A patient who is infected with community-acquired pneumonia and is hospitalized has a better chance of survival and a lower risk of admission to the ICU (intensive care unit) if he/she had already received the pneumococcal vaccine, compared to patients who had not been vaccinated, according to an article published in Archives of Internal Medicine (JAMA/Archives), October 8th issue.
The authors explain that community-acquired pneumonia is a common illness which causes a substantial number of deaths and illnesses. The vaccine which protects from Streptococcus pneumoniae, one of the causes of pneumonia – 23-valent polysaccharide pneumococcal vaccine (PPV), has been on the market for over twenty years. Guidelines recommend vaccination for high risk groups – adults and people in nursing homes. Vaccination rates remain stubbornly well below the target of 80%-90% for these vulnerable groups.
Jennie Johnstone, M.D., University of Alberta, Edmonton, Canada, and team gathered information on 3,415 patients who had been infected with community-acquired pneumonia and were hospitalized between 2000-2002. The researchers found out what each patient’s vaccination status was by checking medical records, contacting primary care physicians and interviewing the patients themselves.
624 of the patients had either died or were admitted to the ICU. 22% of all the patients had been vaccinated with PPV. 10% of those who had been vaccinated were admitted to the ICU or died, compared to 21% of those who had not received the vaccine, say the researchers. Less than 1% of the vaccinated patients were admitted to the ICU, versus 13% of those who had not been vaccinated.
The authors wrote “In addition to improved clinical outcomes, our results suggest that there may also be an associated reduction in costs associated with pneumococcal vaccination, a health economic benefit that has not been captured in previous cost-effectiveness analyses of this vaccine. Specifically, much of the benefit in our study was in terms of reduction in the need for costly ICU admissions; previous cost analyses have been restricted to examining the benefits of preventing pneumococcal disease but may have not adequately captured the possibility of attenuating the severity or mitigating the cost of disease in those for whom pneumonia is not prevented.”
Of all the patients who were discharged, only 215 (9%), out of 2,416 who were eligible, received a vaccination.
The writers concluded “We believe that our results further the emphasize the importance of adopting current adult pneumococcal vaccination guidelines, particularly since only 22 percent of our population were vaccinated before their hospitalization and less than 10 percent of eligible patients were vaccinated before hospital discharge.”
“Effect of Pneumococcal Vaccination in Hospitalized Adults With Community-Acquired Pneumonia”
Jennie Johnstone, MD; Thomas J. Marrie, MD; Dean T. Eurich, MSc; Sumit R. Majumdar, MD, MPH
Arch Intern Med. 2007;167:1938-1943.
Written by: Christian Nordqvist