Study of impact of pneumococcal vaccine in hospitalised community acquired pneumococcal pneumonia cases: A single center experience

<bold>Methods:</bold> Prospective, observational study included community acquired pneumonia cases with pneumococcal etiology in microbiological workup. History of pneumococcal vaccination PPSV-23 in the last five years is recorded and two groups of 165 cases with and without vaccination each were finally enrolled. Covariates recordings such as age, gender, COPD, diabetes, IHD, stroke, and CURB 65 score at entry point. Use of interventions during indoor periods such as oxygen, vasopressors and ventilatory support; and duration of hospitalization (DOH) were also recorded. Mortality during hospitalization and 30 days were recorded. Statistical analysis done by chi test and ANOVA test. <bold>Results:</bold> CURB 65 score of 2 or less in hospitalised pneumococcal pneumonia in vaccinated and unvaccinated cases in 59.39% & 33.93% and >3 in 40.60% & 66.06% cases respectively. (p<0.00001). Covariates analysis has observed significant association (p<0.00001). Interventions required during hospitalization and duration of hospitalization (DOH) have shown significant association(p<0.00001). Duration since PPSV 23 vaccination (<1yr,1-3 yr and 3-5 yrs) has association with severity and outcomes(p<0.0011). Mortality in the vaccinated and unvaccinated group during hospitalization & 30 days were 2.42% and 12.72%, 1.24% and 5.55% respectively. <bold>Conclusion:</bold> Pneumococcal vaccination strategy has shown more benefit in first three years in preventing severe pneumonia and associated risk of hospitalization, decreasing need of aggressive interventions during hospitalization, decreasing hospitalization duration and inhouse and remote morality at 30 days. Booster PPSV 23 dose after 3 years of first dose is must.