Comparative Effectiveness of New and Conventional Pneumococcal Vaccines in Severe COPD Patients: A Propensity Score Matched Analysis From a Multi-institutional Research Network

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Abstract Rationale: Pneumococcal infections are a major cause of exacerbations and respiratory decline in COPD patients. Pneumococcus i accounts for one-third of community-acquired pneumoniae, Streptococcal pneumoniae often lead to poor clinical outcomes and increased healthcare utilization. We hypothesized the newer pneumococcal vaccines could significantly mitigate these risks, thereby improving patient health care.Objectives: This retrospective cohort study assessed the effectiveness of newer pneumococcal vaccines – PCV15 and PCV20 – in decreasing the rate of exacerbations among COPD patients. Moreover, it also compared the efficacy of newer vaccines with older ones – PCV13 and PPSV23 – in deterring pneumococcal infections and acute respiratory failure in Group D COPD patients.Methods: Utilizing the TriNetX global health research network, we evaluated EHR (electronic health records) data from multiple healthcare facilities/ organizations. TriNetX is a scalable, sustainable network of EHR data for clinical and biomedical research. COPD patients vaccines fourinoculation among the pneumococcal received at least one who years40 >aged (PCV15, PCV20, PCV13, and PPSV23) were included in the study and observed for two years post-vaccination. Exclusion criteria entailed having a history of asthma, heart failure, and interstitial lung disease or receiving both newer and older vaccines, thus maintaining distinct cohorts for PCV15/PCV20 and PCV13/PPSV23. Propensity score matching was utilized to control for patients’ demographic variations between the vaccine clusters.Results: The study identified a cohort of 3,014 individuals with severe chronic obstructive pulmonary disease (COPD) who met the inclusion criteria for both study groups. These patients were receiving triple therapy consisting of a long-acting beta-agonist (LABA), long-acting muscarinic antagonist (LAMA), and inhaled corticosteroid (ICS) at baseline. Propensity score matching was utilized to control for patients’ demographic variations between the vaccine clusters. Compared to the groupimmunized with PCV13 and PPSV23, the group that received PCV15 and PCV20 vaccines exhibited considerably reduced rates of COPD exacerbations with a risk ratio of 0.637 CI (0530, 0.766), pneumococcal pneumonia resulting from Streptococcus with a risk ratio of 0.461 CI (0.334, 0.636), and acute respiratory failure with a risk ratio of 0.614 CI (0.498, 0.757).Conclusions: This study suggests that newer pneumococcal conjugated vaccines (PCV15 and PCV20) are correlated with a diminished risk of COPD exacerbations, streptococcal pneumonia, and acute respiratory failure in Group D COPD patients. These findings underscore the newer vaccines’ potential benefits in this particular population. Additional prospective research studies are necessary to validate these results.

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