Pharm'Up 
A recent prospective surveillance study published in the Journal of the American Medical Association has shed light on the significant and disproportionate burden of hospitalizations from community-acquired pneumonia (CAP) among adults in the United States, especially those aged 65 and older. The findings emphasize that a substantial portion of these cases are caused by Streptococcus pneumoniae serotypes that are preventable with the recently approved V116 vaccine.
The PNEUMO (Pneumococcal Pneumonia Epidemiology, Urine Serotyping, and Mental Outcomes) program, led by investigators at Vanderbilt University Medical Center, conducted the study between September 2018 and October 2022. The research involved 2,016 adults hospitalized with all-cause CAP and found an estimated annual incidence of 340 hospitalizations per 100,000 adults. The incidence was observed to increase with age, confirming that older adults remain the most vulnerable population.
Crucially, the study determined that 14% of all-cause CAP hospitalizations were linked to a Streptococcus pneumoniae infection. Using novel diagnostic techniques, including serotype-specific urinary antigen detection (SSUAD) assays, researchers were able to identify the specific serotypes responsible for the infections. Many of these detected serotypes were found to be covered by the V116 vaccine, a 21-valent pneumococcal conjugate vaccine (PCV21).
Approved by the FDA in 2024, V116 (Capvaxie; Merck) has since been recommended by the Advisory Committee on Immunization Practices (ACIP) for adults 65 years and older, as well as for those with certain risk factors. While clinical trials have shown V116 to elicit a strong immune response, the study highlights a critical gap: despite the existence of effective vaccines, pneumococcal pneumonia continues to be a major cause of hospitalization, partly due to some serotypes not being included in current vaccines and partly due to insufficient vaccination rates.
The data from the PNEUMO program strongly suggest that a greater distribution and uptake of the V116 vaccine could significantly reduce the incidence of CAP hospitalizations, particularly among older adults. The authors of the study stress that pharmacists and primary care providers have a vital role to play in promoting pneumococcal vaccination as a key public health intervention to protect this high-risk population.
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