Effectiveness of the 23-valent polysaccharide vaccine against invasive pneumococcal disease in Navajo adults. 2003

Andrea L Benin, and Katherine L O'Brien, and James P Watt, and Raymond Reid, and Elizabeth R Zell, and Scott Katz, and Connie Donaldson, and Alan Parkinson, and Anne Schuchat, and Mathuram Santosham, and Cynthia G Whitney
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. andrea.benin@yale.edu

Invasive pneumococcal disease occurs 2-3-fold more often among Navajo adults than among adults in the general United States population. The objective of this observational study was to determine the effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPV23) among Navajo adults. Active surveillance identified cases of invasive pneumococcal disease during 1996-1997. Three control patients per case patient were matched according to underlying medical conditions, sex, age, and location of medical care. Effectiveness was calculated by regression analysis of case-control sets and by indirect cohort methodology. Diabetes and alcoholism occurred in 41% and 43% of 108 case patients, respectively; 62% of case patients and 64% of control patients were immunized. Overall vaccine effectiveness was 26% (95% confidence interval [CI], -29% to 58%); 15% (95% CI, -116% to 67%) for patients with diabetes and -5% (95% CI, -141% to 54%) for patients with alcoholism. Overall vaccine effectiveness, as determined by use of the indirect cohort methodology, was 35% (95% CI, -33% to 69%). PPV23 was not significantly effective among Navajo adults and may be inadequate to prevent serious pneumococcal disease in this population.

UI MeSH Term Description Entries
D007198 Indians, North American Members of indigenous North American populations with pre-colonial contact origins. Amerinds, North American,Indigenous North Americans,American Indian, North,American, Indigenous North,Amerind, North American,Indian, North American,Indigenous North American,North American Amerind,North American Amerinds,North American Indian,North American Indians,North American, Indigenous
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011008 Pneumococcal Infections Infections with bacteria of the species STREPTOCOCCUS PNEUMONIAE. Streptococcus pneumoniae Infections,Infections, Pneumococcal,Infections, Streptococcus pneumoniae,Pneumococcal Diseases,Disease, Pneumococcal,Diseases, Pneumococcal,Infection, Pneumococcal,Infection, Streptococcus pneumoniae,Pneumococcal Disease,Pneumococcal Infection,Streptococcus pneumoniae Infection
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D013296 Streptococcus pneumoniae A gram-positive organism found in the upper respiratory tract, inflammatory exudates, and various body fluids of normal and/or diseased humans and, rarely, domestic animals. Diplococcus pneumoniae,Pneumococcus

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