Pneumococcal vaccination in adultsAuthorDaniel M Musher, MDSection EditorJohn G Bartlett, MDDeputy EditorAnna R Thorner, MDDisclosuresAll topics are updated as new evidence becomes available and our peer review process is complete.Literature review current through: Mar 2014. | This topic last updated: Jan 23, 2014.INTRODUCTIONPneumococcal infections, including pneumonia and invasive disease such as bacteremia and meningitis, are an important source of morbidity and mortality in children or = years. J Infect Dis 2010; 201:525.19. Hammitt LL, Bulkow LR, Singleton RJ, et al. Repeat revaccination with 23-valent pneumococcal polysaccharide vaccine among adults aged 55-74 years living in Alaska: no evidence of hyporesponsiveness. Vaccine 2011; 29:2287.20. Musher DM, Manof SB, Liss C, et al. Safety and antibody response, including antibody persistence for 5 years, after primary vaccination or revaccination with pneumococcal polysaccharide vaccine in middle-aged and older adults. J Infect Dis 2010; 201:516.21. Jackson LA, Benson P, Sneller VP, et al. Safety of revaccination with pneumococcal polysaccharide vaccine. JAMA 1999; 281:243.22. Grabenstein JD, Manoff SB. Pneumococcal polysaccharide 23-valent vaccine: long-term persistence of circulating antibody and immunogenicity and safety after revaccination in adults. Vaccine 2012; 30:4435.23. Moberley S, Holden J, Tatham DP, Andrews RM. Vaccines for preventing pneumococcal infection in adults. Cochrane Database Syst Rev 2013; 1:CD000422.24. Pilishvili T, Lexau C, Farley MM, et al. Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine. J Infect Dis 2010; 201:32.25. Musher DM. Editorial commentary: should 13-valent protein-conjugate pneumococcal vaccine be used routinely in adults? Clin Infect Dis 2012; 55:265.26. Griffin MR, Zhu Y, Moore MR, et al. U.S. hospitalizations for pneumonia after a decade of pneumococcal vaccination. N Engl J Med 2013; 369:155.27. 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Effect of pneumococcal vaccination: a comparison of vaccination rates in patients with bacteremic and nonbacteremic pneumococcal pneumonia. Clin Infect Dis 2006; 43:1004.40. Austrian R, Douglas RM, Schiffman G, et al. Prevention of pneumococcal pneumonia by vaccination. Trans Assoc Am Physicians 1976; 89:184.41. Bentley DW, Ha K, Mamot K, et al. Pneumococcal vaccine in the institutionalized elderly: design of a nonrandomized trial and preliminary results. Rev Infect Dis 1981; 3 Suppl:S71.42. Gaillat J, Zmirou D, Mallaret MR, et al. [Clinical trial of an antipneumococcal vaccine in elderly subjects living in institutions]. Rev Epidemiol Sante Publique 1985; 33:437.43. Jackson LA, Janoff EN. Pneumococcal vaccination of elderly adults: new paradigms for protection. Clin Infect Dis 2008; 47:1328.44. Huss A, Scott P, Stuck AE, et al. Efficacy of pneumococcal vaccination in adults: a meta-analysis. CMAJ 2009; 180:48.45. Koivula I, Stn M, Leinonen M, Mkel PH. Clinical efficacy of pneumococcal vaccine in the elderly: a randomized, single-blind population-based trial. Am J Med 1997; 103:281.46. Ortqvist A, Hedlund J, Burman LA, et al. Randomised trial of 23-valent pneumococcal capsular polysaccharide vaccine in prevention of pneumonia in middle-aged and elderly people. Swedish Pneumococcal Vaccination Study Group. Lancet 1998; 351:399.47. Simberkoff MS, Cross AP, Al-Ibrahim M, et al. Efficacy of pneumococcal vaccine in high-risk patients. Results of a Veterans Administration Cooperative Study. N Engl J Med 1986; 315:1318.48. Maruyama T, Taguchi O, Niederman MS, et al. Efficacy of 23-valent pneumococcal vaccine in preventing pneumonia and improving survival in nursing home residents: double blind, randomised and placebo controlled trial. BMJ 2010; 340:c1004.49. Musher DM, Mediwala R, Phan HM, et al. Nonspecificity of assaying for IgG antibody to pneumolysin in circulating immune complexes as a means to diagnose pneumococcal pneumonia. Clin Infect Dis 2001; 32:534.50. Walker FJ, Singleton RJ, Bulkow LR, et al. Reactions after 3 or more doses of pneumococcal polysaccharide vaccine in adults in Alaska. Clin Infect Dis 2005; 40:1730.51. Clutterbuck EA, Lazarus R, Yu LM, et al. Pneumococcal conjugate and plain polysaccharide vaccines have divergent effects on antigen-specific B cells. J Infect Dis 2012; 205:1408.52. Goldblatt D, Southern J, Andrews N, et al. The immunogenicity of 7-valent pneumococcal conjugate vaccine versus 23-valent polysaccharide vaccine in adults aged 50-80 years. Clin Infect Dis 2009; 49:1318.53. O'Brien KL. Pneumococcal conjugate vaccine, polysaccharide vaccine, or both for adults? We're not there yet. Clin Infect Dis 2009; 49:1326.54. Musher DM, Rueda AM, Nahm MH, et al. Initial and subsequent response to pneumococcal polysaccharide and protein-conjugate vaccines administered sequentially to adults who have recovered from pneumococcal pneumonia. J Infect Dis 2008; 198:1019.55. Lazarus R, Clutterbuck E, Yu LM, et al. A randomized study comparing combined pneumococcal conjugate and polysaccharide vaccination schedules in adults. Clin Infect Dis 2011; 52:736.56. Miernyk KM, Butler JC, Bulkow LR, et al. Immunogenicity and reactogenicity of pneumococcal polysaccharide and conjugate vaccines in alaska native adults 55-70 years of age. Clin Infect Dis 2009; 49:241.57. Hak E, Grobbee DE, Sanders EA, et al. Rationale and design of CAPITA: a RCT of 13-valent conjugated pneumococcal vaccine efficacy among older adults. Neth J Med 2008; 66:378.58. FDA expands use of Prevnar 13 vaccine for people ages 50 and older. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm285431.htm (Accessed on January 03, 2012).59. Smith KJ, Wateska AR, Nowalk MP, et al. Cost-effectiveness of adult vaccination strategies using pneumococcal conjugate vaccine compared with pneumococcal polysaccharide vaccine. JAMA 2012; 307:804.60. Rozenbaum MH, van Hoek AJ, Fleming D, et al. Vaccination of risk groups in England using the 13 valent pneumococcal conjugate vaccine: economic analysis. BMJ 2012; 345:e6879.61. Moffitt KL, Malley R. Next generation pneumococcal vaccines. Curr Opin Immunol 2011; 23:407.Topic 7021 Version 33.0 2014 UpToDate, Inc. All rights reserved. | Subscription and License Agreement |Release: 22.2 - C22.74 Licensed to: UpToDate Individual Web - Ivelisse Taveras |Support Tag: [0602-190.166.150.53-13E50B86CF-6.14-179134738]