Vaccination against pneumococcal disease improves outcomes of community-acquired pneumonia
Vaccination against pneumococcal infection does not prevent community-acquired pneumonia, but it does reduce the level of nosocomial mortality and the risk of hospitalization in the intensive care unit and the intensive care unit.
Although the use of the 23-valent pneumococcal polysaccharide vaccine does not prevent the development of community-acquired pneumonia (CAP), this tactic can reduce the course of the disease and improve outcomes in patients with CAP. This hypothesis was confirmed in a population cohort study conducted in Canada in hospitalized patients with community-acquired pneumonia.
As the study showed, patients vaccinated against pneumococcal 23-valent polysaccharide pre-vaccinated with community-acquired pneumonia have a lower mortality rate (40%) and a lower risk of hospitalization in the intensive care unit (ICU). ) compared to unvaccinated people.
The study prospectively collected information on all adult patients hospitalized with CAP in 6 Canadian clinics from 2000 to 2002. Interviewing patients, checking medical records and clarifying necessary information from patients' personal physicians identified the people vaccinated.
The main results evaluated during the study were nosocomial mortality and the transfer of the patient to the intensive care unit and the intensive care unit.
The average age of 3,415 patients with community-acquired pneumonia who were included in the study was 75 years; 46% were women, in 62% of patients, pneumonia was characterized by a severe course, 22% of patients were vaccinated with the pneumococcal vaccine. At the end of the study, 624 patients died or were transferred to intensive care. Pre-vaccination against pneumococcal infection reduced the risk of a similar result (10% (73/760) in vaccinated patients against 21% (551/2655) in unvaccinated patients (p less than 0.001)). This risk reduction is mainly due to the small number of patients admitted to the ICU (2/760 [less than 1%] vs 349/2655 [13%]). In vaccinated patients, the probability of death or hospitalization in the ICU was 0.62 (95% confidence interval, 0.42-0.92; p = 0.02).
Patients with community-acquired pneumonia who were pre-vaccinated with the pneumococcal vaccine have an approximately 40% lower mortality or probability of being transferred to intensive care than unvaccinated patients. The data obtained make it possible to recommend vaccination against pneumococcal infection in patients at high risk of developing pneumonia. In addition, vaccination with the pneumococcal vaccine is more cost effective from an economic point of view.
The limitations of this study were observational design, lack of randomization, bias and possible distortion; lack of precise determination of the intensity of immunity or dates of vaccination; incomplete information on the etiology of pneumonia; limit the evaluation of results only to the period of hospitalization; exclusion of pregnant or lactating women, as well as HIV positive patients.
According to the results of the study, the authors concluded that vaccination against pneumococcal infection does not prevent community-acquired pneumonia, but improves the outcome of the disease.