Utility of pneumococcal vaccine among elderly population in buraidah primary health care centers

Background: People with chronic diseases tend to land up with high mortality and morbidity. Objective of the study is to determine the prevalence of Pneumococcal vaccine utility among the 50 years and above age group population, to find the demographic profile, the knowledge of PCV among the general population.Methods: A cross-sectional study was conducted randomly in 6 primary health care centers in Buraidah city, Saudi Arabia from the aged 50 years and above population. Sample size was calculated by using WHO statistical software for sample size determination, the result of sample size was 236 participants. A interview-based questionnaire was used after obtaining consent from each participant. Data entered and analyzed using the SPSS software 21.0 version. For categorical analysis, chi square test was applied.Results: In the present study, a total of 202 samples of the population has participated and response rate was 86%. About only 12.9% (26/202) of study population taken PCV vaccine in the study. About 79.7% were having different chronic diseases. About 83.7% were given a response as PCV prevents the disease. There was statistically significant association was observed between different levels of education and chronic heart disease with PCV vaccination status (p<0.05).Conclusions: Based on the study results, Pneumococcal vaccination coverage was low, in comparison with Riyadh study in 2018; our study vaccination coverage was more. Still need Health promotional measures among the general public to increase the coverage of PCV.

Single-Dose 13-Valent Conjugate Pneumococcal Vaccine in People Living With HIV – Immunological Response and Protection

BackgroundPatients living with HIV (PLHIV) are prone to invasive pneumococcal disease. The 13-valent conjugated pneumococcal vaccine (PCV13) is currently recommended for all PLHIV, followed in most guidelines by a 23-valent polysaccharide pneumococcal vaccine. Data are scarce concerning the immunological efficacy of PCV13 among PLHIV.ObjectiveTo assess the immunological response at one month, and the immunological protection at 1-, 6-, and 12 months in PLHIV with a CD4 cell count above 200 cells/µl after a single dose of PCV13, as measured by both ELISA and opsonophagocytic assay (OPA).MethodsPLHIV with CD4 cell count &gt;200 cells/µl were included. Specific IgG serum concentrations for eight serotypes by ELISA and seven serotypes by OPA were measured at baseline, 1-, 6-, and 12 months after the PCV13 vaccination. Global response was defined as a two-fold increase from baseline of specific IgG antibody levels (μg/ml) assayed by ELISA or as a four-fold increase in OPA titer from baseline, for at least five serotypes targeted by PCV13. Global protection was defined as an IgG-concentration ≥1 µg/ml by ELISA or as an opsonization titer ≥LLOQ by OPA for at least five tested serotypes targeted by PCV13. Factors associated with global response and global protection were assessed using logistic regression.ResultsOf the 38 PLHIV included, 57.9% and 63.2% were global responders, 92.1% and 78.9% were globally protected at one month, and 64.7% and 55.9% were still protected at 12 months, by ELISA and OPA respectively. A CD4/CD8 ratio of &gt;0.8 was significantly associated with a better global response by OPA (OR=6.11, p=0.02), and a CD4 nadir &lt;200 was significantly associated with a poorer global response by ELISA (OR=0.22, p=0.04). A CD4 cell count nadir &lt;200 and age over 50 years were associated with poorer global protection by OPA at M1 (OR=0.18, p=0.04) and M12 (OR= 0.15, p=0.02), respectively. Plasma HIV RNA viral load &lt;40 copies/ml was significantly associated with a better global protection at M1 by ELISA and OPA (OR=21.33, p=0.025 and OR=8.40, p=0.04)ConclusionVaccination with PCV13 in these patients induced immunological response and protection at one month. At one year, more than half of patients were still immunologically protected.

Recent Topics of Pneumococcal Vaccination: Indication of Pneumococcal Vaccine for Individuals at a Risk of Pneumococcal Disease in Adults

Pneumococcal disease is one of the most common and severe vaccine-preventable diseases (VPDs). Despite the advances in antimicrobial treatment, pneumococcal disease still remains a global burden and exhibits a high mortality rate among people of all ages worldwide. The immunization program of the pneumococcal conjugate vaccine (PCV) in children has decreased pneumococcal disease incidence in several countries. However, there are several problems regarding the pneumococcal vaccine, such as indications for immunocompetent persons with underlying medical conditions with a risk of pneumococcal disease, the balance of utility and cost, i.e., cost-effectiveness, vaccine coverage rate, serotype replacement, and adverse events. Especially for individuals aged 19–64 at risk of pneumococcal disease, physicians and vaccine providers should make a rational decision whether the patients should be vaccinated or not, since there is insufficient evidence supporting it. We describe this review regarding topics and problems regarding pneumococcal vaccination from the clinician’s point of view.

