Effectiveness of pneumococcal polysaccharide vaccine against pneumonia and cost analysis for the elderly who receive seasonal influenza vaccine in Japan
Effectiveness of pneumococcal polysaccharide vaccine against pneumonia and cost analysis for the elderly who receive seasonal influenza vaccine in Japan
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DOI：
10.1016/j.vaccine.2010.08.010
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发表时间：
2010-10-08
期刊：
影响因子：
5.5
通讯作者：
Oishi, Kazunori
中科院分区：
文献类型：
--
作者：
Kawakami, Kenji;Ohkusa, Yasushi;Oishi, Kazunori
为了确定肺炎球菌多糖疫苗 (PPV) 对社区获得性肺炎 (CAP) 的临床疗效和节省成本的效果，开展了一项开放标签、随机临床试验，涉及 786 名 65 岁以上的日本受试者，在 2 年期间接受常规流感疫苗。研究对象被随机分配到 PPV 组 (n = 394) 或非 PPV 组 (n = 392)。比较两组全因肺炎的发病率、入院情况和医疗费用。在 2 年期间，PPV 疫苗接种显着降低了 75 岁以上受试者（41.5%，P = 0.039）和行走困难受试者（62.7%，P = 0.005）因全因肺炎入院的发生率，但并非所有 65 岁以上研究受试者（P = 0.183）均如此。对于因全因肺炎而行走困难的受试者，Kaplan-Meier 生存曲线显示两组之间存在显着差异 (P = 0.0146)。 PPV 疫苗接种显着降低了所有研究对象第一年的医疗费用 (P = 0.027)。我们目前的数据表明，PPV 对 75 岁以上研究对象的全因肺炎有效，尽管对于所有 65 岁以上研究对象效果并不显着。 (C) 2010 Elsevier Ltd. 保留所有权利。
To determine the clinical efficacy and cost-saving effect of pneumococcal polysaccharide vaccine (PPV) against community-acquired pneumonia (CAP), an open-label, randomized clinical trial was conducted involving 786 Japanese subjects older than 65 years of age receiving a routine influenza vaccine during the 2-year period. Study subjects were randomly assigned to either a PPV group (n = 394) or to a non-PPV group (n = 392). The incidence, admission and the medical cost for all-cause pneumonia were compared between these two groups. PPV vaccination significantly reduced the incidence of admission for all-cause pneumonia for subjects older than 75 years of age (41.5%, P = 0.039) and for those who had difficulty walking (62.7%, P = 0.005), but not for all study subjects older than 65 years of age (P = 0.183), for the 2-year period. The Kaplan-Meier survival curves for subjects who had difficulty walking free from all-cause pneumonia demonstrated a significant difference (P = 0.0146) between the two groups. PPV vaccination significantly reduced medical costs for all study subjects during the first year period (P = 0.027). Our present data demonstrated that PPV was effective for all-cause pneumonia for study subjects older than 75 years of age, although the effect was not significant for all study subjects older than 65 years of age. (C) 2010 Elsevier Ltd. All rights reserved.