Explore the vast range of titles available.

Streptococcus pneumoniae remains the leading cause of community-acquired pneumonia in adults and bacterial meningitis in children worldwide. In addition to pneumonia, invasive pneumococcal diseases (IPDs), such as bacteremia and meningitis, pose a significant burden, particularly among older adults and individuals with underlying comorbidities. These diseases lead to substantial morbidity and mortality. Pneumococcal vaccination has been a cornerstone of disease prevention, reducing incidence and antimicrobial resistance. Recent advances in understanding S. pneumoniae epidemiology, genomic diversity, and the real-world impact of conjugate vaccines have driven the development and licensure of new-generation pneumococcal vaccines with expanded serotype coverage. Introducing 15-valent (PCV15), 20-valent (PCV20), and 21-valent (PCV21) conjugate vaccines has reshaped pneumococcal immunization strategies, particularly in adults, replacing previous sequential vaccine recommendations in many settings. In parallel, emerging epidemiological data and shifts in pneumococcal serotype distribution continue to influence vaccine policy decisions and immunization guidelines worldwide. In light of these advancements, adult pneumococcal vaccination recommendations continuously evolve to enhance protection in high-risk populations and optimize long-term immunity. This review provides an updated overview of the pneumococcal disease burden, the evolution of pneumococcal vaccines, and the latest immunization strategies in an expanding vaccine landscape. Additionally, we discuss future directions in pneumococcal vaccine development and the potential impact of novel vaccination approaches on public health outcomes.

To update the European League Against Rheumatism (EULAR) recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD) published in 2011. Four systematic literature reviews were performed regarding the incidence/prevalence of vaccine-preventable infections among patients with AIIRD; efficacy, immunogenicity and safety of vaccines; effect of anti-rheumatic drugs on the response to vaccines; effect of vaccination of household of AIIRDs patients. Subsequently, recommendations were formulated based on the evidence and expert opinion. The updated recommendations comprise six overarching principles and nine recommendations. The former address the need for an annual vaccination status assessment, shared decision-making and timing of vaccination, favouring vaccination during quiescent disease, preferably prior to the initiation of immunosuppression. Non-live vaccines can be safely provided to AIIRD patients regardless of underlying therapy, whereas live-attenuated vaccines may be considered with caution. Influenza and pneumococcal vaccination should be strongly considered for the majority of patients with AIIRD. Tetanus toxoid and human papilloma virus vaccination should be provided to AIIRD patients as recommended for the general population. Hepatitis A, hepatitis B and herpes zoster vaccination should be administered to AIIRD patients at risk. Immunocompetent household members of patients with AIIRD should receive vaccines according to national guidelines, except for the oral poliomyelitis vaccine. Live-attenuated vaccines should be avoided during the first 6 months of life in newborns of mothers treated with biologics during the second half of pregnancy. These 2019 EULAR recommendations provide an up-to-date guidance on the management of vaccinations in patients with AIIRD.

In October 2024, the Advisory Committee on Immunization Practices (ACIP) voted to expand the age-based recommendation for pneumococcal vaccination in adults, lowering the youngest age to be vaccinated from 65 to 50 years. This study estimated the incremental health and economic outcomes of age-based use of PCV21 (comparison #1) or PCV20 (comparison #2) versus a previous risk-based recommendation of PCV20 in adults aged 50–64 years in the United States (US). A static multi cohort state-transition Markov model was employed to conduct an economic evaluation from a societal perspective with a lifetime time horizon. Model inputs were obtained or derived from published literature and publicly available databases or reports. Outcomes assessed included undiscounted clinical cases: invasive pneumococcal disease (IPD), inpatient and outpatient non-bacteremic pneumococcal pneumonia (NBPP), post-meningitis sequelae (PMS), deaths from IPD and inpatient NBPP, as well as discounted (at 3 % per year) quality-adjusted life years (QALYs), total cost (in 2023 USD), and the incremental cost-effectiveness ratios (ICERs) reported as $/QALY gained. Probabilistic/Deterministic sensitivity analysis (PSA/DSA) and scenario analysis were conducted. In all pairwise comparisons, PCV21 (comparison #1) showed a reduction in clinical cases and significantly lower ICERs, at least ten times lower than those observed with PCV20 (comparison #2). The ICER for comparison #1 was $73,000 (95 % uncertainty interval (UI): $40,000, $134,000) per QALY gained. In scenario analyses, the ICER ranged from cost-saving to $80,000/QALY gained. In contrast, the ICER for comparison #2 was $820,000 (95% UI: $572,000, $1.4 million)/QALY gained and varying from $290,000 to $1.0 million/QALY gained in scenario analyses. An age-based vaccination strategy for adults aged 50–64 years in the US can lead to reductions in pneumococcal disease cases and associated mortality compared to a risk-based strategy. Moreover, PCV21 was a more effective and economically favorable option than PCV20 across a wide range of scenarios and input values.

