Effectiveness of pneumococcal vaccination in reducing hospitalization and mortality among the elderly: A systematic review and meta-analysis

This meta-analysis assesses pneumococcal vaccine effectiveness in reducing hospitalization and mortality among the elderly. The studies retrieved from PubMed, Scopus, Embase, and Cochrane through March 2025. Of 3,002 identified studies, 35 met inclusion criteria (30 cohort, 3 RCTs, 2 case–control), encompassing 1.65 million vaccinated and 2.62 million unvaccinated individuals. Pneumonia-related hospitalization significantly declined in subgroups receiving mixed pneumococcal polysaccharide vaccine (PPV) and conjugate vaccine (PCV-13), notably among individuals aged >75 and those with chronic conditions. All-cause hospitalization dropped (OR: 0.94; 95% CI: 0.91–0.97), especially in PPV-23 recipients, Asian populations, and those with comorbidities. Pneumonia mortality decreased across age groups >60, and all-cause mortality declined among those aged 60–75. No significant impact was observed on emergency visit rates. Although findings favor vaccine effectiveness, high heterogeneity warrants further comparative trials to confirm outcomes.