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dc.contributor.authorStreeter, Adam
dc.contributor.authorRodgers, LR
dc.contributor.authorMasoli, J
dc.contributor.authorLin, NX
dc.contributor.authorBlé, A
dc.contributor.authorHamilton, W
dc.contributor.authorHenley, WE
dc.date.accessioned2022-10-31T16:25:10Z
dc.date.issued2022-10-13
dc.identifier.issn1932-6203
dc.identifier.issn1932-6203
dc.identifier.othere0275642
dc.identifier.urihttp://hdl.handle.net/10026.1/19805
dc.description.abstract

<jats:sec id="sec001"> <jats:title>Background</jats:title> <jats:p>The 23-valent pneumococcal polysaccharide vaccine (PPV23) is recommended for UK older adults, but how age moderates effectiveness is unclear.</jats:p> </jats:sec> <jats:sec id="sec002"> <jats:title>Methods</jats:title> <jats:p>Three annual cohorts of primary-care patients aged≥65y from the Clinical Practice Research Datalink selected from 2003–5 created a natural experiment (n = 324,804), reflecting the staged introduction of the vaccine. The outcome was symptoms consistent with community-acquired pneumococcal pneumonia (CAP) requiring antibiotics or hospitalisation. We used the prior event rate ratio (PERR) approach to address bias from unmeasured confounders.</jats:p> </jats:sec> <jats:sec id="sec003"> <jats:title>Results</jats:title> <jats:p>Vaccinated patients had higher rates of CAP in the year before vaccination than their controls, indicating the potential for confounding bias. After adjustment for confounding using the prior event rate ratio (PERR) method, PPV23 was estimated to be effective against CAP for two years after vaccination in all age sub-groups with hazard ratios (95% confidence intervals) of 0.86 (0.80 to 0.93), 0.74 (0.65 to 0.85) and 0.65 (0.57 to 0.74) in patients aged 65–74, 75–79 and 80+ respectively in the 2005 cohort. Age moderated the effect of vaccination with predicted risk reductions of 8% at 65y and 29% at 80y.</jats:p> </jats:sec> <jats:sec id="sec004"> <jats:title>Conclusions</jats:title> <jats:p>PPV23 is moderately effective at reducing CAP among UK patients aged≥65y, in the two years after vaccination. Vaccine effectiveness is maintained, and may increase, in the oldest age groups in step with increasing susceptibility to CAP.</jats:p> </jats:sec>

dc.format.extente0275642-e0275642
dc.format.mediumElectronic-eCollection
dc.languageen
dc.language.isoeng
dc.publisherPublic Library of Science
dc.subjectAged
dc.subjectAnti-Bacterial Agents
dc.subjectCohort Studies
dc.subjectCommunity-Acquired Infections
dc.subjectHumans
dc.subjectPneumococcal Infections
dc.subjectPneumococcal Vaccines
dc.subjectPneumonia
dc.subjectPneumonia, Pneumococcal
dc.subjectStreptococcus pneumoniae
dc.subjectUnited Kingdom
dc.subjectVaccination
dc.titleReal-world effectiveness of pneumococcal vaccination in older adults: Cohort study using the UK Clinical Practice Research Datalink
dc.typejournal-article
dc.typeJournal Article
dc.typeResearch Support, Non-U.S. Gov't
plymouth.author-urlhttps://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000924819300051&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008
plymouth.issue10
plymouth.volume17
plymouth.publication-statusPublished online
plymouth.journalPLoS ONE
dc.identifier.doi10.1371/journal.pone.0275642
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeUnited States
dcterms.dateAccepted2022-09-21
dc.rights.embargodate2022-11-1
dc.identifier.eissn1932-6203
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1371/journal.pone.0275642
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2022
rioxxterms.typeJournal Article/Review


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