01-022 · EVIDENCE A · SOURCE-SENSITIVE
Pneumococcal vaccine for people over 65
65 岁以上打肺炎球菌疫苗
Several hundred yuan. In some regions, it is provided free of charge for seniors.
In a trial involving 84,500 seniors, the 13-valent pneumococcal vaccine cut cases of pneumonia caused by strains it targets by roughly 46%, and reduced instances of the most severe invasive infections by 75%. However, it showed no effect on pneumonia cases caused by any other pathogens, so it won’t prevent all types of pneumonia. The absolute confidence interval width is 95.2%.
A
Move “Pneumococcal vaccine for people over 65” to Future Me's calendar
The excuse
If I do not open the notes, no new task has technically appeared.
What feels good now
Today I keep a little money, a few minutes and avoid interrupting my default routine.
What the source says
The source summarizes the return this way: “In a trial involving 84,500 seniors, the 13-valent pneumococcal vaccine cut cases of pneumonia caused by strains it targets by roughly 46%, and reduced instances of the most severe invasive infections by 75%. However, it showed no effect on pneumonia cases caused by any other pathogens, so it won’t prevent all types of pneumonia. The absolute confidence interval width is 95.2%.” Evidence grade A. The original states the population, caveats, and sources; this is not a personal forecast.
Use the original facts and limits. For an urgent medical, safety, financial, or legal issue, contact a qualified local professional or service.
THE ENGLISH EDITION
Original recommendation and evidence
22. Pneumococcal vaccine for people over 65
Cost: Several hundred yuan. In some regions, it is provided free of charge for seniors.
In plain terms: In a trial involving 84,500 seniors, the 13-valent pneumococcal vaccine cut cases of pneumonia caused by strains it targets by roughly 46%, and reduced instances of the most severe invasive infections by 75%. However, it showed no effect on pneumonia cases caused by any other pathogens, so it won’t prevent all types of pneumonia. The absolute confidence interval width is 95.2%.
Benefit: Researchers in the Netherlands randomly assigned 84,500 seniors over 65 to two groups for comparison. They used the 13-valent pneumococcal conjugate vaccine. Its effectiveness against pneumonia caused by strains it targets was 45.6%, with a 95% confidence interval of 21.8–62.5. This figure refers to the specific bacterial strains the vaccine can protect against. For the most dangerous form of pneumococcal disease, the effectiveness was 75.0% (95% CI 41.4–90.8). No protective effect was observed against pneumonia cases caused by any other pathogens.
Evidence grade: A
Sources: Bonten MJ, Huijts SM, Bolkenbaas M, et al. (2015). Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. New England Journal of Medicine, 372(12), 1114-1125. <https://doi.org/10.1056/NEJMoa1408544>
Notes: This vaccine only protects against the specific bacterial strains it targets; it does not prevent all types of pneumonia. The 23-valent polysaccharide vaccine commonly used for seniors in China is a different formulation from the 13-valent conjugate vaccine used in this trial, so the effectiveness figures here cannot be directly applied to that vaccine.
Read the complete Chinese source and notes
22. 65 岁以上打肺炎球菌疫苗
成本: 几百元。部分地区对老年人免费。
说人话: 8.45 万老人的试验里，13 价肺炎球菌疫苗把疫苗管得住的那几型肺炎挡掉约 46%，把最凶险的侵袭性感染挡掉 75%。但对「所有原因的肺炎」没看出效果，别指望它管住全部肺炎。
收益: 荷兰把 8.45 万名 65 岁以上老人随机分成两组来比。用的是 13 价肺炎球菌结合疫苗。它对疫苗覆盖型肺炎的效力是 45.6%。可信范围是 95.2% CI 21.8–62.5。疫苗覆盖型就是这支疫苗管得住的那几个菌型。对侵袭性肺炎球菌病的效力是 75.0%（95% CI 41.4–90.8），这是最凶险的那一类感染。对全部原因加在一起的肺炎，它没有效果
证据等级: A
来源: Bonten MJ, Huijts SM, Bolkenbaas M, et al. (2015). Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. New England Journal of Medicine, 372(12), 1114-1125. <https://doi.org/10.1056/NEJMoa1408544>
备注: 它只防疫苗覆盖的那几个型别，不是打了就不得肺炎。中国老年人常打的是 23 价多糖疫苗，和这项试验用的 13 价结合疫苗不是同一种，上面的效力数据不能直接套过去
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