{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T01:19:33Z","timestamp":1773796773799,"version":"3.50.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"6","funder":[{"DOI":"10.13039\/100000030","name":"US Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["GS-10F-0133S:75FCMC21F0067"],"award-info":[{"award-number":["GS-10F-0133S:75FCMC21F0067"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Acumen LLC"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pneumonia causes high rates of hospitalization among adults living in long-term care (LTC) facilities and is a major cause of mortality in this population. Since 2014, pneumococcal conjugate vaccines (PCVs) have been recommended for US adults aged \u226565 years; however, effectiveness of PCVs against all-cause pneumonia hospitalization among adults living in LTC remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used Medicare Fee-for-Service claims data to construct an open cohort of beneficiaries aged \u226565 years between September 2014 and December 2019. We estimated 13-valent PCV (PCV13) vaccine effectiveness (VE) by comparing rates of pneumonia hospitalization among PCV13-exposed and PCV13-unexposed time during LTC stays. Discrete-time logistic regression models with generalized estimating equations were used to estimate VE, incorporating time-varying exposures and covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 3 485 071 beneficiaries meeting the eligibility criteria, the proportion vaccinated with PCV13 increased from 1.1% to 52.7% during the study period. The characteristics of beneficiaries with shorter LTC stays differed from those with longer LTC stays: a lower proportion of beneficiaries aged \u226585 years (LTC stay \u2264100 vs &amp;gt;100 days: 38.5% vs 48.2%), but a higher proportion with chronic medical conditions (71.4% vs 66.4%), immunocompromising conditions (36.6% vs 25.2%), and recent hospitalizations (84.1% vs 74.7%). Vaccine effectiveness of PCV13 only against all-cause pneumonia hospitalization was 3.8% (95% CI 2.4%\u20135.2%) overall: 5.6% (3.9%\u20137.2%) for LTC stays \u2264100 days and 0.3% (\u22122.1%\u20132.77%) for LTC stays &amp;gt;100 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>13-Valent PCV reduced the risk of pneumonia hospitalization among this population. Differences in beneficiary characteristics could explain differences in VE by length of LTC stay.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf405","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T11:41:03Z","timestamp":1753962063000},"page":"e953-e961","source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine Against Pneumonia Hospitalization Among Medicare Beneficiaries Aged \u226565 Years in Long-Term Care"],"prefix":"10.1093","volume":"232","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9361-8405","authenticated-orcid":false,"given":"Lindsay","family":"Zielinski","sequence":"first","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]},{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0808-0231","authenticated-orcid":false,"given":"Kristin","family":"Andrejko","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8303-0656","authenticated-orcid":false,"given":"Nong","family":"Shang","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1862-6370","authenticated-orcid":false,"given":"Soyoun","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3346-0770","authenticated-orcid":false,"given":"Gordana","family":"Derado","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2568-3509","authenticated-orcid":false,"given":"Arnstein","family":"Lindaas","sequence":"additional","affiliation":[{"name":"Acumen LLC , Burlingame, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanxin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Acumen LLC , Burlingame, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1333-6262","authenticated-orcid":false,"given":"Bradley","family":"Lufkin","sequence":"additional","affiliation":[{"name":"Acumen LLC , Burlingame, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8020-6839","authenticated-orcid":false,"given":"Yoganand","family":"Chillarige","sequence":"additional","affiliation":[{"name":"Acumen LLC , Burlingame, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9190-5619","authenticated-orcid":false,"given":"Miwako","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,2]]},"reference":[{"key":"2026031304472867600_jiaf405-B1","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1056\/NEJMoa1500245","article-title":"Community-acquired pneumonia requiring hospitalization among U.S. Adults","volume":"373","author":"Jain","year":"2015","journal-title":"N Engl J Med"},{"key":"2026031304472867600_jiaf405-B2","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.idc.2017.07.015","article-title":"Bacterial 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