On August 13, 2014, the Advisory Committee on Immunization Practices (ACIP) recommended routine use of 13-valent pneumococcal conjugate vaccine (PCV13 [Prevnar 13, Wyeth Pharmaceuticals, Inc., a subsidiary of Pfizer Inc.]) among adults aged ≥65 years. PCV13 should be administered in series with the 23-valent pneumococcal polysaccharide vaccine (PPSV23 [Pneumovax23, Merck & Co., Inc.]), the vaccine currently recommended for adults aged ≥65 years. PCV13 was approved by the Food and Drug Administration (FDA) in late 2011 for use among adults aged ≥50 years. In June 2014, the results of a randomized placebo-controlled trial evaluating efficacy of PCV13 for preventing community-acquired pneumonia among approximately 85,000 adults aged ≥65 years with no prior pneumococcal vaccination history (CAPiTA trial) became available and were presented to ACIP. The evidence supporting PCV13 vaccination of adults was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework and determined to be type 2 (moderate level of evidence); the recommendation was categorized as a Category A recommendation. This report outlines the new recommendations for PCV13 use, provides guidance for use of PCV13 and PPSV23 among adults aged ≥65 years, and summarizes the evidence considered by ACIP to make this recommendation.

On June 20, 2012, the Advisory Committee on Immunization Practices (ACIP) recommended routine use of 13-valent pneumococcal conjugate vaccine (PCV13; Prevnar 13, Wyeth Pharmaceuticals, Inc., a subsidiary of Pfizer, Inc.) for adults aged ≥19 years with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid (CSF) leaks, or cochlear implants. PCV13 should be administered to eligible adults in addition to the 23-valent pneumococcal polysaccharide vaccine (PPSV23; Pneumovax 23, Merck & Co. Inc.), the vaccine currently recommended for these groups of adults. The evidence for the benefits and risk of PCV13 vaccination of adults with immunocompromising conditions was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework and designated as a Category A recommendation. This report outlines the new ACIP recommendations for PCV13 use; explains the recommendations for the use of PCV13 and PPSV23 among adults with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants; and summarizes the evidence considered by ACIP to make its recommendations.

On February 24, 2010, a 13-valent pneumococcal conjugate vaccine (PCV13 [Prevnar 13, Wyeth Pharmaceuticals Inc., a subsidiary of Pfizer Inc.]) was licensed by the Food and Drug Administration (FDA) for prevention of invasive pneumococcal disease (IPD) caused by the 13 pneumococcal serotypes covered by the vaccine and for prevention of otitis media caused by serotypes in the 7-valent pneumococcal conjugate vaccine formulation (PCV7 [Prevnar, Wyeth]). PCV13 is approved for use among children aged 6 weeks-71 months and succeeds PCV7, which was licensed by FDA in 2000. The Pneumococcal Vaccines Work Group of the Advisory Committee on Immunization Practices (ACIP) reviewed available data on the immunogenicity, safety, and cost-effectiveness of PCV13, and on estimates of the vaccine-preventable pneumococcal disease burden. The working group then presented policy options for consideration of the full ACIP. This report summarizes recommendations approved by ACIP on February 24, 2010, for 1) routine vaccination of all children aged 2-59 months with PCV13, 2) vaccination with PCV13 of children aged 60-71 months with underlying medical conditions that increase their risk for pneumococcal disease or complications, and 3) PCV13 vaccination of children who previously received 1 or more doses of PCV7. CDC guidance for vaccination providers regarding transition from PCV7 to the PCV13 immunization program also is included.

This article presents the World Health Organization (WHO) recommendations on the use of pneumococcal vaccines excerpted from the Pneumococcal vaccines WHO position paper – 2012 recently published in the Weekly Epidemiological Record [1]. The current document replaces the position paper on the use 7-valent pneumococcal conjugate vaccine published in 2007 [2]. Incorporating the most recent developments in the field of pneumococcal vaccines this position paper focuses on the currently available 10-valent and 13-valent conjugate vaccines and their introduction and use in national immunization programmes. It also deals with the 23-valent polysaccharide vaccine, though in less detail than provided in the April 2008 position paper which remains valid [3]. Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of scientific evidence for a few key conclusions. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines worldwide. This paper reflects the recommendations of the WHO's Strategic Advisory Group of Experts (SAGE) on immunization. Recommendations on the use of pneumococcal vaccines were discussed by SAGE at its meetings in November 2006 (conjugate vaccine) and April 2008 (polysaccharide vaccine) and most recently in November 2011. Evidence presented at these meetings can be accessed at http://www.who.int/immunization/sage/previous/en/index.html.

