{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T14:00:01Z","timestamp":1774879201534,"version":"3.50.1"},"reference-count":22,"publisher":"FapUNIFESP (SciELO)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: The aim of the study was to determine whether vaccinating older adults with PCV13 (pneumococcal conjugate vaccine) and\/or PPSV23 (pneumococcal polysaccharide vaccine) and\/or the influenza vaccine can reduce pneumonia-related hospitalizations and all-cause death.  METHODS: Retrospective cohort of subjects \u226560 years who attended an outpatient clinic in Minas Gerais, Brazil (May 1, 2021 to April 26, 2024). Data regarding pneumonia hospitalizations, all-cause death, pneumococcal and influenza vaccination, demographic, and clinical characteristics were collected from an electronic health record (data in the cloud were available upon request). Only patients with valid data were included and were divided into groups based on their vaccination history, pneumococcal vaccinations (PVC13 and\/or PPSV23), influenza vaccination, pneumococcal+influenza vaccinations, and unvaccinated, to calculate the association of vaccination with pneumonia hospitalizations and all-cause death by Cox proportional hazard models, adjusted for demographic and clinical factors.  RESULTS: A total of 12,268 older adults were analyzed, with a median age of 79 (interquartile range 72\u201386), and 73% were female. Vaccination rates were 56% for influenza, 29% for pneumococcal vaccines, and 24% for both influenza and pneumococcal vaccines. Neither pneumococcal nor influenza vaccination alone showed a protective effect against pneumonia hospitalization. The combination of pneumococcal and influenza vaccines was associated with a 35% reduction in pneumonia hospitalization (HR 0.65; 95%CI 0.51\u20130.83). There was no association between vaccination and allcause death, although the influenza vaccine tended to reduce this risk (HR 0.68; 95%CI 0.46\u20131.00; p-value 0.053).  CONCLUSION: Despite low vaccination rates, the combination of influenza and pneumococcal vaccines reduces pneumonia hospitalizations among older adults by 35%.<\/jats:p>","DOI":"10.1590\/1806-9282.20250884","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:08:13Z","timestamp":1774876093000},"source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of influenza and pneumococcal vaccination in frail older adults"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8749-6541","authenticated-orcid":false,"given":"Daniela Castelo","family":"Azevedo","sequence":"first","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9138-9952","authenticated-orcid":false,"given":"Estev\u00e3o Alves","family":"Valle","sequence":"additional","affiliation":[{"name":"Mais 60 Sa\u00fade,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5535-3223","authenticated-orcid":false,"given":"D\u00e9bora Cerqueira","family":"Calderaro","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","year":"2009"},{"issue":"Suppl 5","key":"ref2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/j.1469-0691.2012.03937.x","article-title":"Understanding the burden of pneumococcal disease in adults.","volume":"18","author":"Blasi F","year":"2012","journal-title":"Clin Microbiol Infect"},{"issue":"Suppl 01","key":"ref3","first-page":"171","article-title":"Burden of disease by lower respiratory tract infections in Brazil, 1990 to 2015: estimates of the Global Burden of Disease 2015 study.","volume":"20","author":"Corr\u00eaa RA","year":"2017","journal-title":"Rev Bras Epidemiol"},{"key":"ref4","year":"2024"},{"key":"ref5","year":"2023"},{"key":"ref6","year":"2024"},{"issue":"9","key":"ref7","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1007\/s00038-016-0819-7","article-title":"Multimorbidity in adults from a southern Brazilian city: occurrence and patterns.","volume":"61","author":"Nunes BP","year":"2016","journal-title":"IntJ Public Health"},{"issue":"2","key":"ref8","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1370\/afm.1363","article-title":"Measures of multimorbidity and morbidity burden for use in primary care and community settings: a systematic review and guide.","volume":"10","author":"Huntley AL","year":"2012","journal-title":"Ann Fam Med"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1093\/epirev\/mxs009","article-title":"Multimorbidity in older adults.","volume":"35","author":"Salive ME","year":"2013","journal-title":"Epidemiol Rev"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1590\/s1518-8787.2016050006963","article-title":"Clinical-Functional Vulnerability Index-20 (IVCF-20): rapid recognition of frail older adults.","volume":"50","author":"Moraes EN","year":"2016","journal-title":"Rev Saude Publica"},{"issue":"8","key":"ref11","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1007\/s40266-022-00958-7","article-title":"A cohort study on influenza vaccine and all-cause mortality in older adults: methodological concerns and public health implications.","volume":"39","author":"Lapi F","year":"2022","journal-title":"Drugs Aging"},{"issue":"12","key":"ref12","doi-asserted-by":"crossref","first-page":"3056","DOI":"10.1080\/21645515.2016.1221552","article-title":"Comparison of dual influenza and pneumococcal polysaccharide vaccination with influenza vaccination alone for preventing pneumonia and reducing mortality among the elderly: a meta-analysis.","volume":"12","author":"Zhang YY","year":"2016","journal-title":"Hum Vaccin Immunother"},{"issue":"1","key":"ref13","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1001\/jamainternmed.2022.5472","article-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.","volume":"183","author":"Kobayashi M","year":"2023","journal-title":"JAMA Intern Med"},{"issue":"6","key":"ref14","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1080\/21645515.2020.1845525","article-title":"Preventive effects of influenza and pneumococcal vaccination in the elderly - results from a population-based retrospective cohort study.","volume":"17","author":"Rose N","year":"2021","journal-title":"Hum Vaccin Immunother"},{"issue":"12","key":"ref15","doi-asserted-by":"crossref","first-page":"3875","DOI":"10.1111\/jgs.19176","article-title":"Protection against influenza hospitalizations from enhanced influenza vaccines among older adults: a systematic review and network meta-analysis.","volume":"72","author":"Ferdinands JM","year":"2024","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"ref16","doi-asserted-by":"crossref","first-page":"356","DOI":"10.3390\/vaccines8030356","article-title":"Impact of influenza vaccination on mortality in the oldest old: a propensity score-matched cohort study.","volume":"8","author":"Walzer P","year":"2020","journal-title":"Vaccines (Basel)"},{"issue":"7","key":"ref17","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.jiac.2020.03.016","article-title":"Pneumococcal vaccination reduces in-hospital mortality, length of stay and medical expenditure in hospitalized elderly patients.","volume":"26","author":"Naito T","year":"2020","journal-title":"J Infect Chemother"},{"issue":"10","key":"ref18","doi-asserted-by":"crossref","first-page":"e0275642","DOI":"10.1371\/journal.pone.0275642","article-title":"Real-world effectiveness of pneumococcal vaccination in older adults: cohort study using the UK clinical practice research datalink.","volume":"17","author":"Streeter AJ","year":"2022","journal-title":"PLoS One"},{"key":"ref19","year":"2023"},{"key":"ref20","year":"2023"},{"key":"ref21","year":"2022"},{"issue":"2","key":"ref22","first-page":"e2017272","article-title":"Vaccination coverage and use of the Brazilian Health System for vaccination against influenza and pneumonia in adults and elderly with self-reported diabetes, municipality of S\u00e3o Paulo, 2003, 2008 and 2015.","volume":"27","author":"Monteiro CN","year":"2018","journal-title":"Epidemiol Serv Saude"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0104-42302026000102212&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:08:15Z","timestamp":1774876095000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302026000102212&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S0104-42302026000102212"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.20250884","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"value":"1806-9282","type":"electronic"},{"value":"0104-4230","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e20250884"}}