1440. Potential Impact of Routine Use of 13-Valent Pneumococcal Conjugate Vaccine on Hospitalizations for Pneumonia among Older Adults in Canada
Bibliographic record
Abstract
In Canada, 13-valent pneumococcal conjugate vaccine (PCV13) was licensed for the prevention of vaccine-type (VT) pneumonia in adults in July 2015. Herd effects stemming from the routine pediatric PCV13 program have historically led to reductions in VT disease in older adults, and there is currently no recommendation for a routine age-based PCV13 program for this age group. However, recent data suggest these indirect effects may have plateaued, leaving a persistent and substantial burden of potentially preventable pneumococcal disease in older adults. We evaluated the potential impact of PCV13 immunization program for Canadian adults aged ≥65 years on hospitalizations for community-acquired pneumonia (CAP). We constructed a mathematical model based on Canada-specific burden of disease estimates and published estimates of PCV13 effectiveness and durability. We estimated the number of hospitalizations averted as the product of (i) the size of the Canadian population aged ≥65 years, (ii) the incidence of all-cause CAP, (iii) the proportion of CAP that is VT, (iv) PCV13 effectiveness, and (v) the duration of protection for PCV13 over a 5-year time horizon. We assumed that rates of all-cause CAP, the proportion of VT CAP, and PCV13 effectiveness remained constant over the 5-year assessment period. We assumed a 5% annual all-cause mortality rate in the overall population. We estimated hospital days averted as the product of hospitalizations averted and median length of stay. Model assumptions are summarized in Table 1. Based on model assumptions, PCV13 use in Canadian adults aged ≥65 years would lead to an annual rate reduction of 62 (11–77) hospitalizations per 100,000 persons, per year. This reduction, applied to the entire Canadian population of older adults, would avert an estimated 17,274 (3,037–21,711) hospitalizations and 138,192 (24,298–173,690) hospital days over a 5-year period. Despite herd effects from the routine pediatric program, direct PCV13 immunization of older adults in Canada could result in considerable additional reduction in hospitalizations for pneumonia. J. Vojicic, S. Dion, R. E. Isturiz, C. Laferriere, M. Major, R. M. Nepal, and J. A. Suaya: Pfizer: Employee and Shareholder, Benefits and stock and Salary; J. M. McLaughlin, Pfizer: Employee, Salary.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".