Background
Pneumococcal vaccination has been a preventive method to reduce pneumonia related mortality. However, real-world data of efficacy of pneumococcal vaccine in reducing mortality is lacking, especially in elderly patients.
Aims
This study was conducted to assess the effects of prior pneumococcal vaccination in elderly pneumonia patients.
Methods
The data was procured from the Health Insurance Review and Assessment and Quality Assessment database. The hospitalized patients who met the criteria of community-acquired pneumonia (CAP) were included and they were grouped according to vaccination state. Patients were aged ? 65 years and treated beta-lactam, quinolone, or macrolide. Patients were excluded when treatment outcomes were unknown.
Results
Total 4515 patients were evaluated, and 1609 of them were vaccinated priorly. Mean ages were 77.0, 54.2% of them were male, mean Charlson comorbidity index was 3.0. Compared to counterpart, vaccinated group showed significant improvement in 30-days mortality (hazard ratio 0.58, 95% confidence interval 0.41-0.81; P-value < 0.01) (Table 1). Vaccinated group showed better survival experience than those in non-vaccinated group (log-rank test < 0.05).
Table 1. Multivariable cox proportional hazard ratio for 30-day mortality
| Hazard ratio | p-value | |
| Age | 1.08 (1.06-1.10) | <0.01 |
| CURB Low | Ref | Ref |
| CURB Moderate | 3.56 (2.43-5.22) | <0.01 |
| CURB High | 11.51 (7.63-17.37) | <0.01 |
| Vaccinated (vs. non-vaccinated) | 0.58 (0.41-0.81) | <0.01 |
Conclusions
Among elderly hospitalized CAP, prior pneumococcal vaccination was associated with improving 30-day mortality.