Pneumococcal vaccination for elderly subjects: license extension. Still no proof of clinical efficacy

(1) In France the licensed indications of a 23-valent polyoside pneumococcal vaccine called Pneumo 23 degrees have been extended to cover people over 65. (2) The only relevant published double-blind trial showed no reduction in the risk of pneumonia or death after vaccination in this age group. Similarly, a comparative unblinded trial involving more than 26,000 elderly people showed no reduction in the risk of pneumonia. (3) Some retrospective studies suggest that the vaccine may reduce the risk of infection with bacteraemia or meningitis, with no clear protection against the serotypes usually associated with diminished susceptibility to penicillin. (4) Randomised trials have also failed to show that older pneumococcal vaccines reduce the risk of pneumonia or death. (5) The adverse effects of Pneumo 23 degrees are generally mild and local. They occur most frequently after booster injections.