Adult vaccination for pneumococcal disease: a comparisonof the national guidelines in Europe

Abstract

AbstractPneumococcal disease constitutes a major global health problem. Adults aged over 50 years and younger adults with specificchronic health conditions are at risk for invasive pneumococcal disease, associated with substantial morbidity and mortality. InEurope, two vaccine types are used in adults for pneumococcal immunization: pneumococcal polysaccharide vaccine (PPV23)and pneumococcal conjugate vaccine (PCV13). To provide an overview and to compare the national guidelines for pneumococcalimmunization for adults in Europe. In November 2016, national guidelines on pneumococcal vaccination for adults of 31European countries were obtained by Google search, the website of European Centre for Disease Prevention and Control, andcontacting public health officials. In our analysis, we distinguished between age-based and risk-based guidelines. In October2017, we used the same method to retrieve guideline updates. We observed great variability regarding age, risk groups, vaccinetype, and use of boosters. In age-based guidelines, vaccination is mostly recommended in adults aged over 65 years using PPV23.Boosters are generally not recommended. An upper age limit for vaccination is reported in three countries. In the immunocompromisedpopulation, vaccination with both vaccines and administration of a booster is mostly recommended. In the populationwith chronic health conditions, there is more heterogeneity according vaccine type, sequence, and administration of boosters.Asplenia is the only comorbidity for which all countries recommend vaccination. The great variability in European pneumococcalvaccination guidelines warrants European unification of the guidelines for better control of pneumococcal disease.Keywords Pneumococcal vaccination . Adults . Europe . Recommendations . PCV13 . PPV2