Age- and time-dependent waning vaccine effectiveness of PPV23 against community-acquired pneumonia among adults aged 60 and older: A cohort study
The 23-valent pneumococcal polysaccharide vaccine (PPV23) is recommended for adults to prevent pneumococcal diseases, while its effectiveness over time remains unclear. This study aimed to assess the age- and time-dependent effectiveness of PPV23 in reducing community-acquired pneumonia (CAP) incide...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
|
| Series: | Human Vaccines & Immunotherapeutics |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/21645515.2025.2541508 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849735976984772608 |
|---|---|
| author | Biying Wang Chen Qian Yanan Wu Liping Yi Hongjie Yu Xiaohua Liu Yonggen Jiang Tao Zhang Genming Zhao |
| author_facet | Biying Wang Chen Qian Yanan Wu Liping Yi Hongjie Yu Xiaohua Liu Yonggen Jiang Tao Zhang Genming Zhao |
| author_sort | Biying Wang |
| collection | DOAJ |
| description | The 23-valent pneumococcal polysaccharide vaccine (PPV23) is recommended for adults to prevent pneumococcal diseases, while its effectiveness over time remains unclear. This study aimed to assess the age- and time-dependent effectiveness of PPV23 in reducing community-acquired pneumonia (CAP) incidence among adults aged 60 and older in China. We conducted a prospective cohort study in Shanghai, China, identifying CAP cases via inpatient and outpatient medical records. Vaccine effectiveness (VE) was estimated using Cox regression models with time-dependent vaccination status, adjusted for demographic characteristics, comorbidities, and seasonal influenza activity. Subgroup analyses stratified by age group, comorbidity status, and observation period were performed. A total of 35,491 participants were included, yielding observation of 158,448 person-years. Overall incidence of CAP was 30.69 (95% confidence interval [CI]: 29.83, 31.57) per 1000 person-years. PPV23 seemed to be ineffective when encompassing all cohort participants in the initial analyses. However, subgroup analyses showed significant adjusted VE for those vaccinated before age 60 (VE = 32.83%, 95% CI: 16.40, 46.03). Significant protection was observed within the first-year post-vaccination (VE = 43.63%, 95% CI: 25.30, 57.47) but declined over time. Furthermore, age-time stratification indicated valid protection for those vaccinated before age 65 within the first year. In addition, VE was higher in those without comorbidities. PPV23 demonstrated modest effectiveness against CAP among those vaccinated before the age of 65 within the first year and decline over time. These findings advocate for prioritizing PPV23 vaccination before age 65 to maximize short-term protection against CAP, underscoring the need for effective booster strategies. |
| format | Article |
| id | doaj-art-8db6f0df5ce6446d8532c836095335cb |
| institution | DOAJ |
| issn | 2164-5515 2164-554X |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| spelling | doaj-art-8db6f0df5ce6446d8532c836095335cb2025-08-20T03:07:24ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2025-12-0121110.1080/21645515.2025.2541508Age- and time-dependent waning vaccine effectiveness of PPV23 against community-acquired pneumonia among adults aged 60 and older: A cohort studyBiying Wang0Chen Qian1Yanan Wu2Liping Yi3Hongjie Yu4Xiaohua Liu5Yonggen Jiang6Tao Zhang7Genming Zhao8Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, ChinaDepartment of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaDepartment of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaDepartment of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaDepartment of Communicable Disease Control, Shanghai Jiading District Center for Disease Control and Prevention, Shanghai, ChinaDepartment of Communicable Disease Control, Shanghai Minhang District Center for Disease Control and Prevention, Shanghai, ChinaDepartment of Communicable Disease Control, Shanghai Songjiang District Center for Disease Control and Prevention, Shanghai, ChinaShanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, ChinaDepartment of Epidemiology, School of Public Health, Fudan University, Shanghai, ChinaThe 23-valent pneumococcal polysaccharide vaccine (PPV23) is recommended for adults to prevent pneumococcal diseases, while its effectiveness over time remains unclear. This study aimed to assess the age- and time-dependent effectiveness of PPV23 