1
|
Kim S, Kim MJ, Myong JP, Lee YH, Kim BY, Hwang A, Kim GO, Jeong SH, Yoon HK, An TJ, Lim JU. Prior pneumococcal vaccination improves in-hospital mortality among elderly population hospitalized due to community-acquired pneumonia. BMC Pulm Med 2024; 24:168. [PMID: 38589839 PMCID: PMC11000283 DOI: 10.1186/s12890-024-02928-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/22/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Pneumococcal vaccination is a preventive method to reduce pneumonia related mortality. However, real-world data on efficacy of the pneumococcal vaccine in reducing mortality is lacking, especially in elderly patients. This study was conducted to assess the effects of prior pneumococcal vaccination in elderly pneumonia patients. METHODS The data was procured from the Health Insurance Review and Assessment and Quality Assessment database. Hospitalized patients who met the criteria of community-acquired pneumonia (CAP) were included and they were grouped according to vaccination state. Patients were aged ≥ 65 years and treated with beta-lactam, quinolone, or macrolide. Patients were excluded when treatment outcomes were unknown. RESULTS A total of 4515 patients were evaluated, and 1609 (35.6%) of them were vaccinated prior to hospitalization. Mean age was 77.0 [71.0;82.0], 54.2% of them were male, and mean Charlson comorbidity index (CCI) was 3.0. The patients in the vaccinated group were younger than those in the unvaccinated group (76.0 vs. 78.0 years; P < 0.001), and showed higher in-hospital improvement (97.6 vs. 95.0%; P < 0.001) and lower 30-day mortality (2.6 vs. 5.3%; P < 0.001). After adjusting confounding factors such as age, gender, CURB score and CCI score, the vaccinated group demonstrated a significant reduction in 30-day mortality (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.41-0.81; P < 0.01) and in-hospital mortality (HR 0.53, 95% CI0.37-0.78; P < 0.001) compared to the unvaccinated group in multivariate analysis. Vaccinated group showed better 30-day survival than those in non-vaccinated group (log-rank test < 0.05). CONCLUSIONS Among elderly hospitalized CAP patients, prior pneumococcal vaccination was associated with improved in-hospital mortality and 30-day mortality.
Collapse
Affiliation(s)
- Seohyun Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, Yeouido St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Moon Jin Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, Yeouido St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jun-Pyo Myong
- Department of Occupational and Environmental Medicine, Seoul St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun-Hee Lee
- Department of Urology, Seoul St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bo Yeon Kim
- Healthcare Review and Assessment Committee, Health Insurance Review and Assessment Service , Wonju, Korea
| | - Ahyoung Hwang
- Quality Assessment Department, Health Insurance Review and Assessment Service , Wonju, Korea
| | - Gui Ok Kim
- Quality Assessment Administration Department, Health Insurance Review and Assessment Service , Wonju, Korea
| | - Sung Hwan Jeong
- Healthcare Review and Assessment Committee, Health Insurance Review and Assessment Service , Wonju, Korea
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Gil Medical Center, Gachon University, Incheon, Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, Yeouido St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tai Joon An
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, Yeouido St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Jeong Uk Lim
- Division of Pulmonary and Critical Care Medicine, Department of Internal medicine, Yeouido St. Mary`s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| |
Collapse
|
2
|
Htay H, Foo MWY, Gan SSW, Jayaballa M, Oei EL, Tan MSH, Wang W, Wu SY, Tan CS. COVID-19 vaccination in peritoneal dialysis patients. Int Urol Nephrol 2023; 55:653-659. [PMID: 36036315 PMCID: PMC9421120 DOI: 10.1007/s11255-022-03302-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/06/2022] [Indexed: 10/28/2022]
Abstract
BACKGROUND COVID-19 vaccine is recommended in Peritoneal dialysis (PD) patients, but a paucity of data is available regarding vaccine-related adverse effects among PD patients. METHOD A cross-sectional study was conducted in a single center between October and November 2021. PD patients were provided with the online survey link to participate in the study. RESULTS A total of 107 PD patients responded to the survey (55%: male, 79%: Chinese, 40%: > 65 years old). Of these, 95% received the COVID-19 vaccine (77% received two doses and 22% received three doses). Most participants (91%) received Pfizer vaccine. The main source of vaccine information was from the government (48%). The most common reason to receive and refuse vaccines were the perception of the seriousness of COVID-19 infection (63%) and concern about vaccine safety (60%), respectively. After the first dose, 25% of patients developed one or more vaccine-related adverse effects. Common local adverse effect was pain at the injection site (21%), and systemic adverse effects were muscle pain (15%), fatigue (13%). Similar adverse effects were observed with subsequent doses. None of them required hospitalization for vaccine-related adverse effects. Female patients had a higher risk of developing adverse effects than male patients after the first dose (odds ratio: 3.37; 95% confidence interval: 1.25 - 9.08). No such difference was observed in the subsequent dose. Age, race, employment status and history of drug allergy were not associated with the risk of adverse effects. CONCLUSIONS The COVID-19 vaccine was well-tolerated by most PD patients, but few experienced non-severe adverse effects. All PD patients should be vaccinated against SAR-COV-2 infection.
