{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:32:16Z","timestamp":1792801936130,"version":"4.5.0"},"reference-count":25,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"<jats:sec id=\"ab-ioi220071-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>The association of 13-valent pneumococcal conjugate vaccine (PCV13) use with pneumonia hospitalization in older adults, especially those with underlying medical conditions, is not well described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi220071-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association of PCV13 use with pneumonia, non\u2013health care\u2013associated (non-HA) pneumonia, and lobar pneumonia (LP) hospitalization among US Medicare beneficiaries 65 years or older.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi220071-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This cohort study with time-varying exposure assignment analyzed claims data from US Medicare beneficiaries 65 years or older enrolled in Parts A\/B with a residence in the 50 US states or the District of Columbia by September 1, 2014. New Medicare Parts A\/B beneficiaries within 6 months after their 65th birthday were continuously included in the cohort after September 1, 2014, and followed through December 31, 2017. Participants were censored if they died, changed enrollment status, or developed a study outcome. Most of the analyses were conducted from 2018 to 2019, and additional analyses were performed from 2021 to 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi220071-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Use of PCV13 vaccination 14 days or more before pneumonia hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi220071-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Discrete-time survival models were used to estimate the incidence rate ratio (IRR) and number of pneumonia hospitalizations averted through PCV13 use. The adjusted IRR for the association of PCV13 vaccination with pneumonia hospitalization was used to estimate vaccine effectiveness (VE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi220071-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At the end of follow-up (December 2017), 24\u202f121\u202f625 beneficiaries (13\u202f593\u202f975 women [56.4%]; 418\u202f005 [1.7%] Asian, 1\u202f750\u202f807 [4.8%] Black, 338\u202f044 [1.4%] Hispanic, 111\u202f508 [0.5%] Native American, and 20\u202f700\u202f948 [85.8%] White individuals) were in the cohort; 4\u202f936\u202f185 (20.5%) had received PCV13 only, and 10\u202f646\u202f220 (79.5%) had not received any pneumococcal vaccines. More than half of the beneficiaries in the cohort were younger than 75 years, White, and had either immunocompromising or chronic medical conditions. Coverage with PCV13 increased from 0.8% (September 2014) to 41.5% (December 2017). The VE for PCV13 was estimated at 6.7% (95% CI, 5.9%-7.5%) for pneumonia, 4.7% (95% CI, 3.9%-5.6%) for non-HA pneumonia, and 5.8% (95% CI, 2.6%-8.9%) for LP. From September 2014 through December 2017, an estimated 35\u202f127 pneumonia (95% CI, 33\u202f011-37\u202f270), 24\u202f643 non-HA pneumonia (95% CI, 22\u202f761-26\u202f552), and 1294 LP (95% CI, 797\u20131819) hospitalizations were averted through PCV13 use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ioi220071-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>The study results suggest that PCV13 use was associated with reduced pneumonia hospitalization among Medicare beneficiaries 65 years or older, many of whom had underlying medical conditions. Increased PCV13 coverage and use of recently approved higher-valent pneumococcal conjugate vaccines may avert additional pneumonia hospitalizations in adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamainternmed.2022.5472","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T11:02:22Z","timestamp":1670238142000},"page":"40","source":"Crossref","is-referenced-by-count":36,"title":["Association of Pneumococcal Conjugate Vaccine Use With Hospitalized Pneumonia in Medicare Beneficiaries 65 Years or Older With and Without Medical Conditions, 2014 to 2017"],"prefix":"10.1001","volume":"183","author":[{"given":"Miwako","family":"Kobayashi","sequence":"first","affiliation":[{"name":"Division of Bacterial Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Spiller","sequence":"additional","affiliation":[{"name":"Division of Bacterial 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Institution, Stanford University, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffery A.","family":"Kelman","sequence":"additional","affiliation":[{"name":"US Centers for Medicare & Medicaid Services, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Deng","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nong","family":"Shang","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia G.","family":"Whitney","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Department of Global Health, Emory University, Atlanta, 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