in reducing community-acquired pneumonia (CAP) incidence among adults aged 60 and older in China. We conducted a prospective cohort study in Shanghai, China, identifying CAP cases via inpatient and outpatient medical records. Vaccine effectiveness (VE) was estimated using Cox regression models with time-dependent vaccination status, adjusted for demographic characteristics, comorbidities, and seasonal influenza activity. Subgroup analyses stratified by age group, comorbidity status, and observation period were performed. A total of 35,491 participants were included, yielding observation of 158,448 person-years. Overall incidence of CAP was 30.69 (95% confidence interval [CI]: 29.83, 31.57) per 1000 person-years. PPV23 seemed to be ineffective when encompassing all cohort participants in the initial analyses. However, subgroup analyses showed significant adjusted VE for those vaccinated before age 60 (VE = 32.83%, 95% CI: 16.40, 46.03). Significant protection was observed within the first-year post-vaccination (VE = 43.63%, 95% CI: 25.30, 57.47) but declined over time. Furthermore, age-time stratification indicated valid protection for those vaccinated before age 65 within the first year. In addition, VE was higher in those without comorbidities. PPV23 demonstrated modest effectiveness against CAP among those vaccinated before the age of 65 within the first year and decline over time. These findings advocate for prioritizing PPV23 vaccination before age 65 to maximize short-term protection against CAP, underscoring the need for effective booster strategies.https://www.tandfonline.com/doi/10.1080/21645515.2025.2541508Pneumococcal vaccinationPneumoniaVaccine effectivenessElderlyWaning |
| spellingShingle | Biying Wang Chen Qian Yanan Wu Liping Yi Hongjie Yu Xiaohua Liu Yonggen Jiang Tao Zhang Genming Zhao Age- and time-dependent waning vaccine effectiveness of PPV23 against community-acquired pneumonia among adults aged 60 and older: A cohort study Human Vaccines & Immunotherapeutics Pneumococcal vaccination Pneumonia Vaccine effectiveness Elderly Waning |
| title | Age- and time-dependent waning vaccine effectiveness of PPV23 against community-acquired pneumonia among adults aged 60 and older: A cohort study |
| title_full | Age- and time-dependent waning vaccine effectiveness of PPV23 against community-acquired pneumonia among adults aged 60 and older: A cohort study |
| title_fullStr | Age- and time-dependent waning vaccine effectiveness of PPV23 against community-acquired pneumonia among adults aged 60 and older: A cohort study |
| title_full_unstemmed | Age- and time-dependent waning vaccine effectiveness of PPV23 against community-acquired pneumonia among adults aged 60 and older: A cohort study |
| title_short | Age- and time-dependent waning vaccine effectiveness of PPV23 against community-acquired pneumonia among adults aged 60 and older: A cohort study |
| title_sort | age and time dependent waning vaccine effectiveness of ppv23 against community acquired pneumonia among adults aged 60 and older a cohort study |
| topic | Pneumococcal vaccination Pneumonia Vaccine effectiveness Elderly Waning |
| url | https://www.tandfonline.com/doi/10.1080/21645515.2025.2541508 |
| work_keys_str_mv | AT biyingwang ageandtimedependentwaningvaccineeffectivenessofppv23againstcommunityacquiredpneumoniaamongadultsaged60andolderacohortstudy AT chenqian ageandtimedependentwaningvaccineeffectivenessofppv23againstcommunityacquiredpneumoniaamongadultsaged60andolderacohortstudy AT yananwu ageandtimedependentwaningvaccineeffectivenessofppv23againstcommunityacquiredpneumoniaamongadultsaged60andolderacohortstudy AT lipingyi ageandtimedependentwaningvaccineeffectivenessofppv23againstcommunityacquiredpneumoniaamongadultsaged60andolderacohortstudy AT hongjieyu ageandtimedependentwaningvaccineeffectivenessofppv23againstcommunityacquiredpneumoniaamongadultsaged60andolderacohortstudy AT xiaohualiu ageandtimedependentwaningvaccineeffectivenessofppv23againstcommunityacquiredpneumoniaamongadultsaged60andolderacohortstudy AT yonggenjiang ageandtimedependentwaningvaccineeffectivenessofppv23againstcommunityacquiredpneumoniaamongadultsaged60andolderacohortstudy AT taozhang ageandtimedependentwaningvaccineeffectivenessofppv23againstcommunityacquiredpneumoniaamongadultsaged60andolderacohortstudy AT genmingzhao ageandtimedependentwaningvaccineeffectivenessofppv23againstcommunityacquiredpneumoniaamongadultsaged60andolderacohortstudy |