Community Pneumococcal Vaccination Support Program for Older Adults Reduces Pneumonia-Related Mortality

Evidence from a real-world study of Sera Town, Japan, indicates the benefit of a pneumococcal vaccination support program for older adults, with the initiation of such a program—which provided 23-valent pneumococcal polysaccharide vaccines (PPSV23) to all residents aged 65 and older—reducing pneumonia-related mortality by 25% in the community. The findings, published in the Journal of Epidemiology, could help inform future decisions on pneumococcal vaccination programs, especially for patients at high risk.^1,2

Community vaccination can bring broad benefits for older adults at risk of pneumococcal disease and pneumonia. | Image Credit: © Drazen - stock.adobe.com

Community Vaccination Programs Provide Protection Against Severe Disease

Older adults are at increased risk of developing severe disease if infected with Streptococcus pneumoniae, the bacteria that can cause pneumococcal pneumonia and invasive pneumococcal disease. If severe disease develops, it can cause hospitalization, and hospitalized patients with pneumonia are at risk of losing the ability to perform basic activities of daily living and experiencing poor quality of life. These factors all contribute to increased mortality, especially in Japan, where 74,000 individuals die from pneumonia each year and 98% of these deaths occur in people aged 65 and older.^1,3

Pneumococcal vaccines, including PPSV23, are effective at preventing severe disease when infected with Streptococcus pneumoniae. Hindering full proliferation of vaccines across the most high-risk individuals is the capacity—or lack thereof—of health care providers to properly educate patients and offer them vaccines. Simultaneously, there is a major lack of research on the real-world effectiveness of community-based vaccination programs among the elderly.¹

Prior to the beginning of a national routine pneumococcal vaccination program for older adults in Japan, researchers conducted a jointly planned investigation in Sera Town, a “super-aged” community in Japan, by implementing a pneumococcal vaccination support program. The investigation was in conjunction with Hiroshima University and ran from 2010—years before the national rollout of pneumococcal vaccines in 2014—until 2015. Members of the program provided educational resources, promoted community health initiatives, and offered PPSV23 vaccination to all Sera Town residents aged 65 years and older. Five years later, a follow-up survey was conducted among residents to assess the effectiveness of the vaccine—and program—against pneumonia.^1,2

“Specifically, we sought to understand the impact of the PPSV23 vaccine on pneumonia incidence and mortality among the elderly population in a rural setting with a high aging rate,” Aya Sugiyama, lecturer in the department of epidemiology disease control and prevention at the Graduate School of Biomedical and Health Sciences, Hiroshima University, said in a news release accompanying the study results. Accordingly, the median age of the study cohort was 84, with a range from 70 to 114 years.^1,2

Mortality Rates Significantly Decrease With Vaccination Availability

The researchers determined changes in mortality rates associated with the vaccination program by comparing vital statistics from the study period to those between 2000 and 2016. An interrupted time series analysis was employed to determine the changes and mortality rates over time. In total, 3422 of the 7900 residents aged 65 and older (43%) participated in the program, according to the authors.^1,2

Among the community members involved in the program, 295 developed pneumonia over 14,559 person-years of observation. The post-vaccination incidence rate of pneumonia was 20.3 per 1000 person-years (95% CI, 18.0–22.7), while an interrupted time series analysis determined a 25% reduction in pneumonia mortality rate in Sera Town following the program.^1,2

“Notably, it reversed the previously increasing trend in pneumonia mortality in the community,” Sugiyama continued. The reversal constitutes a major development, with post-project incidence across the population decreasing to 0.04 per 1000 population compared with 0.23 per 1000 population pre-project.^1,2

These results have numerous implications for pharmacists. Not only do they showcase the broad, community-wide benefits of an effective pneumococcal vaccination program, but they also more thoroughly detail the significant impact of pneumonia even among vaccinated older adults. Vaccination campaigns should continue to be targeted specifically towards the most at-risk members of a community, and pharmacists should remain as front-facing health care providers to encourage older adults to receive a vaccine.

“With the completion of this evaluation, the next step is to share these findings to inform future discussions on community-based vaccination strategies,” Sugiyama concluded. “While further research is needed, we hope that our results will serve as a reference for regions exploring effective approaches to pneumonia prevention in older adults.”¹

REFERENCES

1. Hiroshima University. Vaccination support program reduces pneumonia-related mortality by 25 percent among the elderly. EurekAlert! News Release. Released July 2, 2025. Accessed July 8, 2025. https://www.eurekalert.org/news-releases/1089714

2. Sugiyama A, Kataoka M, Tokumo K, et al. Association Between Introduction of the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) and Pneumonia Incidence and Mortality Among General Older Population in Japan: A Community-based Study. J Epidem. 2025;35(5):237-244. doi:10.2188/jea.JE20240285

3. Halpern L. Hospitalized adults with community-acquired pneumonia suffer significant morbidity post discharge. Pharmacy Times. Published July 4, 2025. Accessed July 8, 2025. https://www.pharmacytimes.com/view/hospitalized-adults-with-community-acquired-pneumonia-suffer-significant-morbidity-postdischarge