Extra Pneumococcal Dose Can Save Lives in Care Homes
An additional dose of a pneumococcal vaccine, either 23-valent pneumococcal polysaccharide vaccine (PPV23) or 20-valent pneumococcal conjugate vaccine (PCV20), for new care home residents upon entry could prevent a substantially higher proportion of invasive pneumococcal disease cases and deaths per dose than the single-dose schedule for 65-year-olds, with the PCV20 vaccine demonstrating greater effectiveness over the PPV23 vaccine.
METHODOLOGY:
Researchers in England conducted an observational surveillance study to evaluate the effect of administering an additional dose of a pneumococcal vaccine, either PPV23 or PCV20, at admission to new residents of older care homes, alongside the routine vaccination.
Using national invasive pneumococcal disease surveillance and other data sources, they analysed 121,587 new care home residents (83,271 women and 38,316 men) to estimate the potential number of invasive pneumococcal disease cases and deaths averted over 5 years and calculated the number needed to vaccinate (NNV) to prevent one vaccine-type case and one death.
They compared these results with those of 603,109 individuals (aged 65 years) from the general population who had received a single vaccine dose.
TAKEAWAY:
PPV23 immunisation of all new care home residents would prevent 36% of PPV23-type lifetime cases of invasive pneumococcal disease (NNV, 687) and 48% of deaths (NNV, 1095).
Similarly, PCV20 immunisation would prevent 75% of PCV20-type lifetime cases of invasive pneumococcal disease (NNV, 384) and 80% of deaths (NNV, 774).
An additional dose of both vaccines could prevent five times more cases and 18 times more deaths than the current immunisation policy for adults aged 65 years.
IN PRACTICE:
"Protecting older adults, especially those in aged care facilities, from infectious diseases is necessary to reduce morbidity and mortality. Vaccination, including against pneumococcus, is an effective strategy to promote healthy ageing," the author of a commentary wrote.
SOURCE:
This study was led by Fariyo Abdullahi, MSc, Immunisation and Vaccine Preventable Diseases, UK Health Security Agency, London, England. It was published online on July 01, 2025, in The Lancet Healthy Longevity.
LIMITATIONS:
The national dataset could not identify individuals in temporary or respite care, potentially leading to an undercount of care home residents. This study relied on invasive pneumococcal disease risk estimates from the older study, which may not have reflected current conditions in England. The NNV might be underestimated as frail residents are less likely to receive invasive investigations.
DISCLOSURES:
The Immunisation and Vaccine Preventable Diseases Division provided vaccine manufacturers with postmarketing surveillance reports on pneumococcal and meningococcal infections, with cost recovery charges applied. One author reported performing contract research for pharmaceutical companies on behalf of St George's University of London and the UK Health Security Agency without personal remuneration. The other authors reported having no competing interests.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
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