{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:01:00Z","timestamp":1780372860778,"version":"3.54.1"},"reference-count":24,"publisher":"BMJ","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2012,3,5]]},"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Invasive pneumococcal disease is a serious infection, and it is an important cause of morbidity and mortality in certain groups of \u2018at-risk\u2019 people. Those considered \u2018at-risk\u2019 in the UK include very young children, people aged 65\u2005years and older and people with certain serious chronic diseases, asplenia or immunosuppression. There is little evidence about whether people with immune-mediated diseases are at increased risk of pneumococcal disease and therefore may benefit from pneumococcal vaccination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective cohort studies, using linked hospital data, from the longstanding Oxford Record Linkage Study (1963\u20132008) and from recent English national linked Hospital Episode Statistics (1999\u20132008); analysis of whether people with immune-mediated diseases are more likely than others to be admitted to hospital for pneumococcal disease; calculation of rate ratio for pneumococcal disease in cohorts with immune-mediated disease compared with control cohorts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were elevated rate ratios for many of the immune-mediated diseases, for example, Addison's disease in England 3.8 (95% CI 3.4 to 4.2), autoimmune haemolytic anaemia 4.9 (4.4 to 5.3), Crohn's disease 2.2 (2.1 to 2.3), diabetes mellitus 3.7 (3.4 to 4.1), multiple sclerosis 3.7 (3.5 to 3.8), myxoedema 1.60 (1.58 to 1.63), pernicious anaemia 1.74 (1.66 to 1.83), primary biliary cirrhosis 3.3 (2.9 to 3.7), polyarteritis nodosa 5.0 (4.0 to 6.0), rheumatoid arthritis 2.47 (2.41 to 2.52), scleroderma 4.2 (3.8 to 4.7), Sjogren's syndrome 3.2 (2.9 to 3.5) and systemic lupus erythematosus 5.0 (4.6 to 5.4). Findings in the Oxford and all England data sets were similar.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>People admitted to hospital with immune-mediated diseases are at higher risk than those with invasive pneumococcal disease. Vaccination should be considered in this group of patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech-2011-200168","type":"journal-article","created":{"date-parts":[[2012,4,8]],"date-time":"2012-04-08T00:26:54Z","timestamp":1333844814000},"page":"1177-1181","source":"Crossref","is-referenced-by-count":97,"title":["Risk of invasive pneumococcal disease in people admitted to hospital with selected immune-mediated diseases: record linkage cohort analyses"],"prefix":"10.1136","volume":"66","author":[{"given":"Clare J","family":"Wotton","sequence":"first","affiliation":[{"name":"Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Goldacre","sequence":"additional","affiliation":[{"name":"Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2012,4,6]]},"reference":[{"key":"2025100303350575000_66.12.1177.1","unstructured":"Department of Health. Chapter 25. Pneumococcal. Immunisation Against Infectious Disease 2006-The Green Book. Department of Health, 2010. http:\/\/www.dh.gov.uk\/prod_consum_dh\/groups\/dh_digitalassets\/@dh\/@en\/documents\/digitalasset\/dh_122639.pdf (accessed 20 Jun 2011)."},{"key":"2025100303350575000_66.12.1177.2","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp09X420590"},{"key":"2025100303350575000_66.12.1177.3","doi-asserted-by":"publisher","DOI":"10.1086\/587063"},{"key":"2025100303350575000_66.12.1177.4","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq183"},{"key":"2025100303350575000_66.12.1177.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2009.09350.x"},{"key":"2025100303350575000_66.12.1177.6","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/93.10.669"},{"key":"2025100303350575000_66.12.1177.7","unstructured":"Gill L Goldacre M . English National Record Linkage of Hospital Episode Statistics and Death Registration Records. Oxford: Unit of Health-care Epidemiology, Oxford University, 2003."},{"key":"2025100303350575000_66.12.1177.8","doi-asserted-by":"publisher","DOI":"10.1136\/jech.47.4.316"},{"key":"2025100303350575000_66.12.1177.9","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.175463"},{"key":"2025100303350575000_66.12.1177.10","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-9-1"},{"key":"2025100303350575000_66.12.1177.11","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e3282f2a5e2"},{"key":"2025100303350575000_66.12.1177.12","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1017\/S0950268808001659","article-title":"Cancer and immune-mediated disease in people who have had meningococcal disease: record-linkage studies","volume":"137","author":"Goldacre","year":"2009","journal-title":"Epidemiol Infect"},{"key":"2025100303350575000_66.12.1177.13","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e3282f45764"},{"key":"2025100303350575000_66.12.1177.14","unstructured":"Breslow NE Day NE . Statistical Methods in Cancer Research, Volume II. The design and anlaysis of cohort studies. IARC Scientific Publication No. 82. Lyon: International Agency for Research in Cancer, 1987:103\u201315."},{"key":"2025100303350575000_66.12.1177.15","doi-asserted-by":"publisher","DOI":"10.1002\/art.10524"},{"key":"2025100303350575000_66.12.1177.16","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1017\/S0950268807008436","article-title":"Uptake of pneumococcal polysaccharide vaccine in at-risk populations in England and Wales 1999\u20132005","volume":"136","author":"Pebody","year":"2008","journal-title":"Epidemiol Infect"},{"key":"2025100303350575000_66.12.1177.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2009.03.009"},{"key":"2025100303350575000_66.12.1177.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2008.10.002"},{"key":"2025100303350575000_66.12.1177.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2007.05.003"},{"key":"2025100303350575000_66.12.1177.20","doi-asserted-by":"publisher","DOI":"10.1080\/08916930500285352"},{"key":"2025100303350575000_66.12.1177.21","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.33632"},{"key":"2025100303350575000_66.12.1177.22","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2003.09.036"},{"key":"2025100303350575000_66.12.1177.23","doi-asserted-by":"publisher","DOI":"10.1191\/0961203305lu2242xx"},{"key":"2025100303350575000_66.12.1177.24","doi-asserted-by":"publisher","DOI":"10.1136\/gut.23.7.630"}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech-2011-200168","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T10:35:15Z","timestamp":1759487715000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech-2011-200168"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,4,6]]},"references-count":24,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2012,11,6]]},"published-print":{"date-parts":[[2012,12]]}},"alternative-id":["10.1136\/jech-2011-200168"],"URL":"https:\/\/doi.org\/10.1136\/jech-2011-200168","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"value":"0143-005X","type":"print"},{"value":"1470-2738","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,4,6]]}}}