Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-based Study

Background: With global aging, especially in Asia, preventing pneumonia among seniors is vital. The necessity of introducing pneumococcal vaccines among the elderly has been highlighted, but there is a paucity of community-based real-world evidence on their effect. Sera Town in Hiroshima Prefecture,...

Full description

Saved in:
Bibliographic Details
Main Authors: Aya Sugiyama, Masaaki Kataoka, Kentaro Tokumo, Kanon Abe, Hirohito Imada, Bunlorn Sun, Golda Ataa Akuffo, Tomoyuki Akita, Shingo Fukuma, Noboru Hattori, Junko Tanaka
Format: Article
Language:English
Published: Japan Epidemiological Association 2025-05-01
Series:Journal of Epidemiology
Subjects:
Online Access:https://www.jstage.jst.go.jp/article/jea/35/5/35_JE20240285/_pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849313805109035008
author Aya Sugiyama
Masaaki Kataoka
Kentaro Tokumo
Kanon Abe
Hirohito Imada
Bunlorn Sun
Golda Ataa Akuffo
Tomoyuki Akita
Shingo Fukuma
Noboru Hattori
Junko Tanaka
author_facet Aya Sugiyama
Masaaki Kataoka
Kentaro Tokumo
Kanon Abe
Hirohito Imada
Bunlorn Sun
Golda Ataa Akuffo
Tomoyuki Akita
Shingo Fukuma
Noboru Hattori
Junko Tanaka
author_sort Aya Sugiyama
collection DOAJ
description Background: With global aging, especially in Asia, preventing pneumonia among seniors is vital. The necessity of introducing pneumococcal vaccines among the elderly has been highlighted, but there is a paucity of community-based real-world evidence on their effect. Sera Town in Hiroshima Prefecture, a super-aged community, launched a distinctive pneumococcal vaccination support project for elderly residents and conducted a 5-year follow-up survey. This study evaluates the effectiveness of this vaccination initiative. Methods: From October 2010 to March 2015, Sera Town recruited elderly residents for PPSV23 vaccination with partial cost subsidies. Participants were surveyed annually for 5 years post-vaccination to assess pneumonia incidence, calculated on a person-years basis. Using vital statistics from 2000 to 2016, we quantified changes in mortality rates associated with the vaccination support project through an interrupted-time-series analysis. Results: Of approximately 7,900 residents aged 65 and older, 3,422 (43%) participated in the project (median age: 84 years; range: 70–114 years; 56.7% female). Over 14,559 person-years of observation, 295 participants developed pneumonia. The post-vaccination incidence rate was 20.3 per 1,000 person-years (95% confidence interval [CI], 18.0–22.7). Interrupted time series analysis indicated a 25% reduction in Sera Town’s pneumonia mortality rate post-project, reversing an annual increase of 0.23 per 1,000 population pre-project to an annual decrease of 0.04 per 1,000 population post-project. Conclusion: This study provided real-world evidence on the association with PPSV23 vaccination on the general elderly through a community-based study. The results may be particularly useful for regions where PPSV23 serotypes are prevalent, offering insights for areas facing aging challenges.
format Article
id doaj-art-91033c29f79048dfb9b60efbb43393e3
institution Kabale University
issn 0917-5040
1349-9092
language English
publishDate 2025-05-01
publisher Japan Epidemiological Association
record_format Article
series Journal of Epidemiology
spelling doaj-art-91033c29f79048dfb9b60efbb43393e32025-08-20T03:52:38ZengJapan Epidemiological AssociationJournal of Epidemiology0917-50401349-90922025-05-0135523724410.2188/jea.JE20240285Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-based StudyAya Sugiyama0Masaaki Kataoka1Kentaro Tokumo2Kanon Abe3Hirohito Imada4Bunlorn Sun5Golda Ataa Akuffo6Tomoyuki Akita7Shingo Fukuma8Noboru Hattori9Junko Tanaka10Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanSera Central Public Hospital, Hiroshima, JapanSera Central Public Hospital, Hiroshima, JapanDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanBackground: With global aging, especially in Asia, preventing pneumonia among seniors is vital. The necessity of introducing pneumococcal vaccines among the elderly has been highlighted, but there is a paucity of community-based real-world evidence on their effect. Sera Town in Hiroshima Prefecture, a super-aged community, launched a distinctive pneumococcal vaccination support project for elderly residents and conducted a 5-year follow-up survey. This study evaluates the effectiveness of this vaccination initiative. Methods: From October 2010 to March 2015, Sera Town recruited elderly