{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:45:22Z","timestamp":1792053922264,"version":"4.4.0"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Older adults with type 2 diabetes mellitus are at elevated risk for severe pneumococcal disease, experiencing higher rates of complications and mortality. However, the evidence for the protective benefits of the 23\u2010valent pneumococcal polysaccharide vaccine (PPSV23) against mortality in this demographic remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 8649 elderly people with type 2 diabetes mellitus in Soochow, China, comprising 3247 PPSV23\u2010vaccinated individuals and 5402 unvaccinated patients. Cox proportional hazards analyses were performed to calculate the adjusted hazard ratios (HRs) of the association between PPSV23 vaccination and the risk of all cause mortality, pneumonia\u2010related mortality, cardiovascular disease\u2010related mortality and cancer mortality. Inverse probability weighting (IPW) was applied to estimate the average treatment effect (ATE) of universal PPSV23 vaccination compared to unvaccinated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the follow\u2010up period, a total of 1557 deaths were recorded. Compared to unvaccinated elderly people with type 2 diabetes mellitus, those receiving PPSV23 vaccine exhibited significantly lower risks of all\u2010cause mortality (HR: 0.47; 95% CI: 0.42\u20130.53), with reductions also observed in deaths related to cardiovascular disease (HR: 0.50; 95% CI: 0.41\u20130.62), pneumonia (HR: 0.62; 95% CI: 0.43\u20130.89) and cancer (HR: 0.54; 95% CI: 0.42\u20130.70). Furthermore, IPW estimates indicated that universal PPSV23 vaccination among the elderly people with type 2 diabetes mellitus could prevent an average of 11.4% of all\u2010cause deaths (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), 4.0% of cardiovascular disease\u2010related deaths (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), 0.8% of pneumonia\u2010related deaths (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) and 1.9% of cancer deaths (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PPSV23 vaccination is associated with a reduced risk of all cause mortality, cardiovascular disease\u2010related mortality, pneumonia\u2010related mortality and cancer mortality in elderly people with type 2 diabetes mellitus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70341","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T19:48:36Z","timestamp":1777578516000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Protective effects of 23\u2010valent pneumococcal polysaccharide vaccination against mortality among elder patients with type 2 diabetes mellitus"],"prefix":"10.1111","volume":"43","author":[{"given":"Xiaoling","family":"Peng","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Statistics, School of Public Health Medical College of Soochow University  Soochow China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujun","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Immunization Changshu Center for Disease Control and Prevention  Soochow China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingchao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Immunization Wuzhong Center for Disease Control and Prevention  Soochow China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deqi","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Immunization Wuzhong Center for Disease Control and Prevention  Soochow China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guorong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics, School of Public Health Medical College of Soochow University  Soochow China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics, School of Public Health Medical College of Soochow University  Soochow China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoqun","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics, School of Public Health Medical College of Soochow University  Soochow China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xulei","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics, School of Public Health Medical College of Soochow University  Soochow China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics, School of Public Health Medical College of Soochow University  Soochow China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics, School of Public Health Medical College of Soochow University  Soochow China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Immunization Changshu Center for Disease Control and Prevention  Soochow China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5175-1662","authenticated-orcid":false,"given":"Chen","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics, School of Public Health Medical College of Soochow University  Soochow China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02724-0"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2012.03943.x"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.6085"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofae530"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.2174\/1573399815666191024085838"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2016.02.032"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14080859"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2023.01.006"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2025.127029"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(15)00129-1"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987320932069"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000003563"},{"issue":"3","key":"e_1_2_12_14_1","first-page":"221","article-title":"Chinese guidelines for lipid management (2023)","volume":"51","author":"Management. JCotCGfL","year":"2023","journal-title":"Zhonghua Xin Xue Guan Bing Za Zhi"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2023.02.077"},{"issue":"1","key":"e_1_2_12_16_1","article-title":"Vaccines for preventing pneumococcal infection in adults","author":"Moberley S","year":"2013","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0120544"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3861-8"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/7.5.613"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2014.914243"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9150(00)00758-9"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200712-1777OC"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2022.10.003"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0022847"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.122.321636"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-025-03022-x"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-024-02331-x"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/v13061109"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-022-00876-6"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfimm\/iqab007"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12979-019-0164-9"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41541-024-00874-4"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-76556-7"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alcohol.2019.01.002"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2013.12.013"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.70341","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.70341","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.70341","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:02:18Z","timestamp":1792051338000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.70341"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":34,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/dme.70341"],"URL":"https:\/\/doi.org\/10.1111\/dme.70341","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"assertion":[{"value":"2026-01-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70341"}}