•We investigated pneumococcal vaccination-related factors using administrative data.•The population was the eligible persons for routine pneumococcal vaccination.•Vaccination coverage was approximately 30% for the entire eligible population.•Individual factors such as health check-up participation were the primary factors. To investigate individual and environmental vaccination-related factors among the older adults in Japan, using administrative data. We conducted a cohort study and included people who reached the relevant age (≥65 years) for routine pneumococcal vaccination of older adults between April 2015 and March 2020. Monthly data of residents in the two municipalities from April 2014 to March 2020 and vaccination records from April 2015 to March 2020 were used. We defined five cohorts according to the year in which routine vaccinations were available. Each cohort was followed for a total of two years, with the first year being the “baseline period” and second year being the “vaccine follow-up period.” Pneumococcal vaccination data was extracted from vaccination records at “first dose.” Age, sex, socioeconomic status, comorbidities, hospital visit history, hospitalization history, Specific Health Check-ups participation, and information on contracted hospitals for pneumococcal vaccination were used as covariates. A multivariate logistic regression model was used to investigate the relationship between pneumococcal vaccination and vaccination-related factors. Odds ratios (OR) and 95 % confidence intervals (95 % CI) were calculated. Analysis included 17,991 patients. Vaccination coverage was 33.6 % for all subjects. Multivariate analysis found the following as significant vaccination-related factors: female (OR: 1.18, 95 % CI: 1.11–1.26), not low income (1.76, 1.17–2.76), hospital visits: ≥once/month (1.27, 1.19–1.35), and Specific Health Check-ups participation (2.10, 1.95–2.27). No significant results were found for hospitals that contracted pneumococcal vaccination. Individual factors, such as sex and Specific Health Check-ups participation, were found to be important factors affecting pneumococcal vaccination among older adults in Japan. Environmental factors, such as the characteristics of residential areas, should be evaluated in further investigations.

Background Since 2014, Belgium’s Superior Health Council has recommended pneumococcal vaccination for adults aged 19–85 years at increased risk for pneumococcal diseases with a specific vaccine administration sequence and timing. Currently, Belgium has no publicly funded adult pneumococcal vaccination program. This study investigated the seasonal pneumococcal vaccination trends, evolution of vaccination coverage and adherence to the 2014 recommendations. Methods INTEGO is a general practice morbidity registry in Flanders (Belgium) that represents 102 general practice centres and comprised over 300.000 patients in 2021. A repeated cross-sectional study was performed for the period between 2017 and 2021. Using adjusted odds ratios computed via multiple logistic regression, the association between an individual’s characteristics (gender, age, comorbidities, influenza vaccination status and socioeconomic status) and schedule-adherent pneumococcal vaccination status was assessed. Results Pneumococcal vaccination coincided with seasonal flu vaccination. The vaccination coverage in the population at risk decreased from 21% in 2017 to 18.2% in 2018 and then started to increase to 23.6% in 2021. Coverage in 2021 was highest for high-risk adults (33.8%) followed by 50- to 85-year-olds with comorbidities (25.5%) and healthy 65- to 85-year-olds (18.7%). In 2021, 56.3% of the high-risk adults, 74.6% of the 50+ with comorbidities persons, and 74% of the 65+ healthy persons had an adherent vaccination schedule. Persons with a lower socioeconomic status had an adjusted odds ratio of 0.92 (95% Confidence Interval (CI) 0.87–0.97) for primary vaccination, 0.67 (95% CI 0.60–0.75) for adherence to the recommended second vaccination if the 13-valent pneumococcal conjugate vaccine was administered first and 0.86 (95% CI 0.76–0.97) if the 23-valent pneumococcal polysaccharide vaccine was administered first. Conclusion Pneumococcal vaccine coverage is slowly increasing in Flanders, displaying seasonal peaks in sync with influenza vaccination campaigns. However, with less than one-fourth of the target population vaccinated, less than 60% high-risk and approximately 74% of 50 + with comorbidities and 65+ healthy persons with an adherent schedule, there is still much room for improvement. Furthermore, adults with poor socioeconomic status had lower odds of primary vaccination and schedule adherence, demonstrating the need for a publicly funded program in Belgium to ensure equitable access.

On February 20, 2013, the Advisory Committee on Immunization Practices (ACIP) recommended routine use of 13-valent pneumococcal conjugate vaccine (PCV13; Prevnar 13, Wyeth Pharmaceuticals, Inc., a subsidiary of Pfizer, Inc.) for children aged 6-18 years with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid (CSF) leaks, or cochlear implants who have not previously received PCV13. PCV13 should be administered to these children regardless of whether they received the 7-valent pneumococcal conjugate vaccine (PCV7) or the 23-valent pneumococcal polysaccharide vaccine (PPSV23). Recommendations for PPSV23 use for children in this age group remain unchanged. The evidence for the benefits and risks associated with PCV13 vaccination of children with immunocompromising conditions was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. This recommendation reflects a policy change from permissive and off-label recommendation of PCV13 in the pediatric immunocompromised population to a category A recommendation. This report summarizes the evidence considered by ACIP to make this recommendation and reviews the recommendations for use of PCV13 and PPSV23 for children aged 6-18 years.