residents for PPSV23 vaccination with partial cost subsidies. Participants were surveyed annually for 5 years post-vaccination to assess pneumonia incidence, calculated on a person-years basis. Using vital statistics from 2000 to 2016, we quantified changes in mortality rates associated with the vaccination support project through an interrupted-time-series analysis. Results: Of approximately 7,900 residents aged 65 and older, 3,422 (43%) participated in the project (median age: 84 years; range: 70–114 years; 56.7% female). Over 14,559 person-years of observation, 295 participants developed pneumonia. The post-vaccination incidence rate was 20.3 per 1,000 person-years (95% confidence interval [CI], 18.0–22.7). Interrupted time series analysis indicated a 25% reduction in Sera Town’s pneumonia mortality rate post-project, reversing an annual increase of 0.23 per 1,000 population pre-project to an annual decrease of 0.04 per 1,000 population post-project. Conclusion: This study provided real-world evidence on the association with PPSV23 vaccination on the general elderly through a community-based study. The results may be particularly useful for regions where PPSV23 serotypes are prevalent, offering insights for areas facing aging challenges.https://www.jstage.jst.go.jp/article/jea/35/5/35_JE20240285/_pdfpneumococcal vaccinationelderlyincidencemortalityinterrupted time series analysis
spellingShingle Aya Sugiyama
Masaaki Kataoka
Kentaro Tokumo
Kanon Abe
Hirohito Imada
Bunlorn Sun
Golda Ataa Akuffo
Tomoyuki Akita
Shingo Fukuma
Noboru Hattori
Junko Tanaka
Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-based Study
Journal of Epidemiology
pneumococcal vaccination
elderly
incidence
mortality
interrupted time series analysis
title Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-based Study
title_full Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-based Study
title_fullStr Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-based Study
title_full_unstemmed Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-based Study
title_short Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-based Study
title_sort association between introduction of the 23 valent pneumococcal polysaccharide vaccine ppsv23 and pneumonia incidence and mortality among general older population in japan a community based study
topic pneumococcal vaccination
elderly
incidence
mortality
interrupted time series analysis
url https://www.jstage.jst.go.jp/article/jea/35/5/35_JE20240285/_pdf
work_keys_str_mv AT ayasugiyama associationbetweenintroductionofthe23valentpneumococcalpolysaccharidevaccineppsv23andpneumoniaincidenceandmortalityamonggeneralolderpopulationinjapanacommunitybasedstudy
AT masaakikataoka associationbetweenintroductionofthe23valentpneumococcalpolysaccharidevaccineppsv23andpneumoniaincidenceandmortalityamonggeneralolderpopulationinjapanacommunitybasedstudy
AT kentarotokumo associationbetweenintroductionofthe23valentpneumococcalpolysaccharidevaccineppsv23andpneumoniaincidenceandmortalityamonggeneralolderpopulationinjapanacommunitybasedstudy
AT kanonabe associationbetweenintroductionofthe23valentpneumococcalpolysaccharidevaccineppsv23andpneumoniaincidenceandmortalityamonggeneralolderpopulationinjapanacommunitybasedstudy
AT hirohitoimada associationbetweenintroductionofthe23valentpneumococcalpolysaccharidevaccineppsv23andpneumoniaincidenceandmortalityamonggeneralolderpopulationinjapanacommunitybasedstudy
AT bunlornsun associationbetweenintroductionofthe23valentpneumococcalpolysaccharidevaccineppsv23andpneumoniaincidenceandmortalityamonggeneralolderpopulationinjapanacommunitybasedstudy
AT goldaataaakuffo associationbetweenintroductionofthe23valentpneumococcalpolysaccharidevaccineppsv23andpneumoniaincidenceandmortalityamonggeneralolderpopulationinjapanacommunitybasedstudy
AT tomoyukiakita associationbetweenintroductionofthe23valentpneumococcalpolysaccharidevaccineppsv23andpneumoniaincidenceandmortalityamonggeneralolderpopulationinjapanacommunitybasedstudy
AT shingofukuma associationbetweenintroductionofthe23valentpneumococcalpolysaccharidevaccineppsv23andpneumoniaincidenceandmortalityamonggeneralolderpopulationinjapanacommunitybasedstudy
AT noboruhattori associationbetweenintroductionofthe23valentpneumococcalpolysaccharidevaccineppsv23andpneumoniaincidenceandmortalityamonggeneralolderpopulationinjapanacommunitybasedstudy
AT junkotanaka associationbetweenintroductionofthe23valentpneumococcalpolysaccharidevaccineppsv23andpneumoniaincidenceandmortalityamonggeneralolderpopulationinjapanacommunitybasedstudy