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Peer-reviewedCC BY 4.0Epidemiology and Infection

Impact of 23-valent pneumococcal polysaccharide vaccination on non-invasive pneumococcal pneumonia: A regression discontinuity analysis

  • Femke S. Vernooij1
  • F. Annabel Niessen1,2
  • Anneke Steens1
  • Mirjam Knol1
  • Hester de Melker1
  • Jan van de Kassteele1
  • C.H. (Henri) Van Werkhoven1,3
  • PPV23-NIPP Study Group
  1. 1Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Netherlands
  2. 2Department of Medical Microbiology, Univerisity Medical Center Utrecht, Utrecht University, Netherlands
  3. 3Julius Center for Health Sciences and Primary Care, Univerisity Medical Center Utrecht, Utrecht University, Netherlands
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Abstract

The aim of this study was to evaluate the impact of the vaccination programme with 23-valent pneumococcal polysaccharide vaccine (PPV23) on non-invasive pneumococcal pneumonia (NIPP) in adults above 60 years old during the first three post-implementation years. For this retrospective impact study with a regression discontinuity design, we included patients aged 56 to 85 years who presented with NIPP at the hospital between November 1, 2016 and September 30, 2023. NIPP was defined as a positive pneumococcal urinary antigen test without meeting criteria for invasive pneumococcal disease (blood and/or cerebrospinal fluid culture positive for Streptococcus pneumoniae). We estimated the overall impact and the impact stratified by time since eligibility for vaccination for each birth cohort. Data were obtained from 14 laboratories throughout the Netherlands, which were estimated to cover 34.9% of the Dutch population. We observed 3821 NIPP patients, of whom 634 were eligible for vaccination. The overall impact was 19.7% (95% confidence interval 8.5, 29.7). Impact estimates decreased over time since eligibility, although non-significantly with overlapping confidence intervals. These insights contribute to the existing body of evidence about PPV23 impact on NIPP, informing future vaccination policy.

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Cite

BibTeXRIS
BibTeX
@article{vernooij2026impact,
  title = {{Impact of 23-valent pneumococcal polysaccharide vaccination on non-invasive pneumococcal pneumonia: A regression discontinuity analysis}},
  author = {Femke S. Vernooij and F. Annabel Niessen and Anneke Steens and Mirjam Knol and Hester de Melker and Jan van de Kassteele and C.H. (Henri) Van Werkhoven and PPV23-NIPP Study Group},
  journal = {Epidemiology and Infection},
  year = {2026},
  month = jul,
  doi = {10.1017/s0950268826101952},
  url = {https://doi.org/10.1017/s0950268826101952},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Impact of 23-valent pneumococcal polysaccharide vaccination on non-invasive pneumococcal pneumonia: A regression discontinuity analysis
AU  - Femke S. Vernooij
AU  - F. Annabel Niessen
AU  - Anneke Steens
AU  - Mirjam Knol
AU  - Hester de Melker
AU  - Jan van de Kassteele
AU  - C.H. (Henri) Van Werkhoven
AU  - PPV23-NIPP Study Group
PY  - 2026
DA  - 2026/07/23
JO  - Epidemiology and Infection
DO  - 10.1017/s0950268826101952
UR  - https://doi.org/10.1017/s0950268826101952
AB  - The aim of this study was to evaluate the impact of the vaccination programme with 23-valent pneumococcal polysaccharide vaccine (PPV23) on non-invasive pneumococcal pneumonia (NIPP) in adults above 60 years old during the first three post-implementation years. For this retrospective impact study with a regression discontinuity design, we included patients aged 56 to 85 years who presented with NIPP at the hospital between November 1, 2016 and September 30, 2023. NIPP was defined as a positive pneumococcal urinary antigen test without meeting criteria for invasive pneumococcal disease (blood and/or cerebrospinal fluid culture positive for Streptococcus pneumoniae). We estimated the overall impact and the impact stratified by time since eligibility for vaccination for each birth cohort. Data were obtained from 14 laboratories throughout the Netherlands, which were estimated to cover 34.9% of the Dutch population. We observed 3821 NIPP patients, of whom 634 were eligible for vaccination. The overall impact was 19.7% (95% confidence interval 8.5, 29.7). Impact estimates decreased over time since eligibility, although non-significantly with overlapping confidence intervals. These insights contribute to the existing body of evidence about PPV23 impact on NIPP, informing future vaccination policy.
SN  - 0950-2688
SN  - 1469-4409
ER  -