antibody titers. PPSV23 administration significantly decreases health-care utilization.

Promising Expectations for Pneumococcal Vaccination during COVID-19.

The emergence of new viral infections has increased over the decades. The novel virus is one such pathogen liable for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, popularly known as coronavirus disease 2019 (COVID-19). Most fatalities during the past century’s influenza pandemics have cooperated with bacterial co/secondary infections. Unfortunately, many reports have claimed that bacterial co-infection is also predominant in COVID-19 patients (COVID-19 associated co/secondary infection prevalence is up to 45.0%). In the COVID-19 pandemic, Streptococcus pneumoniae is the most common coinfecting pathogen. Half of the COVID-19 mortality cases showed co-infection, and pneumonia-related COVID-19 mortality in patients >65 years was 23%. The weakening of immune function caused by COVID-19 remains a high-risk factor for pneumococcal disease. Pneumococcal disease and COVID-19 also have similar risk factors. For example, underlying medical conditions on COVID-19 and pneumococcal diseases increase the risk for severe illness at any age; COVID-19 is now considered a primary risk factor for pneumococcal pneumonia and invasive pneumococcal disease. Thus, pneumococcal vaccination during the COVID-19 pandemic has become more critical than ever. This review presents positive studies of pneumococcal vaccination in patients with COVID-19 and other medical conditions and the correlational effects of pneumococcal disease with COVID-19 to prevent morbidity and mortality from co/secondary infections and superinfections. It also reports the importance and role of pneumococcal vaccination during the current COVID-19 pandemic era to strengthen the global health system.

Rates and associates of influenza and pneumococcus vaccination in diabetes mellitus: A nationwide cross-sectional study (TEMD vaccination study).

BACKGROUNDVaccination against influenza and pneumococcus is effective in reducing morbidity and mortality in patients with diabetes.AIMTo investigate the prevalence of influenza and pneumococcal vaccinations and to search for the independent associates of vaccination in Turkish patients with diabetes.METHODSIn this cross-sectional, nationwide, multicenter study, adult patients with type 1 diabetes (T1DM) (n = 454) and type 2 diabetes (T2DM) (n = 4721), who were under follow-up for at least a year in the outpatient clinics, were consecutively enrolled. Sociodemographic, clinical, and laboratory parameters of patients were recorded. Vaccination histories were documented according to the self-statements of the patients.RESULTSPatients with T1DM and T2DM had similar vaccination rates for influenza (23.6% vs 21.2%; P = 0.240) and pneumococcus (8% vs 7%; P = 0.451) vaccinations. Longer diabetes duration and older age were the common independent associates of having vaccination for both types of diabetes patients. Higher education level, using statin treatment, and having optimal hemoglobin A1c levels were the common independent associates of influenza and pneumococcal vaccination in patients with T2DM.CONCLUSIONTEMD Vaccination Study shows that patients with T1DM and T2DM had very low influenza and pneumococcal vaccination rates in Turkey. The lower rates of vaccination in certain populations urges the necessity of nationwide vaccination strategies targeting these populations.