Evaluating the association between routine pneumococcal vaccination and COVID-19 severity among older adults in the United States: A case control study

The relationship between infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and disease caused by Streptococcus pneumoniae remains uncertain. This case-control study investigated the association between pneumococcal vaccination and the progression to severe outcomes among CO...

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Main Authors: Ottavia Prunas, Andrew Tiu, Kayoko Shioda, Shweta Bansal, Daniel M. Weinberger
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Vaccine: X
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590136225000166
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author Ottavia Prunas
Andrew Tiu
Kayoko Shioda
Shweta Bansal
Daniel M. Weinberger
author_facet Ottavia Prunas
Andrew Tiu
Kayoko Shioda
Shweta Bansal
Daniel M. Weinberger
author_sort Ottavia Prunas
collection DOAJ
description The relationship between infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and disease caused by Streptococcus pneumoniae remains uncertain. This case-control study investigated the association between pneumococcal vaccination and the progression to severe outcomes among COVID-19 patients aged 65 and older in the United States. We identified COVID-19 patients aged 65 and older with severe outcomes (cases) and those with non-severe or less severe outcomes (controls) from Medicare data from April 2020 to December 2021. Logistic regression models were employed to evaluate the association between prior receipt of pneumococcal vaccination (13-valent conjugate vaccine [PCV13] and/or 23-valent pneumococcal polysaccharide vaccine [PPSV23]) and severe COVID-19 outcomes. A total of 28,124 COVID-19 patients exhibited severe respiratory symptoms or were admitted to the intensive care unit (ICU). The odds of progression from non-severe symptoms to severe respiratory symptoms were modestly lower among COVID-19 patients with PCV13 receipt (odds ratio (OR): 0.91 (95 % confidence interval [CI], 0.88, 0.93), compared to those without PCV13. The odds of requiring ICU admission were lower among COVID-19 patients with severe respiratory outcomes who received PCV13, compared to those who did not (OR: 0.92; 95 % CI, 0.88, 0.97). The magnitude of the associations was similar when evaluating the associations between the receipt of influenza or zoster vaccinations and the severity of COVID-19 outcomes. Finally, there was no association between receiving PPSV23 more than five years ago and COVID-19 severity. Overall, our findings indicated modest to no association between pneumococcal vaccination and severe COVID-19 outcomes among older adults with COVID-19.
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spelling doaj-art-a9dbcc4d1f694ebeabb5b83115c2c76c2025-08-20T03:25:05ZengElsevierVaccine: X2590-13622025-06-012410062210.1016/j.jvacx.2025.100622Evaluating the association between routine pneumococcal vaccination and COVID-19 severity among older adults in the United States: A case control studyOttavia Prunas0Andrew Tiu1Kayoko Shioda2Shweta Bansal3Daniel M. Weinberger4Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland; Corresponding author: Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.Department of Biology, Georgetown University, Washington, DC, USADepartment of Global Health, School of Public Health, Boston University, Boston, MA, USADepartment of Biology, Georgetown University, Washington, DC, USADepartment of Epidemiology of Microbial Diseases and Public Health Modeling Unit, Yale School of Public Health, Yale University; New Haven, CT, USAThe relationship between infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and disease caused by Streptococcus pneumoniae remains uncertain. This case-control study investigated the association between pneumococcal vaccination and the progression to severe outcomes among COVID-19 patients aged 65 and older in the United States. We identified COVID-19 patients aged 65 and older with severe outcomes (cases) and those with non-severe or less severe outcomes (controls) from Medicare data from April 2020 to December 2021. Logistic regression models were employed to evaluate the association between prior receipt of pneumococcal vaccination (13-valent conjugate vaccine [PCV13] and/or 23-valent pneumococcal polysaccharide vaccine [PPSV23]) and severe COVID-19 outcomes. A total of 28,124 COVID-19 patients exhibited severe respiratory symptoms or were admitted to the intensive care unit (ICU). The odds of progression from non-severe symptoms to severe respiratory symptoms were modestly lower among COVID-19 patients with PCV13 receipt (odds ratio (OR): 0.91 (95 % confidence interval [CI], 0.88, 0.93), compared to those without PCV13. The odds of requiring ICU admission were lower among COVID-19 patients with severe respiratory outcomes who received PCV13, compared to those who did not (OR: 0.92; 95 % CI, 0.88, 0.97). The magnitude of the associations was similar when evaluating the associations between the receipt of influenza or zoster vaccinations and the severity of COVID-19 outcomes. Finally, there was no association between receiving PPSV23 more than five years ago and COVID-19 severity. Overall, our findings indicated modest to no association between pneumococcal vaccination and severe COVID-19 outcomes among older adults with COVID-19.http://www.sciencedirect.com/science/article/pii/S2590136225000166Case-control studyCOVID-19 severitySars-CoV-2Streptococcus pneumoniaePneumococcal conjugate vaccineOlder adults
spellingShingle Ottavia Prunas
Andrew Tiu
Kayoko Shioda
Shweta Bansal
Daniel M. Weinberger
Evaluating the association between routine pneumococcal vaccination and COVID-19 severity among older adults in the United States: A case control study
Vaccine: X
Case-control study
COVID-19 severity
Sars-CoV-2
Streptococcus pneumoniae
Pneumococcal conjugate vaccine
Older adults
title Evaluating the association between routine pneumococcal vaccination and COVID-19 severity among older adults in the United States: A case control study
title_full Evaluating the association between routine pneumococcal vaccination and COVID-19 severity among older adults in the United States: A case control study
title_fullStr Evaluating the association between routine pneumococcal vaccination and COVID-19 severity among older adults in the United States: A case control study
title_full_unstemmed Evaluating the association between routine pneumococcal vaccination and COVID-19 severity among older adults in the United States: A case control study
title_short Evaluating the association between routine pneumococcal vaccination and COVID-19 severity among older adults in the United States: A case control study
title_sort evaluating the association between routine pneumococcal vaccination and covid 19 severity among older adults in the united states a case control study
topic Case-control study
COVID-19 severity
Sars-CoV-2
Streptococcus pneumoniae
Pneumococcal conjugate vaccine
Older adults
url http://www.sciencedirect.com/science/article/pii/S2590136225000166
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