Effectiveness of the 23-valent polysaccharide vaccine against invasive pneumococcal disease in Navajo adults
Effectiveness of the 23-valent polysaccharide vaccine against invasive pneumococcal disease in Navajo adults
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DOI：
10.1086/375782
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发表时间：
2003-07-01
影响因子：
6.4
通讯作者：
Whitney, CG
中科院分区：
文献类型：
--
作者：
Benin, AL;O'Brien, KL;Whitney, CG
侵袭性肺炎球菌疾病在纳瓦霍成年人中的发生率是美国普通成年人的2-3倍。这项观察性研究的目的是确定23价肺炎球菌多糖疫苗（PPV 23）在纳瓦霍成年人中的有效性。1996-1997年期间，积极监测发现了侵袭性肺炎球菌病病例。根据基础医疗条件、性别、年龄和医疗护理地点，每例患者匹配3名对照患者。通过病例对照组的回归分析和间接队列方法计算有效性。糖尿病和酒精中毒分别发生在41%和43%的108例患者中，62%的病例患者和64%的对照患者进行了免疫接种。总体疫苗有效性为26%（95%置信区间[CI]，-29%至58%）;糖尿病患者为15%（95% CI，-116%至67%），酒精中毒患者为-5%（95% CI，-141%至54%）。使用间接队列方法确定的总体疫苗有效性为35%（95% CI，-33%至69%）。PPV 23在纳瓦霍成年人中并不显着有效，可能不足以预防该人群中的严重肺炎球菌疾病。
Invasive pneumococcal disease occurs 2-3-fold more often among Navajo adults than among adults in the general United States population. The objective of this observational study was to determine the effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPV23) among Navajo adults. Active surveillance identified cases of invasive pneumococcal disease during 1996-1997. Three control patients per case patient were matched according to underlying medical conditions, sex, age, and location of medical care. Effectiveness was calculated by regression analysis of case-control sets and by indirect cohort methodology. Diabetes and alcoholism occurred in 41% and 43% of 108 case patients, respectively; 62% of case patients and 64% of control patients were immunized. Overall vaccine effectiveness was 26% (95% confidence interval [CI], -29% to 58%); 15% (95% CI, -116% to 67%) for patients with diabetes and -5% (95% CI, -141% to 54%) for patients with alcoholism. Overall vaccine effectiveness, as determined by use of the indirect cohort methodology, was 35% (95% CI, -33% to 69%). PPV23 was not significantly effective among Navajo adults and may be inadequate to prevent serious pneumococcal disease in this population.