Association of Pneumococcal Conjugate Vaccination With Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Older Adult Recipients of Coronavirus Disease 2019 Vaccines: A Longitudinal Cohort Study

Author:

Lewnard Joseph A123,Hong Vennis4,Grant Lindsay R5,Ackerson Bradley K4,Bruxvoort Katia J6ORCID,Pomichowski Magdalena4,Arguedas Adriano5,Cané Alejandro5,Jodar Luis5ORCID,Gessner Bradford D5,Tartof Sara Y47

Affiliation:

1. Center for Computational Biology, School of Public Health

2. College of Statistics, Data Science, and Society

3. Augmented Graduate Group in Computational Precision Health, University of California, Berkeley

4. Department of Research and Evaluation, Kaiser Permanente Southern California , Pasadena

5. Pfizer Vaccines , Collegeville, Pennsylvania

6. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham

7. Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine , Pasadena, California

Abstract

Abstract Background Pneumococcal carriage is associated with increased acquisition and duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among adults. While pneumococcal conjugate vaccines (PCVs) prevent carriage of vaccine-serotype pneumococci, their potential impact on coronavirus disease 2019 (COVID-19)–related outcomes remains poorly understood in populations with prevalent immunity against SARS-CoV-2. Methods We undertook a retrospective cohort study of adults aged ≥65 years in the Kaiser Permanente Southern California healthcare system who had received ≥2 COVID-19 vaccine doses, comparing risk of SARS-CoV-2 infection between 1 January 2021 and 31 December 2022 among recipients and nonrecipients of 13-valent PCV (PCV13) employing multiple strategies to mitigate bias from differential test-seeking behavior. Results The ajusted hazard ratio of confirmed SARS-CoV-2 infection comparing PCV13 recipients to nonrecipients was 0.92 (95% confidence interval [CI], .90–.95), corresponding to prevention of 3.9 (95% CI, 2.6–5.3) infections per 100 person-years. Following receipt of 2, 3, and ≥4 COVID-19 vaccine doses, aHRs (95% CI) were 0.85 (.81–.89), 0.94 (.90–.97), and 0.99 (.93–1.04), respectively. The aHR (95% CI) for persons who had not received COVID-19 vaccination in the preceding 6 months was 0.90 (.86–.93), versus 0.94 (.91–.98) within 6 months after COVID-19 vaccination. Similarly, aHRs (95% CI) were 0.92 (.89–.94) for persons without history of documented SARS-CoV-2 infection, versus 1.00 (.90–1.12) for persons with documented prior infection. Conclusions Among older adults who had received ≥2 COVID-19 vaccine doses, PCV13 was associated with modest protection against SARS-CoV-2 infection. Protective effects of PCV13 were greater among individuals expected to have weaker immune protection against SARS-CoV-2 infection.

Funder

Pfizer

Publisher

Oxford University Press (OUP)

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