Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
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Year : 2016  |  Volume : 11  |  Issue : 2  |  Page : 89-90
Personalizing pneumococcal vaccination recommendations: The Saudi Thoracic Society guidelines

Institut Clìnic de Pneumologia i Cirurgia Toràcica, Respiratory Intensive Care Unit, Hospital Clinic, Barcelona, Spain

Date of Submission22-Feb-2016
Date of Acceptance14-Mar-2016
Date of Web Publication11-Apr-2016

Correspondence Address:
Antoni Torres
Institut Clìnic de Pneumologia i Cirurgia Toràcica, Respiratory Intensive Care Unit, Hospital Clinic, Barcelona
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1817-1737.180033

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How to cite this article:
Torres A. Personalizing pneumococcal vaccination recommendations: The Saudi Thoracic Society guidelines. Ann Thorac Med 2016;11:89-90

How to cite this URL:
Torres A. Personalizing pneumococcal vaccination recommendations: The Saudi Thoracic Society guidelines. Ann Thorac Med [serial online] 2016 [cited 2023 Jan 27];11:89-90. Available from:

Streptococcus pneumoniae is one of the main pathogens causing infections in children and adults. In children, it can cause meningitis, otitis media, and pneumonia, while in adults, it is mainly responsible for invasive and noninvasive community-acquired pneumonia (CAP). The burden of the disease is a very high in terms of morbidity and mortality. For example, in adults, mortality can reach up to 30% in severe CAP cases admitted to the Intensive Care Unit.[1] The positive side of all of this is that S. pneumoniae infection is a potentially preventable disease. For many years, we have used PPV23 valent vaccine in adults to prevent invasive pneumococcal disease (IPD). The introduction in children of the conjugated (pneumococcal conjugate vaccine [PCV] 7 and PCV13) vaccines has been followed by a decrease in pneumococcal IPD, and non-IPD disease in children and by a herd-immunity effect in adults (in IPD in non-IPD CAP).[2],[3] The “CAPITA”[4] study has confirmed the efficacy of PCV13 in adults over 65 years of age, showing 45% efficacy in protecting against the first episode of vaccine-type (VT) pneumococcal CAP and 75% in preventing the first episode of VT IPD.

The availability of the conjugated vaccines and the results of CAPITA studies have had a fundamental influence on the USA and EU recommendations for pneumococcal vaccination.[5],[6] In the US, these recommendations, issued by the Advisory Committee on Immunization Practices, are consistent for the whole country. This is not the case in Europe, where each country has modifications according to age or risk factors and budget. In this issue of Annals of Thoracic Medicine, a group of Saudi experts provides recommendations for pneumococcal vaccination. The most important aspect of these guidelines is the recommendation of universal vaccination of all adults over 50 years of age.

This recommendation is based on the following arguments:

(1) High prevalence of sickle-cell disease, which is a disease with a high risk for S. pneumoniae infection; (2) high prevalence of chronic diseases in younger age groups; (3) prescription of over-the-counter antibiotics in private pharmacies, which increases the risk of S. pneumoniae resistant to antibiotics. In addition, very importantly, Saudi Arabia has to face a unique every year situation because of the Hajj and Umrah season, in which there is an increased risk of respiratory tract infections, including S. pneumonia.[7] The panel of experts from the Saudi Thoracic Society believes that these arguments justify the recommendation for the universal pneumococcal vaccine in patients over 50 years of age.[8]

   References Top

Mongardon N, Max A, Bouglé A, Pène F, Lemiale V, Charpentier J, et al. Epidemiology and outcome of severe pneumococcal pneumonia admitted to intensive care unit: A multicenter study. Crit Care 2012;16:R155.  Back to cited text no. 1
Harboe ZB, Dalby T, Weinberger DM, Benfield T, Mølbak K, Slotved HC, et al. Impact of 13-valent pneumococcal conjugate vaccination in invasive pneumococcal disease incidence and mortality. Clin Infect Dis 2014;59:1066-73.  Back to cited text no. 2
Rodrigo C, Bewick T, Sheppard C, Greenwood S, Mckeever TM, Trotter CL, et al. Impact of infant 13-valent pneumococcal conjugate vaccine on serotypes in adult pneumonia. Eur Respir J 2015;45:1632-41.  Back to cited text no. 3
Bonten MJ, Huijts SM, Bolkenbaas M; CAPITA Coauthors. Vaccine against pneumococcal pneumonia in adults. N Engl J Med 2015;373:93.  Back to cited text no. 4
Tomczyk S, Bennett NM, Stoecker C, Gierke R, Moore MR, Whitney CG, et al. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged=65 years: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2014;63:822-5.  Back to cited text no. 5
European Centre for Disease Control (ECDC). Vaccine Schedule. Available from: [Last accessed on 2016 Feb 29].  Back to cited text no. 6
Memish ZA, Assiri A, Turkestani A, Yezli S, Al Masri M, Charrel R, et al. Mass gathering and globalization of respiratory pathogens during the 2013 Hajj. Clin Microbiol Infect 2015;21:571.e1-8.  Back to cited text no. 7
Alharbi NS, Al-Barrak AM, Al-Moamary MS, Zeitouni MO, Idrees MM, Al-Ghobain MO, et al. The Saudi thoracic society pneumococcal vaccination guidelines – 2016. Ann Thorac Med 2016;11:93.  Back to cited text no. 8
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