Germany first recommended vaccination with 23-valent polysaccharide vaccine (PPV23) for adults 60 years of age and older in 1998. Despite the longstanding recommendation, pneumococcal vaccination rates among adults are low.
We are performing a two-year, prospective survey of treating physicians for the lifetime pneumococcal vaccination status of adults ages 60 and older with IPD. Vaccine effectiveness was estimated using the indirect cohort method.
We determined the vaccination status for 839 cases of IPD (of 4751 eligible cases) occurring in older adults in 2018 or 2019. Of these, 616 (73.4%) had received no pneumococcal vaccination prior to illness. 177 (21.1%) cases had been vaccinated with PPV23, 35 (4.2%) had been vaccinated with PCV13, and 11 (1.3%) cases had received both vaccines. 413 cases were caused by PPV23 serotypes; 179 were caused by serotype 3. Preliminary, age-adjusted estimates of vaccine effectiveness for PPV23 are:
| Serotypes | age-adjusted Vaccine Effectiveness | 95% Confidence Intervals | |
| PPV23 serotypes | -20% |
| |
| PPV23 serotypes except 3 | 62% | 45% · 73% | |
| Serotype 3 alone | -128% | -231% · -56% | |
| PPV23nonPCV13 serotypes | 58% | 39% · 71% |
PPV23 provides modest direct protection against IPD caused by most targeted serotypes, but effectiveness against serotype 3 IPD is lacking.