Autoimmune Disorders

Pneumococcal Vaccination Significantly Reduces the Risk of Severe Disease in Patients With IBD

Vaccination against pneumococcus significantly reduces the risk of severe pneumococcal disease in patients with inflammatory bowel disease (IBD), according to a recent study.1

Pneumococcal pneumonia, meningitis, and bacteremia are common infections in the United States, especially among older adults.2 However, these diseases are preventable with vaccination. The pneumococcal 13-valent conjugate vaccine (PCV13) is recommended for children younger than aged 2 years, and the pneumococcal polysaccharide vaccine (PPSV23) is recommended for adults aged 65 years or older.2

For their study, the researchers first identified patients with IBD and severe pneumococcal disease using the VA Health Administration database. Of the total 1798 cases identified, 1513 were bacteremia, 283 were pneumonia, and 2 were meningitis infections. Patients with severe pneumococcal disease tended to be older, have more comorbidities, and have increased mortality risk.

Then, they collected data on pneumococcal vaccination status and immunosuppressant medication use, since immunosuppressants are known to increase the risk for infection. In fact, the researchers found that immunosuppressant use had increased the risk of severe pneumococcal disease among study participants as well.

Using a Cox proportional hazards model allowed the researchers to calculate the risk of severe pneumococcal disease while controlling for demographics, medication use, vaccination status, and comorbidities. They ultimately found higher hazard ratios for participants with Crohn disease (1.15; 95% CI, 1.05-1.27) and those with more comorbidities (1.45; 95% CI, 1.42-1.48).

Moreover, results of the vaccination status analysis showed that participants who received the PCV13 were 5 times less likely to have severe pneumococcal disease, regardless of whether they received it alone or in addition to the PPSV23.

“Vaccination with PCV13 alone or in combination with PPSV23 and revaccination with PPSV23, was protective against [severe pneumococcal disease],” the researchers concluded. “All IBD patients should be evaluated for pneumococcal vaccination, particularly those receiving or expected to receive immunosuppressive therapies.”1

—Amanda Balbi

References

  1. Love BL, Finney CJ, Gaidos JKJ. Effectiveness of conjugate and polysaccharide pneumococcal vaccines for prevention of severe pneumococcal disease among inflammatory bowel disease patients. J Crohns Colitis. Published online: January 25, 2021. https://doi.org/10.1093/ecco-jcc/jjab017
  2. Pneumococcal disease. Centers for Disease Control and Prevention. Reviewed: September 1, 2020. Accessed: February 4, 2021. https://www.cdc.gov/pneumococcal/about/facts.html