老年人顺序性肺炎球菌疫苗接种的现实有效性:一个队列研究
Yong Yi Tan1, Reen Wan Li Ho2,3, Jue Tao Lim1
1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
The Journal of infectious diseases
|March 6, 2026
概括
连续接种PCV-13接种PPSV-23的肺炎球菌疫苗显著降低了老年人肺炎球菌疾病,肺炎住院和全因死亡的风险. 与单个疫苗相比,这种策略提供了更好的保护.
科学领域:
- 老年学是一门学科.
- 免疫学 免疫学 免疫学
- 流行病学 流行病学
背景情况:
- 对于肺炎球菌疫苗的有效性,现实世界的比较数据有限.
- 评估单独的PCV-13,单独的PPSV-23或顺序的PCV-13/PPSV-23对于老年人来说至关重要.
研究的目的:
- 评估老年人不同肺炎球菌疫苗接种策略的实际有效性.
- 单独比较PCV-13,单独比较PPSV-23,以及连续PCV-13,其次是PPSV-23.
主要方法:
- 对65-89岁的新加坡成年人进行基于人口的回顾性队列研究 (2020-2024年).
- 对肺炎球菌病,肺炎住院病例和全因死亡率进行时间对事件分析,死亡是竞争风险.
- 考克斯回归模型使用了疫苗接种状态,人口统计和并发症的时间依赖共变量. 接种疫苗和结果数据来源于国家注册表和医疗保健声明.
主要成果:
- 顺序PCV-13/PPSV-23显著降低了肺炎球菌病 (aHR=0.22),肺炎住院 (aHR=0.94),以及所有原因死亡率 (aHR=0.70).
- 单独使用PCV-13也显示了肺炎 (aHR=0.96) 和死亡率 (aHR=0.86) 的风险降低,但低于连续接种疫苗.
- 连续接种疫苗时没有观察到保护的显著减弱;剂量之间的较长间隔 (≥365天) 显示出数量上较低的风险.
结论:
- 接种PCV-13后接种PPSV-23的连续接种与老年人肺炎,肺炎和死亡率的风险降低有关.
- 这些发现支持目前对老年人群连续性肺炎球菌疫苗接种策略的建议.
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