Collapse
Affiliation(s)
- Htay Htay
- Department of Renal Medicine, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore, 169856, Singapore. .,DUKE-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
| | - Marjorie Wai Yin Foo
- grid.163555.10000 0000 9486 5048Department of Renal Medicine, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore, 169856 Singapore ,grid.428397.30000 0004 0385 0924DUKE-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
| | - Sheryl Shien Wen Gan
- grid.163555.10000 0000 9486 5048Department of Renal Medicine, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore, 169856 Singapore ,grid.428397.30000 0004 0385 0924DUKE-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
| | - Mathini Jayaballa
- grid.163555.10000 0000 9486 5048Department of Renal Medicine, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore, 169856 Singapore ,grid.428397.30000 0004 0385 0924DUKE-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
| | - Elizabeth Ley Oei
- grid.163555.10000 0000 9486 5048Department of Renal Medicine, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore, 169856 Singapore ,grid.428397.30000 0004 0385 0924DUKE-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
| | - Mabel Si Hua Tan
- grid.413815.a0000 0004 0469 9373Department of Renal Medicine, Changi General Hospital, Singapore, Singapore
| | - Wei Wang
- grid.163555.10000 0000 9486 5048Department of Renal Medicine, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore, 169856 Singapore
| | - Sin Yan Wu
- grid.163555.10000 0000 9486 5048Department of Renal Medicine, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore, 169856 Singapore
| | - Chieh Suai Tan
- grid.163555.10000 0000 9486 5048Department of Renal Medicine, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore, 169856 Singapore ,grid.428397.30000 0004 0385 0924DUKE-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
| |
Collapse
|
3
|
Kesiena O, Atarere J, Singireddy S, Ademiluyi A, Famojuro O. The Role of Health Information Technology in Pneumococcal Vaccination Uptake Among Adults with Heart Disease. Telemed J E Health 2021; 28:699-705. [PMID: 34515541 DOI: 10.1089/tmj.2021.0333] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Health information technology (HIT) may influence pneumococcal vaccination uptake in high-risk populations. This study assessed the association of HIT utilization on pneumococcal vaccine (PCV) uptake among adults ≥40 years with heart disease. Methods: This was a cross-sectional study of 2,134 individuals representing 16,813,593 United States adults ≥40 years with heart disease using the National Health Interview Survey data. The independent variables were use of the Internet to (1) look up health information, (2) fill a prescription, and (3) schedule a medical appointment, and use of an e-mail (4) communicate with a health care provider. The dependent variable was PCV uptake. Chi-square analysis was used to evaluate group differences, and a multiple logistic regression was used to analyze the association between HIT utilization and PCV uptake. Results: Those who use the Internet to fill up a prescription and to communicate with their health care provider were more likely to take up the PCV (adjusted odds ratio [AOR] 1.56; 95% confidence interval [CI] 1.03-2.37, p = 0.035) and (AOR 1.95; 95% CI 1.23-3.10, p = 0.005) respectively. Compared with those who did not use HIT in any form, those who used HIT in at least three or four forms had a higher PCV uptake (AORs 1.93; 95% CI 1.19-3.13, p = 0.008) and (AOR 2.33 95% CI 1.22-4.47, p = 0.011) respectively. Conclusion: Our analysis shows a positive association of HIT utilization and PCV uptake. It further stresses the importance of electronic health in preventive medicine. This implies that HIT can be used purposively in other aspects of preventive health. Larger studies should evaluate the relationship between different uses of HIT and the uptake of different vaccines.
Collapse
Affiliation(s)
- Onoriode Kesiena
- Department of Internal Medicine, Piedmont Athens Regional Medical Center, Athens, Georgia, USA
| | - Joseph Atarere
- Department of Biostatistics and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Shreyas Singireddy
- Department of Internal Medicine, Piedmont Athens Regional Medical Center, Athens, Georgia, USA
| | - Ademayowa Ademiluyi
- Department of Internal Medicine, Piedmont Athens Regional Medical Center, Athens, Georgia, USA
| | - Oluwaseun Famojuro
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| |
Collapse
|
4
|
McIntosh EDG, Feemster K, Rello J. Protecting adults at risk of pneumococcal infection and influenza from exposure to SARS-CoV-2. Hum Vaccin Immunother 2021; 18:1-7. [PMID: 34406914 PMCID: PMC8920219 DOI: 10.1080/21645515.2021.1957647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
There is a paucity of evidence linking pneumococcal infection and influenza with SARS-CoV-2 and COVID-19. There is circumstantial evidence of the possibility of an association between S. pneumoniae and SARS-CoV-2 such as the increased binding of S. pneumoniae to coronavirus-infected human airway epithelium, the frequent use of broad-spectrum antibiotics in the management of COVID-19 which could mask secondary bacterial infection, and the observation that pneumococcal vaccination is associated with decreased SARS-CoV-2 nasopharyngeal swab positivity. We performed a targeted literature review for the year 2020, using search terms S. pneumoniae, influenza, SARS-CoV-2, and found 25 relevant articles of a total of 291. Pneumococcal and influenza vaccinations have the potential to contribute toward efforts aimed at reducing the health burden of SARS-CoV-2, especially by reducing preventable admissions to hospital for pneumonia and the consequent risk of nosocomial SARS-CoV-2 transmission.
Collapse
Affiliation(s)
| | - K Feemster
- Medical Affairs, Pneumococcal Vaccines, Global Medical and Scientific Affairs, Merck Research Laboratories, Merck & Co., Inc, Kenilworth, NJ, USA
| | - J Rello
- Universitat Internacional de Catalunya, Head Research Group, Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES) and Head, Clinical Research/Epidemiology in Pneumonia & Sepsis (CRIPS), Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
| |
Collapse
|