• S M Huijts, F E J Coenjaerts, M Bolkenbaas, C H van Werkhoven, D E Grobbee, Bonten M J M MJM Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands; Department of Medical Microbiology, UMC Utrecht, Utrecht, The , and CAPiTA study team.
• Department of Respiratory Medicine, UMC Utrecht, Utrecht, The Netherlands; Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands. Electronic address: s.m.huijts@umcutrecht.nl.
• Clin. Microbiol. Infect. 2018 Jul 1; 24 (7): 764-770.

ObjectivesOur objective was to evaluate whether vaccination with the 13-valent pneumococcal conjugate vaccine (PCV13) prevents the incidence of community-acquired pneumonia (CAP) caused by influenza (influenza-associated CAP, IA-CAP) or other respiratory viruses in the elderly.MethodsThis analysis was part of the Community-Acquired Pneumonia immunization Trial in Adults (CAPiTA); a double blind, randomized, placebo-controlled trial in 84 496 immunocompetent individuals aged ≥65 years. CAP was defined by clinical and radiological criteria, and oropharyngeal swabs were collected from all individuals referred to a sentinel centre with a clinical suspicion of pneumonia. Presence of influenza A and B, parainfluenza 1, 2, 3 and 4, human adeno-, boca-, corona-, metapneumo-, rhino- and respiratory syncytial viruses was determined by real-time PCR.ResultsOf 3209 episodes of suspected pneumonia, viral aetiology was tested in 2917 and proportions with influenza virus, human metapneumovirus and respiratory syncytial virus were 4.6%, 2.5% and 3.1%, respectively. There were 1653 oropharyngeal swabs for PCR testing available from 1814 episodes that fulfilled criteria for CAP, yielding 23 first episodes of IA-CAP in the PCV13 and 35 in the in placebo group-vaccine efficacy for IA-CAP of 34.4% (95% CI -11.1% to 61.2%; p 0.117). Annual influenza vaccination was received by 672 (87.2%) in the PCV13 group and 719 (87.7%) in the placebo group of the confirmed CAP cases.ConclusionIn a randomized study of 84 496 elderly individuals with a high uptake of influenza vaccination, PCV13 was not associated with a statistically significant reduction of influenza or virus-associated CAP. Overall incidence of non-influenza viral pneumonia was low.Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

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