Boost Pneumococcal Vaccine Use in Care Homes

New data suggests enhanced protection for vulnerable seniors

Expanding pneumococcal vaccinations for older adults residing in care homes could significantly curb infections and fatalities. The 20-valent pneumococcal conjugate vaccine (PCV20) shows promise in surpassing the current 23-valent pneumococcal polysaccharide vaccine (PPV23) program’s impact.

Enhanced Protection Identified

The increased risk of pneumococcal infections within care facilities stems from residents’ advanced age, frailty, and co-existing health conditions. Outbreaks are also more common in these settings, with respiratory viral infections potentially leading to secondary pneumococcal pneumonia. Older adults may exhibit less typical symptoms for pneumonia, such as diarrhea or confusion, complicating early diagnosis.

Pneumococcal disease is classified as community-acquired or hospital-acquired. Nursing home-acquired pneumonia falls under the latter due to elevated infection risks and potential multidrug resistance. This specific type affects approximately 1 to 2 individuals per 1000 nursing home residency days, with mortality rates for hospitalized patients ranging from 13% to 41%.

Study Highlights Vaccine Efficacy

A recent observational study analyzed data from the UK Health Security Agency concerning laboratory-confirmed invasive pneumococcal disease (IPD) cases among individuals aged 65 and over in England. Between 2022 and 2023, the study identified 2574 IPD cases within this demographic. The research indicated that PPV23 serotypes were responsible for approximately 69.4% of these cases, while PCV20 serotypes accounted for 60.8%.

The incidence of IPD caused by PPV23 serotypes was 16.9 per 100,000 people, compared to 14.7 per 100,000 for PCV20 serotypes. Case fatality rates were similar, with an overall rate of 25.2%, and 24.9% for PPV23 and 24.6% for PCV20. Projections suggest that vaccinating all adults aged 65 and older in England could prevent 31 PPV23 IPD deaths over five years, with PCV20 preventing an estimated 43 deaths.

“We found that vaccinating new residents has the potential to substantially reduce the burden of pneumococcal disease and deaths in care homes for older adults when compared with the general population of adults aged 65 years who are currently eligible for pneumococcal vaccination,” the study authors said. “PCV20 is likely to have a greater effect against IPD and death than PPV23.”

—Study Authors

Targeted Prevention in Care Homes

The study specifically focused on care home residents, reporting that implementing vaccinations for all residents could prevent an estimated 117 PPV23 IPD cases and 317 PCV20 IPD cases. This targeted approach shows a significant benefit for this vulnerable population.

Recent data indicates a rise in pneumococcal disease cases in the UK, with a notable increase in hospital admissions for pneumonia among those over 65. For instance, in the first quarter of 2024, hospital admissions for pneumonia rose by 15% compared to the previous year, according to the Office for National Statistics (Office for National Statistics, 2024).

The research authors emphasized that vaccinating new residents entering older adult care homes offers a substantial opportunity to lessen the impact of pneumococcal disease and related deaths. They concluded that PCV20 is likely to provide greater protection against IPD and mortality than PPV23.