Community Program Slashes Elderly Pneumonia Deaths by 25%

A team of researchers has assessed the effectiveness of a community-driven initiative aimed at increasing pneumococcal vaccination rates among older adults in Sera Town, located in Hiroshima Prefecture, Japan. The findings of this real-world evaluation were published in the Journal of Epidemiology. (1^✔ ✔Trusted Source
Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-based Study

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Pneumonia: A Major Killer of Seniors in Japan

Pneumonia is one of the leading causes of death in Japan. Each year about 74,000 people die from pneumonia with 98 percent of these deaths occurring in people aged 65 and older. The bacteria Streptococcus pneumoniae is the primary cause of pneumonia.

In October 2014, Japan began a nationwide routine vaccination program for the elderly under the National Immunization Program with the 23-valent pneumococcal polysaccharide vaccine (PPSV23).

Sera Town, a mountainous municipality in eastern Hiroshima Prefecture, jointly planned and implemented a pneumococcal vaccination support program with a research team at Hiroshima University in October 2010—well before the nationwide rollout. The program, which ran until March 2015, aimed to promote community health and provided PPSV23 vaccination to all residents aged 65 and older. The vaccine used in the project was approved in Japan at the time for elderly individuals. As part of this collaborative initiative, a five-year follow-up survey was conducted to assess the vaccine’s preventive effect against pneumonia.

“Specifically, we sought to understand the impact of the PPSV23 vaccine on pneumonia incidence and mortality among the elderly population in a rural setting with a high aging rate,” said Aya Sugiyama, a lecturer in the Department of Epidemiology Disease Control and Prevention at the Graduate School of Biomedical and Health Sciences, Hiroshima University. The Sera Town residents who took part in the project ranged in age from 70 to 114 years old, with a median age of 84.

Evaluating the Impact of Vaccination Programs on Mortality in Japan's Super-Aged Society

To assess changes in mortality following the introduction of the vaccination program, the researchers used aggregated demographic data from Japan’s vital statistics covering the years 2000 to 2016. They applied an interrupted time series analysis to quantify the level and trend changes in mortality rates over time, specifically looking at the mortality rates before and after the vaccination project was introduced in the town. The study aimed to generate real-world evidence on the effectiveness of vaccination support programs in super-aged societies.

Their analysis of the data showed them that the pneumococcal vaccination support program for older residents in Sera Town was associated with a 25 percent reduction in pneumonia-related mortality. “Notably, it reversed the previously increasing trend in pneumonia mortality in the community,” said Sugiyama.

Scientists use the person-year method in studies where they follow individuals over a period of time. A person-year is one person being followed for one year. “These findings underscore both the public health significance of local vaccination efforts and the burden of pneumonia in aging populations,” said Sugiyama.

The research team sees the findings as particularly relevant for Japan, which has the most aged population in the world.

“With the completion of this evaluation, the next step is to share these findings to inform future discussions on community-based vaccination strategies. While further research is needed, we hope that our results will serve as a reference for regions exploring effective approaches to pneumonia prevention in older adults,” said Sugiyama.

Reference:

1. Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-based Study - (https://www.jstage.jst.go.jp/article/jea/35/5/35_JE20240285/_article)

Source-Eurekalert