High pneumococcal community-acquired pneumonia burden in older adults highlights the critical role of pharmacists in driving 21-valent vaccine uptake and patient-centered prevention strategies.
In an interview with Pharmacy Times, Carlos G. Grijalva, MD, MPH, a professor in the Division of Pharmacoepidemiology at Vanderbilt University Medical Center, discussed the persistent burden of community-acquired pneumonia (CAP) among older adults and the implications for pneumococcal vaccination and prevention strategies. Grijalva coauthored a cross-sectional study,
According to Grijalva, the findings underscore the importance of targeted prevention efforts, especially in high-risk populations. Pharmacists can play a pivotal role by leveraging incidence data to guide vaccine education and recommendations, ensuring that eligible adults—particularly those 65 years and older—are appropriately immunized. Given that a meaningful proportion of pneumococcal pneumonia hospitalizations may be preventable with the 21-valent vaccine, pharmacists are well positioned to address gaps in adult vaccination.
Pharmacy Times: Based on these results, what should clinicians and pharmacists understand about the current burden of pneumococcal disease?
Carlos G. Grijalva, MD, MPH: Community-acquired pneumonia remains an important cause of hospitalization among adults, especially among adults 65 years or older. A large fraction of those pneumonias are caused by Streptococcus pneumoniae serotypes covered by the recently approved 21-valent pneumococcal conjugate vaccine.
Pharmacy Times: How might pharmacists use these incidence data to inform vaccine education and recommendation strategies, especially for adults 65 years and older who had the highest burden in your study?
Grijalva: Identifying the pathogens causing pneumonia among adults 65 years or older is necessary to inform preventive efforts. A 21-valent pneumococcal conjugate vaccine that provides coverage over the most common pneumococcal serotypes causing pneumonia is available and is one of the vaccines recommended for use in adults 50 years or older or in younger adults at high risk for pneumococcal diseases.
Pharmacy Times: The study utilized serotype-specific urinary antigen detection to more accurately identify pneumococcal CAP. Can you explain why this diagnostic approach matters for clinical practice and how pharmacists might communicate its importance to patients and providers?
Grijalva: Determining the etiology of pneumonia is very challenging. Using traditional diagnostic tests, it is possible to isolate the causative pathogen through cultures in some patients or to identify whether a bacterial pathogen (eg, pneumococcus) was involved, but without more details about the specific serotype. Yet, for many patients, establishing the specific cause of their disease is not possible. This study used a novel urinary test to identify specific pneumococcal serotypes that were causing pneumonia in study patients. Although this urinary test is not available for use in clinical practice, it facilitated the identification of the specific causes of pneumonia, which would not be possible through traditional diagnostic tests.
Pharmacy Times: Given that a significant fraction of pneumococcal pneumonia hospitalizations were potentially preventable with V116, what role do you see for pharmacists in improving adult pneumococcal vaccination rates and addressing vaccine hesitancy?
Grijalva: Pneumococcal serotypes included in the 21-valent pneumococcal conjugate vaccine are leading causes of severe pneumonia in adults, especially in adults 65 years or older. These vaccines are available and recommended for protection of adults against pneumococcal disease caused by serotypes covered by the vaccine.
Pharmacy Times: Beyond pneumococcal vaccination, what are key counseling points pharmacists should emphasize to at-risk patients (such as those with chronic conditions) to help reduce the risk and severity of pneumococcal disease?
Grijalva: In addition to following the current vaccination recommendations, it is important to discuss preventive strategies with their health care providers based on specific clinical factors and preferences.