06. United States Healthcare Provider Preferences for Adult Pneumococcal Vaccine Recommendations

Background Pneumococcal vaccine recommendations for US adults are complex, varying by age and underlying conditions, and include both 23-valent polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine. The Advisory Committee on Immunization Practices (ACIP) will vote on new recommendations in October after the 15- (PCV15) and 20-valent (PCV20) conjugate vaccines are approved. Stakeholder acceptability is part of ACIP’s evidence to recommendation framework, but few data are available on health care providers’ (HCPs) preferences for potential recommendations. Methods 752 HCPs (300 physicians, 150 nurse practitioners, 150 physician assistants, & 152 pharmacists) were surveyed. Object case best-worst scaling (BWS) was used to elicit preferences for hypothetical recommendations for 1) adults 19-64 years with chronic conditions and 2) immunocompetent adults ≥65 years. Presented recommendations included combinations of PCV15/PCV20 either as routine or after shared clinical decision making (SCDM), and PPSV23 as routine, SCDM, or no recommendation. Following BWS, HCPs were asked to assume ACIP was considering implementing both of their preferred recommendations for the age/risk groups. HCPs were then given the opportunity to change their selections and propose recommendations not included in the BWS exercise. Additional information was collected using conventional survey items. Results Routine use of higher-valent PCVs in sequence with PPSV23 was most often preferred for both adults 19-64 with chronic conditions (40%) and immunocompetent adults ≥65 (49%) when elicited separately for each age/risk group. Most respondents (63%) revised their recommendations after considering implementation, which resulted in most (59%) favoring recommendations harmonized across the age/risk groups, and 75% favoring routine use of PCV15 or PCV20 among immunocompetent adults ≥65. When asked directly, HCPs generally approved of the idea of simplifying adult pneumococcal vaccine recommendations, harmonizing the interval between vaccines, and lowering the cutoff for age-based recommendations below 65 years. Conclusion US HCPs generally prefer simplification of the adult pneumococcal recommendation, favoring broad routine use of both higher-valent PCVs and PPSV23. Disclosures Jeffrey Vietri, PhD, Pfizer Inc (Employee, Shareholder) Kelley Meyers, PhD, RTI Health Solutions (Independent Contractor) Christine Poulos, PhD, Pfizer Inc (Other Financial or Material Support, Employee of RTI-HS, which received funds from Pfizer to conduct the study) Erica Chilson, PharmD, Pfizer, Inc (Employee, Shareholder) Vincenza Snow, MD, Pfizer Vaccines (Employee)

21. Systematic Review and Meta-Analysis of Pneumococcal Vaccine Effectiveness against Invasive Pneumococcal Disease among Adults

Background Two new pneumococcal conjugate vaccines (PCVs), PCV15 and PCV20, are anticipated to be licensed for use in U.S. adults in 2021. To help inform the U.S. Advisory Committee on Immunization Practices’ discussions on pneumococcal vaccine use among adults, we conducted a systematic review and meta-analysis. We specifically looked at efficacy or effectiveness of PCV13 and pneumococcal polysaccharide vaccine (PPSV23) against invasive pneumococcal disease (IPD) in adults. Methods We conducted a search of English literature published from 1998 – February 2021 on PCV13 and PPSV23 efficacy or effectiveness studies using eight major databases. Studies targeting adults with immunocompromising conditions were excluded. Title and abstract screening of identified studies and data abstraction were performed by two reviewers. Results were stratified by vaccine product, outcome evaluated (vaccine type (VT) or all IPD), study design, and effect measure. Random effects models were used to pool estimates by stratum. Results Of 3,422 citations reviewed, we identified 26 IPD studies; 4 on PCV13, 22 on PPSV23, 18 with all IPD, and 17 with VT-IPD (Table) as an outcome. Only one randomized-controlled trial (RCT) was identified for PCV13 with an efficacy of 52% (95% CI: 22%, 77%) against all IPD and 75% (95% CI: 41%, 91%) against VT-IPD. A pooled vaccine effectiveness (VE) estimate from three observational studies evaluating PCV13 was 56% (95% CI: 32%, 71%; I2 =12.8) against VT-IPD. Two RCTs evaluating PPSV23 reported efficacies against all IPD ranging between 79-86%; an additional RCT reported no IPD cases during RCT. Vaccine effectiveness estimates from 14 observational studies evaluating PPSV23 ranged between 29-76% against all IPD. Pooled VE estimates from 12 observational studies showed PPSV23 effectiveness against VT-IPD was 38% (95% CI: 28% to 46%; I2 =40.8). Table. Efficacy and effectiveness studies against vaccine-type invasive pneumococcal disease Conclusion Evidence suggests both pneumococcal vaccines are effective against VT-IPD in adults. Given that PCV15 and PCV20 are expected to be licensed based on immunogenicity data and no clinical efficacy data are available for these new vaccines, the findings from this review will help inform policy discussions on use of the new PCVs among adults. Disclosures All Authors: No reported disclosures