Table 5.
Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine Against Hospitalized and Nonhospitalized Lower Respiratory Tract Infection or Pneumonia End Points
| Respiratory Virus Detected |
Nonhospitalized Case Patients | Hospitalized Case Patients | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| PCV13 Receipt | Matched, Adjusted VE (95% CI), %a |
PCV13 Receipt | Matched, Adjusted VE (95% CI), %a |
|||||||
| Case Patients | Controls | Case Patients | Controls | |||||||
| % | No./Total No. | % | No./Total No. | % | No./Total No. | % | No./Total No. | |||
| Any virus detected | 60.4 | 3757/6225 | 61.7 | 77 678/125 931 | 18.6 (9.3–27.0) | 73.0 | 5567/7631 | 75.3 | 76 731/101 956 | 26.8 (19.9–33.1) |
| Any virus detected, by specific virus identified | ||||||||||
| Influenza A | 54.9 | 1046/1905 | 55.2 | 23 498/42 580 | 4.5 (−16.1 to 21.4) | 71.6 | 1469/2051 | 74.6 | 20 593/27 598 | 25.6 (11.4–37.5) |
| Influenza B | 46.8 | 275/588 | 55.7 | 4992/8970 | 46.5 (24.3–62.2) | 66.9 | 370/553 | 75.2 | 3373/4485 | 37.2 (11.8–55.3) |
| RSV | 73.1 | 411/562 | 76.4 | 7960/10 420 | 3.0 (−38.5–32.1) | 78.3 | 705/900 | 79.3 | 10 464/13 202 | 4.4 (−26.0 to 27.5) |
| HCoVs (229E, HKU1, OC43, NL63) | 62.3 | 259/416 | 64.7 | 4632/7160 | 38.7 (2.6–61.4) | 72.1 | 403/559 | 74.9 | 5051/6742 | 19.9 (−13.1 to 43.2) |
| Parainfluenza viruses (1–4) | 71.2 | 384/539 | 70.8 | 9479/13 393 | 18.9 (−19.9 to 45.2) | 79.2 | 570/720 | 79.5 | 8917/11 223 | 16.0 (−15.9 to 39.2) |
| Adenovirusesb | 38.8 | 31/80 | 26.8 | 434/1622 | … | 56.5 | 52/92 | 56.8 | 661/1163 | 43.0 (−60.6 to 79.7) |
| HMPV | 65.1 | 392/602 | 65.5 | 6934/10 589 | 17.4 (−15.6 to 41.0) | 72.0 | 618/858 | 72.1 | 8106/11 245 | 25.0 (1.0–43.2) |
| Enteroviruses | 62.6 | 959/1533 | 63.3 | 19 749/31 197 | 24.1 (4.9–39.4) | 72.7 | 1380/1898 | 74.4 | 19 566/26 298 | 31.7 (18.1–43.0) |
| Single virus detected | ||||||||||
| Influenza A | 54.5 | 977/1793 | 55.4 | 22 198/40 043 | 7.9 (−12.6 to 24.6) | 71.1 | 1350/1900 | 73.8 | 18 973/25 711 | 27.4 (12.9–39.4) |
| Influenza B | 46.5 | 254/546 | 56.7 | 4630/8166 | 45.6 (22.5–61.80 | 66.1 | 320/484 | 72.3 | 2769/3832 | 36.4 (9.0–55.5) |
| RSV | 72.8 | 367/504 | 77.1 | 7006/9088 | 18.0 (−19.5 to 43.8) | 78.2 | 609/779 | 78.7 | 8766/11 142 | 6.5 (−26.0 to 30.6) |
| HCoVs (229E, HKU1, OC43, NL63) | 65.0 | 204/314 | 70.4 | 3661/5202 | 40.8 (−2.7 to 65.9) | 71.6 | 307/429 | 74.5 | 3816/5123 | 32.5 (−1.2 to 55.0) |
| Parainfluenza viruses (1–4) | 70.8 | 357/504 | 71.6 | 8900/12 428 | 30.4 (−3.2 to 53.1) | 79.0 | 529/670 | 79.9 | 8363/10 465 | 19.8 (−12.2 to 42.6) |
| Adenovirusesb | 30.0 | 18/60 | 25.9 | 356/1372 | … | 58.8 | 40/68 | 54.9 | 426/776 | … |
| HMPV | 65.6 | 370/564 | 65.2 | 6499/9973 | 5.4 (−34.1 to 33.3) | 71.4 | 563/789 | 72.2 | 7626/10 563 | 31.7 (8.6–49.0) |
| Enteroviruses | 62.6 | 884/1412 | 63.0 | 17 911/28 421 | 25.9 (6.2–41.5) | 72.1 | 1252/1737 | 74.1 | 18 009/24 311 | 35.6 (22.4–46.7) |
| No virus detected (negative for all)c | 60.8 | 856/1409 | 62.0 | 15 558/25 104 | 29.5 (12.4–43.3) | 71.4 | 1535/2151 | 74.1 | 19 845/26 781 | 30.7 (17.7, 41.7) |
Abbreviations: CI, confidence interval; HCoVs, human coronaviruses; HMPV, human metapneumovirusPCV13, 13-valent pneumococcal conjugate vaccine; RSV, RSV, respiratory syncytial virus; VE, vaccine effectiveness.
VE is calculated for an end point of any medically attended lower respiratory tract infection (LRTI)/pneumonia for which viral respiratory polymerase chain reaction panel testing was conducted and the indicated results (pathogen detections) were obtained. We present results aggregated across LRTI/pneumonia end points in Table 3, while Table 4 presents separate estimates for pneumonia and nonpneumonia LRTI end points. Estimates are obtained via the adjusted odds ratio of prior PCV13 receipt in case patients versus matched controls, for each end point designated according to diagnosis, hospitalization status, and respiratory virus detection, estimated via logistic regression with covariate adjustment for all measured confounders. Estimates without adjustment for confounders that were not included in match assignment are presented in Supplementary Table 22. (For LRTIs, diagnosis codes from the International Classification of Diseases, Tenth Revision, Clinical Modification, are provided in Supplementary Table 1).
Insufficient sample size for model convergence.
We analyzed data from a randomly sampled subset of all virus-negative case patients.