Administration of a pneumococcal vaccine was not associated with subsequent reduced risk of acute MI and stroke in in older adults. The study, published in the May 5, 2010 issue of the Journal of the American Medical Association, explains that pneumococcal vaccine is recommended to adults aged 65 years or older and to persons who have certain underlying medical conditions that may increase the risk for pneumococcal infection, such as chronic cardiovascular diseases (eg, congestive heart failure or cardiomyopathy), chronic pulmonary diseases (eg, chronic obstructive pulmonary disease or emphysema), chronic liver diseases (eg, cirrhosis), or diabetes.
They note that multiple studies have shown that vaccination against influenza can reduce the risk of cardiac events, but whether the same is true for pneumococcal vaccine remains controversial. The researchers reviewed the medical records of approximately 360 000 adult men, aged 45 to 69 years, with no previous history of MI or stroke, who were followed for an average of four years. After adjustment for multiple known confounders, no association was found between previous pneumococcal vaccination and risk of acute MI or stroke.
Streptococcus pneumoniae (pneumococcus) remains an important cause of pneumonia, meningitis, bacteremias, and acute otitis media worldwide. Antimicrobial resistance among pneumococci has escalated dramatically over the past three decades, and is influenced by patterns of antibiotic use, population density, and spread of a few international clones.
Following usage of the pneumococcal conjugate vaccine in children, the incidence of invasive pneumococcal disease declined in both children and adults (reflecting herd immunity). However, emergence of serotypes not encompassed in the vaccine is worrisome, and may be associated with heightened antimicrobial resistance and virulence. Continued vigilance for emergence of novel serotypes and development of vaccines with expanded coverage and immunogenicity will be critical for optimal prevention of pneumococcal infections. Current Opinion Pulmonary Medicine