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Randomised controlled trial
The 23-valent polysaccharide vaccine prevents pneumococcal pneumonia and reduces associated mortality in nursing home residents in Japan
  1. Mark Loeb
  1. McMaster University, West Hamilton, Ontario, Canada
  1. Correspondence to Mark Loeb
    Michael G DeGroote Centre for Learning, Room 3203, 1200 Main Street, West Hamilton, Ontario, L8N 3Z5, Canada; loebm{at}

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Pneumonia is a major cause of morbidity and mortality among older people residents of nursing homes1. Pneumococcus is the most important cause of pneumonia in this population, with an estimated 10-fold higher incidence of invasive (bloodstream) disease compared to community-dwelling seniors2. Despite the presence of an extant body of research and studies that strongly recommend prevention of this invasive disease, there are no clear-cut findings about the causal factors behind pneumonia. A systematic review which compared between two groups, those who had pneumococcal vaccination and those who did not (placebo), found a significant effect of vaccines of various valencies in reducing all-cause pneumonia (OR 0.71, 95% CI 0.52 to 0.97); however, findings did reveal significant heterogeneity3. The 23-pneumococcal polysaccharide vaccine …

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  • Competing interests None.