The European Commission recently approved the pneumococcal vaccine Prevenar 13 (13-valent polysaccharide conjugate vaccine; PCV13) to prevent pneumonia caused by Streptococcus pneumoniae in adults aged 18 years and older. Furthermore, the Joint Committee on Vaccination and Immunisation is currently reviewing the UK’s adult pneumococcal immunisation programme.

Against this background, the CAPiTA study, funded by Pfizer, enrolled 42,240 people aged 65 years or older who received PCV13 and 42,256 in the placebo arm. Mean follow-up was 3.97 years in each group; 12.4 and 12.6 per cent of the PCV13 and placebo groups discontinued. Forty-nine people in the PCV13 group (0.12 per cent) developed a first episode of community acquired pneumonia (CAP) caused by vaccine-type strains compared to 90 (0.21 per cent) in the placebo arm.

This suggests that the vaccine’s efficacy is 45.6 per cent against these strains. Thirty-three and 60 people (0.08 and 0.14 per cent respectively) in the PCV13 and placebo arms developed a first episode of non-bacteremic and non-invasive CAP caused by the vaccine-type strains, suggesting efficacy of 45.0 per cent. A first episode of invasive pneumococcal disease occurred in seven (0.02 per cent) and 28 (0.07 per cent) patients respectively, suggesting 75 per cent efficacy against vaccine-type strains.

Serious adverse events and deaths were similar in both groups but there were more local reactions in the PCV13 group. “This large clinical trial shows that PCV13 is an important option to help with the prevention of vaccine-type pneumococcal pneumonia and invasive pneumococcal infection, especially for older patients,” James Chalmers, respiratory disease consultant at Ninewells Hospital, Dundee and the University of Dundee told Pharmacy Magazine.

“Pharmacists are playing an increasingly vital role in the management of these patients; a group often living with co-morbidities who are at high risk of infections and more likely to experience serious complications that can lead to hospitalisation or mortality.

“The role of pharmacists in supporting and delivering preventative healthcare, including through immunisation, underpins the Government’s current strategies and targets, and is critical for our ageing population and strained healthcare service.” (N Engl J Med 2015; 372:1114-1125)