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Before 2000, children PCV7 was the first pneumococcal conjugate vaccine (PCV) approved for use in children 80% of IPD cases among children in North America (i.e., serotypes 4, 6B, 9V, [...]

Recommendations for adult pneumococcal vaccination in the U.S. were revised in 2022 after the introduction of 15- and 20-valent pneumococcal conjugate vaccines (PCV15 and PCV20) to call for routine PCV use among immunocompetent adults with risk conditions aged 19–64 years. The present study estimated the size of this newly recommended population. A retrospective cohort study was conducted using the Optum de-identified electronic health record (EHR) dataset. Patients who were active in the EHR between January 2016 and June 2021 and had ≥1 condition included in the current pneumococcal recommendation without an immunocompromising condition were included. Data were weighted to account for potential differences between the EHR and U.S. population. Data analyses were conducted in 2022. Of 45.6 million adults aged 19–64 years in the database, 12.5 million met inclusion criteria and had ≥1 qualifying condition, primarily smoking, with chronic lung disease/asthma and/or diabetes also common. After weighting, the U.S. population aged 19–64 years newly eligible for PCVs was approximately 56 million. Approximately one in four U.S. adults aged <65 years is now recommended to receive PCV15 or PCV20, which highlights the need for providers to assess vaccination status, administer the vaccine, or refer patients as appropriate, as well as the need for tools to facilitate patient identification and vaccination. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Pneumonia hospitalization studies using administrative claims rely on pneumonia coded in the first discharge diagnosis field over pneumonia in any coded field, and few have evaluated disposition following discharge. This study reports the total disease burden and discharge disposition among patients with pneumonia coded in any diagnosis field. STUDY DESIGN: Retrospective database review. METHODS: Data from the 2014 National Inpatient Sample of the Healthcare Cost and Utilization Project, a population- weighted, 20% sample of all US community hospitalizations, were analyzed for all pneumonia hospitalizations in adults aged 18 to 64 years and 65 years or older. Number of hospitalizations, hospital stay length, direct medical costs, in-hospital mortality, patient discharge disposition, illness severity, and likelihood of dying were evaluated based on the diagnosis field of pneumonia as a discharge diagnosis (eg, first, second, third, or further). RESULTS: In 2014, an estimated 2.4 million US adult hospitalizations were associated with pneumonia in any of the discharge diagnosis positions (33%-35% in first, 33%-36% in second, and 29%-34% in further positions). When estimates were based only on hospitalizations with pneumonia in the first diagnosis field, approximately 66% of hospitalizations, 78% of hospital days, 87% of in-hospital deaths, 76% and 73% of transfers to short-term hospitals and skilled nursing facilities, 68% of discharges with home health care services, and 82% of direct medical costs were excluded. CONCLUSIONS: Pneumonia hospitalizations were associated with substantial health care resource utilization and in-hospital mortality. Relying only on pneumonia in the first hospital diagnosis field may potentially underestimate the burden associated with pneumonia hospitalizations. [ABSTRACT FROM AUTHOR]

Aim: The US Food and Drug Administration approved the 20-valent pneumococcal conjugate vaccine (PCV20) to prevent pneumococcal disease. In the context of routine PCV20 vaccination, we evaluated the cost-effectiveness and public health and economic impact of a PCV20 catch-up program and estimated the number of antibiotic prescriptions and antibiotic-resistant infections averted., Materials and Methods: A population-based, multi-cohort, decision-analytic Markov model was developed using parameters consistent with previous PCV20 cost-effectiveness analyses. In the intervention arm, children aged 14-59 months who previously completed PCV13 vaccination received a supplemental dose of PCV20. In the comparator arm, no catch-up PCV20 dose was given. The direct and indirect benefits of vaccination were captured over a 10-year time horizon., Results: A PCV20 catch-up program would prevent 5,469 invasive pneumococcal disease cases, 50,286 hospitalized pneumonia cases, 218,240 outpatient pneumonia cases, 582,302 otitis media cases, and 1,800 deaths, representing a net gain of 30,014 life years and 55,583 quality-adjusted life years. Furthermore, 720,938 antibiotic prescriptions and 256,889 antibiotic-resistant infections would be averted. A catch-up program would result in cost savings of $800 million. These results were robust to sensitivity and scenario analyses., Conclusions: A PCV20 catch-up program could prevent pneumococcal infections, antibiotic prescriptions, and antimicrobial-resistant infections and would be cost-saving in the US.