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Relative effectiveness of revaccination with 23-valent pneumococcal polysaccharide vaccine in preventing invasive pneumococcal disease in adult Aboriginal and Torres Strait Islander people, Australia

Takashima, Mari, Lambert, Stephen B., Paynter, Stuart, Ware, Robert S.
Vaccine 2019 v.37 no.12 pp. 1638-1641
Australians, adults, at-risk population, pneumonia, polysaccharides, serotypes, vaccination, vaccines, Queensland
Aboriginal and Torres Strait Islander (Indigenous) Australians have high rates of invasive pneumococcal disease (IPD), with repeat doses of 23-valent polysaccharide pneumococcal vaccine (PPV23) recommended. We report the relative effectiveness of revaccination using a cohort from linked administrative data.All resident North Queensland Indigenous adults who received any PPV23 vaccination between 2000 and 2012 were identified and linked with IPD cases. IPD rates were compared for individuals revaccinated >five years after initial PPV23 dose against individuals not revaccinated.Analysed data included 12,809 individuals and 89,612 person-years. Revaccinated adults had similar rates of IPD as non-revaccinated adults, after adjusting for potential confounders (HR = 0.92; 95%CI: 0.35–2.42). Findings were similar for vaccine-specific serotypes (HR = 1.32; 95%CI: 0.32–5.43).Benefits of PPV23 revaccination against IPD in this high-risk population were not demonstrated, although estimates were imprecise. Findings should be validated in other high-risk cohorts, and against all-cause pneumonia as an outcome.