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Volume 26, Number 10—October 2020
Research

Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine against Invasive Pneumococcal Disease in Adults, Japan, 2013–2017

Reiko Shimbashi, Motoi SuzukiComments to Author , Bin Chang, Hiroshi Watanabe, Yoshinari Tanabe, Koji Kuronuma, Kengo Oshima, Takaya Maruyama, Hiroaki Takeda, Kei Kasahara, Jiro Fujita, Junichiro Nishi, Tetsuya Kubota, Keiko Tanaka-Taya, Tamano Matsui, Tomimasa Sunagawa, Kazunori Oishi, and Adult IPD Study Group
Author affiliations: National Institute of Infectious Diseases, Tokyo, Japan (R. Shimbashi, M. Suzuki, B. Chang, K. Tanaka-Taya, T. Matsui, T. Sunagawa, K. Oishi); Tohoku University Graduate School of Medicine, Miyagi, Japan (R. Shimbashi, M. Suzuki, K. Oshima); Kurume University School of Medicine, Fukuoka, Japan (H. Watanabe); Niigata Prefectural Shibata Hospital, Niigata, Japan (Y. Tanabe); Sapporo Medical University School of Medicine, Hokkaido, Japan (K. Kuronuma); National Hospital Organization Mie National Hospital, Mie, Japan (T. Maruyama); Yamagata Saisei Hospital, Yamagata, Japan (H. Takeda); Nara Medical University, Nara, Japan (K. Kasahara); Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan (J. Fujita); Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan (J. Nishi); Kochi Medical School, Kochi University, Kochi, Japan (T. Kubota); Toyama Institute of Health, Toyama, Japan (K. Oishi)

Main Article

Table 1

Characteristics of 1,121 invasive pneumococcal disease patients with and without PPSV23 serotype, Japan, 2013–2017*

Characteristic Total
PPSV23 serotype, n = 746
Non-PPSV23 serotype, n = 375
p value
Sex
M 679 (61) 443 (59) 236 (63) 0.251
F
442 (39)
303 (41)
139 (37)

Age group, y
20–39 55 (5) 34 (5) 21 (6) 0.437
40–64 309 (28) 211 (28) 98 (26)
65–79 427 (38) 291 (39) 136 (36)
>80
330 (29)
210 (28)
120 (32

Study site, prefecture
Hokkaido 138 (12) 85 (11) 53 (14) 0.612
Miyagi 133 (12) 92 (12) 41 (11)
Yamagata 95 (8) 69 (9) 26 (7)
Niigata 211 (19) 144 (19) 67 (18)
Mie 113 (10) 78 (10) 35 (9)
Nara 80 (7) 51 (7) 29 (8)
Kochi 38 (3) 27 (4) 11 (3)
Fukuoka 222 (20) 146 (20) 76 (20)
Kagoshima 45 (4) 28 (4) 17 (5)
Okinawa
46 (4)
26 (3)
20 (5)

Year
2013 45 (4) 33 (4) 12 (3) 0.602
2014 201 (18) 134 (18) 67 (18)
2015 213 (19) 146 (20) 67 (18)
2016 286 (26) 180 (24) 106 (28)
2017 363 (32) 243 (33) 120 (32)
Unknown
13 (1)
10 (1)
3 (1)

Season†
High season 722 (64) 492 (66) 230 (61) 0.152
Low season 385 (34) 243 (33) 142 (38)
Unknown
14 (1)
11 (1)
3 (1)

BMI group, kg/m2
<18.5 257 (23) 171 (23) 86 (23) 0.895
18.5–24.9 526 (47) 346 (46) 180 (48)
>25 167 (15) 111 (15) 56 (15)
Unknown
171 (15)
118 (16)
53 (14)

Underlying conditions
Immunocompromised conditions 314 (28) 175 (23) 139 (37) <0.001
Other conditions 479 (43) 324 (43) 155 (41)
Without underlying conditions 256 (23) 198 (27) 58 (15)
Unknown
72 (6)
49 (7)
23 (6)

Smoking history
Yes 390 (35) 265 (36) 125 (33) 0.709
No 559 (50) 370 (50) 189 (50)
Unknown
172 (15)
111 (15)
61 (16)

Alcohol intake
Yes 184 (16) 121 (16) 63 (17) 0.439
No 750 (67) 493 (66) 257 (69)
Unknown
187 (17)
132 (18)
55 (15)

Clinical manifestations
Pneumonia 665 (59) 480 (64) 185 (49) <0.001
Meningitis 169 (15) 94 (13) 75 (20)
Bacteremia 188 (17) 104 (14) 84 (22)
Other‡ 98 (9) 68 (9) 30 (8)
Unknown
1 (0)
0 (0)
1 (0)

Fatal outcome
Yes 204 (18) 137 (18) 67 (18) 0.838
No
917 (82)
609 (82)
308 (82)

PPSV23 vaccination within 5 y
Yes 103 (9) 58 (8) 45 (12) <0.001
No 765 (68) 539 (72) 226 (60)
Unknown 253 (23)
149 (20)
104 (28)

*Values are no. (%) unless indicated. BMI, body mass index; EW, epidemiologic week; PPSV23, 23-valent pneumococcal polysaccharide vaccine.
†High season indicates the period from EW 1 to EW 22 and from EW 49 to EW 52, whereas low season indicates the period from EW 23 to EW 48.
‡Includes arthritis, endocarditis, sinusitis, otitis media, vertebritis, cholecystitis, aortic aneurysm, and pleurisy.

Main Article

Page created: August 05, 2020
Page updated: September 17, 2020
Page reviewed: September 17, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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