Beyond the Guidelines: Exploring the Characteristics and Comorbidity Profiles of Adults With Pneumococcal Disease in England Not Covered by Current Pneumococcal Vaccination Criteria
Author(s)
M. Doyinsola Bailey, BSc, MPH, PhD1, Amanda Martino, BA, MPH1, John J. Were, MPH2, Sariga Kakkamani, MSc3, Rafael Coderch Lanau, MSc4, Yi Zheng, MPH, PhD1, Amy Huang, PhD1, Valina C McGuinn, BS1, Ian Matthews, BSc, MSc, PhD5, Smit Patel, BSc, MSc5, Dionysios Ntais, MSc5, Salini Mohanty, BS, MPH, DrPH1, Kelly D. Johnson, BS, MPH, PhD1.
1Merck & Co., Inc., Rahway, NJ, USA, 2Parexel International, London, United Kingdom, 3Parexel International, Brussels, Belgium, 4Parexel, Austin, TX, USA, 5MSD (UK) Ltd, London, United Kingdom.
1Merck & Co., Inc., Rahway, NJ, USA, 2Parexel International, London, United Kingdom, 3Parexel International, Brussels, Belgium, 4Parexel, Austin, TX, USA, 5MSD (UK) Ltd, London, United Kingdom.
OBJECTIVES: In England, pneumococcal vaccines are currently recommended for adults ≥65 years and those with established risk conditions. However, real-world data characterizing a broader population with pneumococcal disease may identify additional vulnerable groups not covered by current public health recommendations. In an exploratory approach, this study examined the comorbidity profiles of adults not currently eligible for pneumococcal vaccines under current JCVI (Joint Committee on Vaccination and Immunization) guidelines.
METHODS: A retrospective study was conducted among adults ≥18 years old diagnosed with pneumococcal disease (PD) between January 2017 and September 2023 in England, using linked data from the Clinical Practice Research Datalink and Hospital Episodes Statistics Admitted Patient Care databases (HES-APC). Individuals ≥65 years, as well as those with chronic or immunocompromising conditions, were excluded as listed in current JCVI recommendations. The most frequently occurring comorbidities were identified in the 12-month period prior to their PD diagnoses and aggregated across health care settings. Results were stratified by age group and sex.
RESULTS: The study identified 1,021,373 PD patients between 2017-2023. After excluding 65% (n=668,916) ≥65 years, 6% (n=56,903) with immunocompromising conditions, and 20% (n=199,655) with chronic conditions, 9% (n=95,899) were included in the analysis. Among those included, the majority were aged 18-49 years (62%), and male (51%). Mental health disorders were common: psychoactive substance abuse (17%), depression (8%), and anxiety (7%). Respiratory conditions accounted for 31% (12% COVID-19, 9% respiratory tract infections, 7% cough, 4% pleural effusion). Hypertension was present in 7%, gastrointestinal disorders in 8%, endocrine disorders in 7%, and obesity in 5%.
CONCLUSIONS: This study identified prevalent conditions that are not currently considered in JCVI pneumococcal vaccination guidelines. Additional research is necessary to assess their potential association with increased susceptibility to pneumococcal disease.
METHODS: A retrospective study was conducted among adults ≥18 years old diagnosed with pneumococcal disease (PD) between January 2017 and September 2023 in England, using linked data from the Clinical Practice Research Datalink and Hospital Episodes Statistics Admitted Patient Care databases (HES-APC). Individuals ≥65 years, as well as those with chronic or immunocompromising conditions, were excluded as listed in current JCVI recommendations. The most frequently occurring comorbidities were identified in the 12-month period prior to their PD diagnoses and aggregated across health care settings. Results were stratified by age group and sex.
RESULTS: The study identified 1,021,373 PD patients between 2017-2023. After excluding 65% (n=668,916) ≥65 years, 6% (n=56,903) with immunocompromising conditions, and 20% (n=199,655) with chronic conditions, 9% (n=95,899) were included in the analysis. Among those included, the majority were aged 18-49 years (62%), and male (51%). Mental health disorders were common: psychoactive substance abuse (17%), depression (8%), and anxiety (7%). Respiratory conditions accounted for 31% (12% COVID-19, 9% respiratory tract infections, 7% cough, 4% pleural effusion). Hypertension was present in 7%, gastrointestinal disorders in 8%, endocrine disorders in 7%, and obesity in 5%.
CONCLUSIONS: This study identified prevalent conditions that are not currently considered in JCVI pneumococcal vaccination guidelines. Additional research is necessary to assess their potential association with increased susceptibility to pneumococcal disease.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH27
Topic
Epidemiology & Public Health
Disease
Vaccines